Beyond the stereotypes
: characterising the unique features of under-researched eating disorder populations, and implications for treatment

Student thesis: Doctoral ThesisDoctor of Philosophy


There are concerns that certain population groups may be underrepresented in the evidence base for eating disorder treatments. This has implications for clinical practice: if eating disorders in these groups are associated with unique features not recognised in previous research, then there is a risk that existing treatment approaches lack applicability in these populations. The aim of the thesis was to explore whether under-recognised minority groups within wider eating disorder populations have unique features that could require treatment adaptations. The thesis focuses on two groups: men with eating disorders, and autistic people with anorexia nervosa.

The first stage of the thesis explored this overall aim through qualitative studies investigating the views of stakeholders across the two groups (Chapters 3-7). The findings indicated that men with eating disorders do not necessarily require fundamentally different treatment approaches compared to their female peers. Rather, stakeholders highlighted the importance of an individualised approach to treatment within an inclusive environment, with gender forming an aspect of this individuality rather than being viewed as a defining feature. By contrast, the qualitative studies indicated that autistic people with anorexia nervosa have specific needs that require treatment adaptations.

The aim of the second stage of the thesis was to further explore these needs in autistic people with anorexia nervosa. The primary focus of this second stage was exploring associations between sensory sensitivity and autistic traits in people with anorexia nervosa (Chapters 10-13). This stage additionally includes a qualitative study exploring eating behaviours in autistic adults (Chapter 8), and a meta-analysis demonstrating a heightened prevalence of alexithymia in autistic people (Chapter 9). The findings suggest that people with anorexia nervosa do not experience objective differences in sensory sensitivity in the areas of taste, smell and interoception, but that further research is required to explore whether sensory sensitivity represents a unique need in autistic people with anorexia nervosa. Finally, stakeholder recommendations that sensory differences need to be recognised and addressed in treatment were implemented in a pilot study exploring the use of a brief sensory screening questionnaire. Overall, the results of the thesis indicate that autistic people with anorexia nervosa may benefit from treatment adaptations, but further empirical research is needed to illuminate the extent to which this group experiences unique needs compared to people with anorexia nervosa only.
Date of Award1 Oct 2020
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorKate Tchanturia (Supervisor) & Catherine Stewart (Supervisor)

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