Understanding the Autistic Experience of Restrictive Eating Disorders—A Systematic Review and Qualitative-Synthesis

Abstract

Objective: To synthesise qualitative findings on the autistic experience of restrictive eating disorders in order to identify common themes and use this to inform future research on the development of more effective care. Method: This systematic review was pre-registered on PROSPERO (CRD42023434116) and followed PRISMA guidelines. CINAHL, PsycINFO, Medline, Embase, Web of Science and Global Health databases were searched. Studies were included if they contained qualitative data detailing the autistic experience of restrictive eating disorders from autistic people, carers or healthcare professionals. The Critical Appraisal Skills Programme was used to assess quality of studies. Recurring themes were identified via thematic synthesis. Results: Nine studies met the inclusion criteria, all focused on anorexia nervosa. Four themes arose from the analysis: (1) the relationship between autism and restrictive eating; (2) the journey to self-understanding; (3) experience of eating disorder services; (4) suggested treatment adaptations. Conclusion: Findings suggest a broad range of mechanisms underlying the development and perpetuation of anorexia nervosa that are related to autism and are not consistently acknowledged and addressed in current care provision. This emphasises the need for more research into developing adapted or novel interventions for autistic people with eating disorders, as well as training programmes for clinicians.