A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences
- 1Clinical Psychology, School of Psychology, University of Sheffield
- 2Division of Psychological Medicine and Clinical Neurosciences, Cardiff University
Abstract
Introduction: Autism and eating disorders frequently co-occur, yet relatively little is known about how autistic adults experience eating disorders.
Methods: This systematic review synthesised qualitative evidence to explore the lived experiences of autistic adults with an eating disorder and inform autism-informed clinical practice. A systematic search identified 13 eligible studies, which were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist and synthesised using thematic synthesis.
Results: Findings were organised into three themes: eating disorder experiences cannot be understood independently of autistic ways of processing the world; recovery is enabled through developing self-understanding and integrating autism into personal identity; and recovery is facilitated when support aligns with autistic needs rather than neurotypical assumptions. Autistic characteristics, particularly sensory sensitivities, interoceptive differences, and a preference for predictability, fundamentally shaped the development, maintenance, and recovery of eating disorders. Sensory-driven food restriction was frequently experienced independently of body image concerns, highlighting potential conceptual overlap with Avoidant/Restrictive Food Intake Disorder (ARFID).
Discussion: Autistic adults described eating disorders as inseparable from their autistic experience, indicating the need for a paradigm shift from conceptualising autism and eating disorders as co-occurring conditions towards a model rooted in lived phenomenological experience. Clinical assessment, formulation, and intervention should adopt autism-informed, individualised approaches that recognise sensory processing and interoceptive differences, while future research should examine these mechanisms across a broader range of eating disorder diagnoses.
Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420261375735.
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BibTeX
@article{watts2026systematic,
title = {{A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences}},
author = {Becky Watts and Samuel J. R. A. Chawner and Gareth Burchell and John R. E. Fox},
journal = {Frontiers in Psychiatry},
year = {2026},
month = oct,
doi = {10.3389/fpsyt.2026.1953234},
url = {https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1953234/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences
AU - Becky Watts
AU - Samuel J. R. A. Chawner
AU - Gareth Burchell
AU - John R. E. Fox
PY - 2026
DA - 2026/10/15
JO - Frontiers in Psychiatry
DO - 10.3389/fpsyt.2026.1953234
UR - https://www.frontiersin.org/articles/10.3389/fpsyt.2026.1953234/full
AB - Introduction: Autism and eating disorders frequently co-occur, yet relatively little is known about how autistic adults experience eating disorders. Methods: This systematic review synthesised qualitative evidence to explore the lived experiences of autistic adults with an eating disorder and inform autism-informed clinical practice. A systematic search identified 13 eligible studies, which were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist and synthesised using thematic synthesis. Results: Findings were organised into three themes: eating disorder experiences cannot be understood independently of autistic ways of processing the world; recovery is enabled through developing self-understanding and integrating autism into personal identity; and recovery is facilitated when support aligns with autistic needs rather than neurotypical assumptions. Autistic characteristics, particularly sensory sensitivities, interoceptive differences, and a preference for predictability, fundamentally shaped the development, maintenance, and recovery of eating disorders. Sensory-driven food restriction was frequently experienced independently of body image concerns, highlighting potential conceptual overlap with Avoidant/Restrictive Food Intake Disorder (ARFID). Discussion: Autistic adults described eating disorders as inseparable from their autistic experience, indicating the need for a paradigm shift from conceptualising autism and eating disorders as co-occurring conditions towards a model rooted in lived phenomenological experience. Clinical assessment, formulation, and intervention should adopt autism-informed, individualised approaches that recognise sensory processing and interoceptive differences, while future research should examine these mechanisms across a broader range of eating disorder diagnoses. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420261375735.
SN - 1664-0640
ER -