A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences

Watts, Becky, Chawner, Samuel J. R. A., Burchell, Gareth and Fox, John R. E. 2026. A systematic review of qualitative research of eating disorders in autistic adults: convergent and divergent experiences. Frontiers in Psychiatry 17 10.3389/fpsyt.2026.1953234

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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.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine Schools > Psychology
Publisher:	Frontiers Media
ISSN:	1664-0640
Date of First Compliant Deposit:	19 October 2026
Last Modified:	19 Oct 2026 14:30
URI:	https://orca.cardiff.ac.uk/id/eprint/190313

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