What and how do people recovered from eating disorders eat? : a systematic literature review : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Nutrition and Dietetics at Massey University, Auckland, New Zealand

Abstract

Background: There is a lack of attention on eating and eating-related behaviours once individuals are recovered from eating disorders (EDs). What and how an individual recovered from EDs eats remain unclear. Aim: The aim of this study is to examine the dietary intake and eating behaviour in individuals recovered from an ED. Methods: We conducted a systematic literature review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Five electronic databases were searched with no restriction on study dates and study design. Included studies reported this review’s primary outcome, dietary intake and eating behaviour. Results were described using a narrative synthesis. The Mixed Methods Appraisal Tool was used for quality appraisal. Details of the protocol for this systematic review was registered on PROSPERO (International Prospective Register for Systemic Reviews, Registration Number: CRD420250605506). Results: From a total of 21,864 records, 20 studies met eligibility criteria. Individuals recovered from EDs had low energy and fat intake compared to the general population. Through examining micronutrient intakes, individuals recovered from AN implied to have higher intake of fruits and vegetables, but lower intake of dairy and meat compared to the general population. With regards to eating behaviour, recovered individuals in our review had a regular eating pattern of at least three meals a day and included the intake of previously avoided or restricted foods into their diet. Conclusion: This review highlights differences in dietary patterns between those recovered from EDs and the general population. Common restrictive eating behaviours found in individuals with active EDs such as low-fat intake, low energy intake, high vegetable and fruit intake, and low dairy and meat intake are also found in individuals recovered from EDs, but to a lesser degree. Overall, eating in individuals recovered from EDs looks largely different from the general population and from individuals with active EDs. The restrictive dietary patterns of recovered individuals warrant further investigation into the nutrient intake and eating behaviours of this group.