PTOTSLPNarrative ReviewChild: care, health and development2025

What Is Known About Eating Disorders and Disordered Eating in Individuals With Physical Disabilities? A Narrative Review.

Revi Bonder, Meaghan Walker, Alene Toulany and 1 others

PMID 41235456

WHAT IT FOUND

People with physical disabilities may restrict food or pursue weight loss to manage incontinence, ease mobility, or cope with stigma, rather than due to typical body image concerns.

Clinicians must assess these disability-specific motivations before assuming standard eating disorder presentations.

Key findings

01Individuals with physical disabilities often restrict food and fluid intake to avoid bowel or urinary incontinence episodes, particularly in school or public settings.

02Weight loss is sometimes pursued to improve mobility, reduce the physical burden on caregivers during transfers, or counter feelings of being 'in the way'.

03Societal ableism and underrepresentation in media can drive disordered eating as a method to seek validation or achieve a sense of normalcy.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

The review included only 29 articles, indicating a very limited evidence base. The narrative methodology means the search may have missed relevant literature compared to a systematic review. Much of the included evidence was 10 to 20 years old, which may not reflect current clinical practices or societal attitudes. The review excluded individuals with intellectual disabilities and autism, so findings do not apply to those groups. The literature lacked strengths-based perspectives such as disability pride, which might be protective factors.

Declared interests

The authors declare no conflicts of interest.

The easy way to misread this

Do not assume that weight loss or food restriction in patients with physical disabilities is driven by the same body image distortions seen in the general population. The review indicates that these behaviours often serve functional purposes, such as managing incontinence or easing mobility, which requires a different clinical approach than standard eating disorder treatment.

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