City Research Online

Abstract

Restrictive practices (RPs) encompass interventions that limit an individual’s freedom, such as restraint, seclusion, and enforced treatment. While widely studied in acute mental health settings, their use within inpatient eating disorder services remains underexplored despite evidence of high prevalence. In addition to these formal restrictive interventions, eating disorder inpatient wards commonly employ structured behavioural rules as part of nutritional rehabilitation programs, including enforced rest periods, supervised meals, locked bathrooms, and limits on fluids or activity. A scoping review methodology following a five-step framework was implemented. Four databases (CINAHL, MEDLINE, Embase, and PsycInfo) were searched. The analysis involved both numerical and narrative synthesis in line with the framework. Thirty-six studies were included. Most originated from the UK, focused on anorexia nervosa, and used quantitative designs, with a substantial proportion conducted in child and adolescent inpatient settings. Common RPs included nasogastric tube feeding under restraint, involuntary admission, and physical restraint. Prevalence varied widely, with a small subset of patients accounting for most RP episodes. RPs were primarily applied in response to medical or nutritional risk rather than aggression, differentiating them from acute psychiatric contexts. Evidence regarding outcomes such as weight restoration, length of stay, and mortality was inconsistent, and RPs were frequently described by patients and staff as distressing, coercive, and potentially traumatic. Findings highlight the distinct nature of RP use in eating disorder settings and the need for context-specific policies, ethical guidance, and intervention strategies to minimize harm while ensuring patient safety.

Publication Type:	Article
Additional Information:	© 2026 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
Publisher Keywords:	11 Medical and Health Sciences, 16 Studies in Human Society, 17 Psychology and Cognitive Sciences, Clinical Psychology, 42 Health sciences, 44 Human society, 52 Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Health & Medical Sciences School of Health & Medical Sciences > Department of Nursing & Midwifery
SWORD Depositor:	Symplectic Administrator

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