Achieving Recovery Through Resilience: Insights From Adults in Midlife Living With Anorexia Nervosa

Abstract

Despite the high percentage of adults living with anorexia nervosa (AN) over the life course, there is limited understanding of what it means to be living with AN in midlife when the majority of research has focused on adolescents and young adults. As such, clinical practice for individuals in midlife is informed by a severe and enduring AN (SE-AN) framework, which assumes that recovery is not necessarily feasible past young adulthood. This study used constructivist grounded theory methodology to understand the experiences of adults in midlife living with AN. In-depth analyses of 19 participant narratives in midlife show that individuals face barriers to seeking help or remaining in recovery; however, midlife can also act as a significant catalyst toward recovery. Subsequently, there is merit in revisiting the utility of the SE-AN framework in the context of life course theory and exploring resilience-informed approaches in supporting recovery from AN.

Conceptualisation of severe and enduring anorexia nervosa: a qualitative meta-synthesis

“…There were 13 papers with a treatment experience focus, half of which [ 45 , 51 , 68 , 69 , 72 , 74 ] reported on novel, non-evidence-based interventions. Relatively fewer papers cited participant experiences of temporal processes of change and recovery, whereby only four of the 36 (8.6%), had the specific focus of recovery [ 46 , 58 , 61 , 63 ].…”

Purification, Punishment, and Control: Eating Disorders, Self-Harm, and Child Sexual Abuse

“…All the participants experienced shame and the desire to "clean" their "gross" bodies, as they somehow felt responsible for the abuse. This "shame" was further compounded by the stigma associated with living with an eating disorder (Firkins et al, 2019;McCallum & Alaggia, 2021). This participant, in particular, wanted to remove the shame, layer by layer.…”

Understanding social inequality in ischemic heart disease from a psychosocial perspective: A qualitative study of the influence of psychosocial factors on socially disadvantaged patients' lived experience of life with ischemic heart disease

“…While experiences of stigmatization and feelings of self-stigmatization due to low social position and failure to comply with a healthy lifestyle were widespread among the participants, they were most profound among the midlife participants (Rasmussen, Petersen, et al, 2021). A qualitative study by McCallum and Alaggia (2020) similarly showed that patients who suffered from an eating disorder felt that they carried a double stigma: stigma associated with their illness and stigma of being at midlife while suffering from their illness. The findings of this PhD study illustrate a triple stigma among midlife socially disadvantaged ischemic heart patients: stigma associated with an illness that is considered caused by the patients' lifestyle, stigma associated with developing the illness early, and stigma associated with being socially disadvantaged.…”

“…Recent empirical qualitative studies have indicated that living with a chronic illness at midlife may also create distinct and particularly burdening psychosocial challenges (Markle et al, 2015;Martinsen et al, 2015;McCallum & Alaggia, 2020). Markle, Attell, and Treiber (2015) showed how midlife patients living with multiple chronic illnesses experienced psychosocial challenges, such as inconsistency between the illness identity and their self-image, concerns about the future, loss of job identity, and stigmatization related to their illness, all of which created social isolation.…”

“…It may also be difficult to find a new job if they lose their job because of ageism and age discrimination (Infurna et al, 2020). Empirical studies have also shown that living with ischemic heart disease at midlife could pose a strain of the patients and their families Andersson, Borglin, Sjöström-Strand, et al, 2013) and that the inability to work because of illness may be especially straining for midlife people because working often used to be an important and essential part of their life Markle et al, 2015;McCallum & Alaggia, 2020).…”