Current and previous eating practices among women recovered from anorexia nervosa: a qualitative approach

Abstract

Objective: The aim of this study was to analyze qualitatively how women, who have recovered from anorexia nervosa, perceive and describe their current eating practices, as well as the ones developed during the eating disorder period. Methods: Seven women were interviewed individually with the objective of investigating their eating practices, transition phases and all relevant aspects that somewhat contributed to the habit-forming; experiences, feelings and perceptions related to mealtime and the influence that food has had over the present subjects' life. The interviews were analyzed by the discourse of the collective subject method. results: The results brought up the following topics: a) control; b) concerns and feelings; c) deprivation d) beauty dictatorship; e) eating competence; f) importance of food; g) food cacophony. conclusions: What stands out is a multiplicity of eating practices, which during the eating disorder were similar to and characterized by restriction; however, after recovery, part of the subjects seem to have developed a higher eating competence, whereas others show a practice similar to the one acquired during the anorexia nervosa, such as the difficulty in realizing when they are satisfied and a feeling of discomfort when facing social interactions. reSUMO Objetivo: Este artigo teve como objetivo analisar qualitativamente como mulheres que se recuperaram da anorexia nervosa percebem e relatam suas práticas alimentares atuais, bem como as práticas vigentes no período do transtorno. Métodos: Foram feitas sete entrevistas individuais com mulheres que vivenciaram a anorexia nervosa. Estas abordaram: hábitos alimentares das entrevistadas; mudanças e fatores importantes para a formação destes; vivências, sentimentos e percepções associados ao momento da refeição; e a influência que a alimentação exerce na vida das participantes hoje. A análise dessas deu-se a partir da técnica do Discurso do Sujeito Coletivo. resultados: Os resultados trouxeram os seguintes temas: a) controle; b) preocupações e sensações; c) privação d) ditadura da beleza; e) competência alimentar; f) importância da alimentação; g) cacofonia alimentar. conclusões: Destaca-se Original article Ulian MD et al. nesses a multiplicidade das práticas alimentares, que durante o transtorno se assemelham e se caracterizam pela restrição; no entanto, após a recuperação dos sujeitos, alguns parecem ter desenvolvido maior competência alimentar, enquanto outros apresentam práticas semelhantes às vigentes na anorexia nervosa, além de dificuldade de perceberem quando estão satisfeitos e sensação de desconforto em situações de interação social. Palavras-chaveAlimentação, práticas alimentares, transtornos alimentares, anorexia nervosa, estudo qualitativo.

Eating Disorder Recovery: A Metaethnography

“…. sense of certainty and security” (Ulian et al, 2013, p. 280) and described it as a “life jacket” or “coping strategy” that became a “locked pattern of eating and living” (Pettersen et al, 2013, p. 94). Toto-Moriarty’s (2013) study established how BN served as a coping mechanism for feelings that needed to be controlled such as, “.…”

“…Nine of the 12 studies included a discussion of individuals’ recognition of ED consequences and how this recognition affected their contemplation of recovery. These losses included limitations, restrictions, and inhibitions (Dawson et al, 2014); scarred development and health dangers (Espíndola & Blay, 2013); deteriorated interpersonal relationships (Jenkins & Ogden, 2012; Lindgren et al, 2015; Pettersen et al, 2013); and irreversible physical damage (Arthur-Cameselle et al, 2018; Lindgren et al, 2015; Ulian et al, 2013). A participant with BN indicated that her realization of the consequences of her ED motivated her recovery, “So I started to notice that I lost things and hurt people.…”

“…Their uncontrollable suffering led participants to acknowledge the negative consequences of their ED. This acknowledgment began the individual’s shift from drowning in denial to recognizing the devastating effects of the problem, and ultimately to contemplating recovery (Dawson et al, 2014; Espíndola & Blay, 2013; Hay & Cho, 2013; Jenkins & Ogden, 2012; Lindgren et al, 2015; Pettersen et al, 2013; Ulian et al, 2013).…”

“…A total of 9 of the 12 studies (Arthur-Cameselle et al, 2018; Dawson et al, 2014; Espíndola & Blay, 2013; Jenkins & Ogden, 2012; Lindgren, Enmark, Bohman, & Lundström, 2015; Linville, Brown, Sturm, & McDougal, 2012; Pettersen et al, 2013; Toto-Moriarty, 2013; Ulian et al, 2013) indicated time in ED recovery with a combined range from 5 months to 44 years while the remaining three studies (Björk et al, 2012; Hay & Cho, 2013; Pettersen et al, 2016) did not report participant’s recovery duration. Recovery transitions varied among studies with some participants designating a status of always recovering (Jenkins & Ogden, 2012), in the later process of recovery (Pettersen et al, 2013), in long-term psychotherapy without evidence of relapse (Toto-Moriarty, 2013), or not engaged in treatment (Lindgren et al, 2015; Ulian et al, 2013). The demographic characteristics of study participants and the methodological characteristics used in the studies are shown in Tables 2 and 3, respectively.…”

Avoidance coping during mealtimes predicts higher eating disorder symptoms

“…Avoidance coping (i.e., the use of avoidance of thoughts, avoidance or denial of emotions; Christiano & Mizes, ) during mealtimes is common in individuals with EDs (Cowdrey, Stewart, Roberts, & Park, ). Avoidance coping strategies employed during mealtimes include avoiding distressing foods, eating alone, food rituals (e.g., eating foods in a specific order; tearing food), and distraction (i.e., redirecting attention to less distressing stimuli; Ulian et al, ; Long, Meyer, Leung, & Wallis, ). Avoidance coping has been widely studied in the anxiety literature (Berman, Wheaton, Mcgrath, & Abramowitz, ), showing that avoidance reduces anxiety in the short term, but maintains anxiety in the long term, creating a reinforcing cycle of anxiety‐avoidance (Beesdo‐Baum et al, ; Wheaton, Gershkovich, Gallagher, Foa, & Simpson, ).…”