Developing shared understandings of recovery and care: a qualitative study of women with eating disorders who resist therapeutic care

Abstract

BackgroundThis paper explores the differing perspectives of recovery and care of people with disordered eating. We consider the views of those who have not sought help for their disordered eating, or who have been given a diagnosis but have not engaged with health care services. Our aim is to demonstrate the importance of the cultural context of care and how this might shape people’s perspectives of recovery and openness to receiving professional care.MethodThis study utilised a mixed methods approach of ethnographic fieldwork and psychological evaluation with 28 women from Adelaide, South Australia. Semi-structured interviews, observations, field notes and the Eating Disorder Examination were the primary forms of data collection. Data was analysed using thematic analysis.Results & DiscussionParticipants in our study described how their disordered eating afforded them safety and were consistent with cultural values concerning healthy eating and gendered bodies. Disordered eating was viewed as a form of self-care, in which people protect and ‘take care’ of themselves. These subjectively experienced understandings of care underlie eating disorder behaviours and provide an obstacle in seeking any form of treatment that might lead to recovery.ConclusionA shared understanding between patients and health professionals about the function of the eating disorder may avoid conflict and provide a pathway to treatment. These results suggest the construction of care by patients should not be taken for granted in therapeutic guidelines. A discussion considering how disordered eating practices are embedded in a matrix of care, health, eating and body practices may enhance the therapeutic relationship.

Embodiment as a Paradigm for Understanding and Treating SE-AN: Locating the Self in Culture

“…As the project was primarily interested in why women delay seeking help for disordered eating, the criteria for recruitment included women who were over 16 years of age who had not seen a health professional for disordered eating; had not been given an eating disorder diagnosis; had been diagnosed but had delayed seeking treatment; or who did not wish to pursue treatment. Following consent to take part in the Eating Disorder Examination [EDE; (47)], the majority (75%) of study participants met the criteria for a diagnosable eating disorder (48).…”

Positioning relapse and recovery through a cultural lens of desire: A South Australian case study of disordered eating

“…The central elements of interest were the denial of eating issues and the delay in seeking treatment. Clearly, there are methodological issues with attempting to locate a population that does not identify as having a problem, that faces social stigma, and is reluctant or too overwhelmed by their situation to engage with services (see Musolino, Warin, Wade, & Gilchrist, 2016). Qualitative and ethnographic research methods were therefore critical to accessing the everyday practices and private experiences of such a hard to reach group.…”

Recovery from anorexia nervosa: the influence of women’s sociocultural milieux

“…14,15 Accordingly, individual recovery may lead to emancipation from body-shaming, ascetic thinness and diet culture, as well as growing awareness of the broader sociocultural dimensions affecting women, such as gender inequity and self-determination. 16…”