Eating disorders treatment experiences and social support: Perspectives from service seekers in mainland China

Abstract

Objective: This study explored treatment experiences and social support among individuals with eating disorders (EDs) in mainland China.Method: Subscribers of a Chinese online social media platform (WeChat) focused on EDs were invited to complete a screening questionnaire that included the Eating Disorder Diagnostic Scale for the DSM-5. Of the 116 questionnaire responses, 31 met inclusion criteria for follow-up interviews. Individuals who never sought treatment were not eligible for follow-up interviews, but provided brief explanations about why they did not seek treatment. All eligible participants (n = 31) completed a semistructured interview about their experiences with ED treatment and social support.Qualitative data from the interviews and survey responses regarding not seeking treatment were subjected to inductive data-driven thematic analysis with deductive coding to illuminate treatment and social support experiences or reasons for not seeking treatment.Results: Themes emerged from interviews revealed positive inpatient treatment experiences for anorexia nervosa, but negative outpatient treatment experiences, unaffordable care, and ineffective psychopharmacological treatments. Parents, friends, and partners were sources of social support, but participants largely felt misunderstood or blamed by these same entities. Shame, not recognizing ED as an illness, and financial constraints were listed as the primary reasons for not seeking treatment.Discussion: The importance of hearing patients' perspectives, improving ED literacy in China, increasing knowledge of culturally specific manifestations of EDs, and developing culturally responsive services and dissemination of treatment resources are emphasized.

Transgender congruence, body appreciation, body dissatisfaction, and disordered eating in Chinese transgender adults

“…The present findings suggest that interventions targeting transgender congruence and body appreciation may be promising potential avenues in the treatment of eating and body image disturbances in Chinese transgender adults. Importantly, there are limited well‐defined treatments existing for EDs in the Chinese context (Chen et al, 2021; Ma et al, 2021), a significant gap in treatment science that may reflect legislative gaps in mental health policy in China. Moreover, only relatively recently (2012) was national legislation passed in China addressing the mental health needs of its population (Phillips et al, 2013); however, this legislation excluded discussion of the mental health needs of sexual and gender minority populations.…”

Research in eating disorders: the misunderstanding of supposing serious mental illnesses as a niche specialty

“…In contrast, in the ED field, Asian countries resulted to be not represented despite the increasing trend of ED incidence in Asian countries which has been recently reported, mostly in China, also given its rapid economic growth [43]. The contribution of Asian countries to the ED research field would be much needed since the prevalence of EDs among female Chinese university students was found to be similar to that reported in Western countries [44]; however, it has been reported that only two specialized centers for the treatment of EDs are currently available in China thus potentially making difficult for patients being engaged in treatment and research studies [45]. However, as the study of EDs is still in its infancy in non-Western countries, it is possible that many publications in other languages are not always available in the online libraries used and are not published in journals in the first quartile.…”

Lessons for mental health systems from the COVID-19 front line: Chinese healthcare workers’ challenges, resources, resilience, and cultural considerations.

“…However, as the current study illustrates, individuals’ perceptions of mental health services cannot be considered in the absence of their cultural context. In fact, Western conceptualizations of psychopathology may be discrepant from how the Chinese public view psychological symptoms and how they should be discussed and treated (Ma, Capobianco, et al, 2020; Ma et al, 2021) Because stress and coping cannot be examined in the absence of cultural context (Wong & Wong, 2006) and psychological services are more beneficial when cultural norms and values are considered (G. C. N. Hall et al, 2016), international researchers and practitioners should attend to the cultural context and knowledge generated from local individuals with lived experience when working with mental health professionals in China.…”

“…However, as the current study illustrates, individuals' perceptions of mental health services cannot be considered in the absence of their cultural context. In fact, Western conceptualizations of psychopathology may be discrepant from how the Chinese public view psychological symptoms and how they should be discussed and treated (Ma, Capobianco, et al, 2020;Ma et al, 2021) Because stress and coping cannot be examined in the absence of cultural context (Wong & Wong, 2006) and psychological services are more beneficial when cultural norms and values are considered (G. C. N. Hall et al, 2016), international researchers and practitioners should attend to the cultural context and knowledge As mental health research and practice is increasingly carried out globally, mental health professionals need to attend to the tendency of overgeneralizing research findings based on predominantly Western samples and using Western psychological frameworks as the norm or default. Future mental health research would benefit from incorporating more diverse perspectives and taking collaborative approaches that allow advancement of the field with recognition of both the limitations and merits of locally generated knowledge.…”