“I’m not a teenager, I’m 22. Why can’t I snap out of it?”A Qualitative Exploration of Seeking Help for a First-Episode Eating Disorder During Emerging Adulthood

Abstract

Background: Eating disorders (EDs) typically have their onset during adolescence or the transition to adulthood. Emerging adulthood (~18-25 years) is a developmental phase which conceptually overlaps with adolescence but also has unique characteristics (e.g. increased independence). Emerging adults tend to come to ED services later in illness than adolescents, and emerging adulthood’s unique characteristics may contribute to such delays. Objective: This study aimed to explore attitudes towards ED symptoms, and their implications for help-seeking, amongst emerging adults receiving ED treatment through FREED, an early intervention care pathway. Method: Participants were 14 emerging adults (mean age 20.9 years; SD=2.0), all currently receiving specialist treatment for a first-episode, recent-onset (< 3 years) ED. Semi-structured interviews relating to experiences of help-seeking were conducted, and data were analysed thematically. Results: Symptom egosyntonicity, gradual reappraisal and feelings of exclusion from ED discourse were key attitudinal phases prior to help-seeking, each of which had distinct implications for help-seeking. Conclusions: Emerging adults with first-episode EDs show a distinct set of help-seeking-related challenges and opportunities (e.g. help-seeking for others; help-seeking at transitions; self-sufficiency). This research might be used to inform the development and evaluation of interventions which aim to facilitate help-seeking amongst emerging adults with first-episode recent-onset EDs.

Examining the significance of age of onset in persons with lifetime anorexia nervosa: Comparing child, adolescent, and emerging adult onsets in nationally representative U.S. study

“…With this context in mind, we note the prevalence of “emerging‐adult” onset is also consistent with other recent epidemiological research (Nagl et al, 2016). These findings highlight the need for greater research attention devoted to onsets of AN during this developmental era (Potterton et al, 2020) in addition to continued work on understanding continuities from adolescence to adulthood (Lewinsohn et al, 2000; Nagl et al, 2016; Waszczuk et al, 2019). Indeed, this developmental period involving transition towards independence might represent a vulnerable period in terms of decreased recognition by self and others of the development of AN.…”

“…To provide further context, a third comparison group comprising “emerging‐adult”‐onset of AN was used. The emerging‐adult‐onset AN group was selected given the importance of this developmental stage in the life course (Wood et al, 2018) and emerging research on initial onsets in emerging adults (Potterton, Austin, Allen, Lawrence, & Schmidt, 2020) and continuities of eating disorders from adolescence (Lewinsohn et al, 2000; Nagl et al, 2016; Waszczuk, Waaktaar, Eley, & Torgersen, 2019). This analysis with a nationally representative sample was intended to address some of the potential confounds in treatment‐seeking clinical biases in the available literature regarding “child‐onset” AN relative to later onsets (Herpertz‐Dahlmann & Dahmen, 2019).…”

A framework for conceptualising early intervention for eating disorders

“…The peak age of onset for an ED is during adolescence and emerging adulthood (i.e., up to age ∼25) (Micali et al., 2013; Solmi et al., 2021; Steinhausen & Jensen, 2015). This is a developmentally sensitive time during which the brain and body are undergoing substantial development and individuals make major life choices (Arnett et al., 2014; Potterton et al., 2020). Developing an ED during this period can lead to long‐lasting consequences for health and life trajectories.…”