The Role of Food in the Family Relationships of Adolescents With Anorexia Nervosa and Bulimia in Northeastern Brazil: A Qualitative Study Using Photo Elicitation

Abstract

Family components can play roles both as protective factors and maintenance mechanisms of eating disorders. We aimed to investigate the role of food in the family relationships of adolescents with anorexia nervosa and bulimia in northeastern Brazil. Using photo elicitation, a visual narrative method that gives insight into the participants' perspective through photograph, we conducted semi-structured interviews with 26 people: four teenage girls with anorexia, four with bulimia, eight mothers, four fathers, five grandmothers, and one sister. Data were analyzed using the principles of Interpretative Phenomenological Analysis, which highlighted the following themes: control of the parent-adolescent relationship through food; food as a mean of experiencing parental presence-absence; food as the focus of conflict in the nuclear family, and food as a source of three-generational conflict. Food seemed to be a means for teens and parents to express physical suffering and psychological violence. Moreover, mourning appeared to influence the girls' relationships with food. Conflict in these families is not focused solely on food, but extends to other subjects, and teenagers' emotional reactivity concerning their relationship with their parents and food during family mealtimes varied. These features reinforced the cultural aspect and influences of eating experiences among adolescent girls with eating disorders. Remarkable disparities exist in the generations' views on what rules and rituals these adolescents must follow at meals. These disparities can obfuscate generational boundaries in these families. Our data reinforce the need to focus on the adolescent's autonomy in the family setting and on family identity as related to food among three generations. These findings necessitate a reorganization of boundaries between these generations.

The use of arts‐based methodologies and methods with young people with complex psychosocial needs: A systematic narrative review

“…Several studies reported the potential of arts-based research methods to elicit information that is not readily expressed in words or text. [36][37][38][39][40] Several authors argued that ABM allowed for participants' viewpoints to be represented with greater authenticity and depth. 2,37,[40][41][42][43][44] Young people were also reported to be able to better disclose and share complex and difficult experiences and emotions.…”

“…[36][37][38][39][40] Several authors argued that ABM allowed for participants' viewpoints to be represented with greater authenticity and depth. 2,37,[40][41][42][43][44] Young people were also reported to be able to better disclose and share complex and difficult experiences and emotions. 2,36,[44][45][46][47] 3.2.2 | Engaging young people with complex psychosocial needs ABM were found to be highly engaging for young people who are traditionally hard to reach and retain in research.…”

“…41,52,54,56 Ethical issues, such as ownership over art, consent and the presentation of photographs including minors, were also reported. 45,47,48,50,54,59 Issues pertaining to group Artwork and associated descriptors 36,[38][39][40][41][43][44][45][46][48][49][50][51][52][53][54]56,57,59,60 19 (76)…”

“…Not described 37,39,40,42,45,[48][49][50][56][57][58][59] 12 (48) Forums with service providers 38,41,44,46 4 (16) Exhibition of artworks 36,44,[51][52][53]55,60 7 (28)…”

Algılanan Anne Reddi İle Ortoreksiya Arasındaki İlişkide Mükemmelliyetçiliğin ve Öz-Eleştirel Ruminasyonun Aracı Rolü: Kadın Örnekleminde Bir Model Testi

“…Parental rejection is defined by Rohner and Rohner (1981) as the lack of warmth and affection from parents towards their children. Considering the role of family that is both a risk and a protective factor in eating disorders (Erriu et al 2020, Ramalho et al 2021) and poor motherhood contributes to disordered eating (Prescott & Le Poire 2002), the role of maternal rejection in the development of ON needed to be evaluated.…”