A life put on hold: adolescents' experiences of having an eating disorder in relation to social contexts outside the family

Abstract

BackgroundAs suffering from an eating disorder often entails restrictions on a person’s everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships.PurposeThe aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family.Patients and methodsThis qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis.ResultsThe adolescents’ descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context.ConclusionYoung people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.

A Critical Review of Studies Assessing Interpretation Bias Towards Social Stimuli in People With Eating Disorders and the Development and Pilot Testing of Novel Stimuli for a Cognitive Bias Modification Training

“…Participants also recalled examples of illness-related rejection experiences, such as being excluded from arrangements to have meals out with friends or not being offered food in social contexts. These findings support other qualitative accounts from young people with anorexia nervosa who have described the impact that their eating disorder and treatment regime had on their social functioning (Lindstedt et al, 2018). Furthermore, the risk of rejection perceived by patients when confiding in others, for example a reluctance to disclose their illness to friends due to a fear of being dismissed or disbelieved, supports the interpersonal model of eating disorders which posits that some problems with social functioning in people with eating disorders may originate in part from maladaptive personality traits, such as the tendency to avoid expressing feelings and the tendency towards interpersonal distrust and negative interactions with others (Arcelus et al, 2013).…”

External support and personal agency - young persons’ reports on recovery after family-based inpatient treatment for anorexia nervosa: a qualitative descriptive study

“…However, results also demonstrated that friends and romantic relationships, even pets, are viewed as important factors in recovery. This implies that clinicians and treatment providers should offer treatments that are attentive towards the young person's wider social context, which concurs with prior studies [53,[55][56][57].…”

“…Still, others have found that some adolescents view family-based approaches as neglecting vital individual aspects valued as important [15,18,20]. Although the present study does not argue against working within a predominantly family-based framework, it may be relevant to investigate further whether there are issues valued as important from the young person's position that are insufficiently addressed in recommended ED treatments [20,53]. Rather than challenging a family-based approach, these findings could be interpreted as shedding light on potential conflicts and dilemmas clinicians may encounter in providing family-based AN treatment, especially in the case of non-remission or relapse.…”

A framework to conceptualize personal recovery from eating disorders: A systematic review and qualitative meta‐synthesis of perspectives from individuals with lived experience

“…Individuals with lived experience connected changes in eating and weight to fuller engagement in life in ways they desired, such as returning to sports or other activities. (Lindstedt et al, 2018) Many individuals also described eating and weight behaviors as important to the key components of recovery described above. Nutritionists were noted as supportive in connecting changes in eating habits and knowledge about food with larger themes of acceptance and selfcompassion.…”