Compliance and resistance to treatment in an Italian residential Centre for eating disorders

Orsini, Gisella

doi:10.1080/13648470.2021.1994333

Cited by 1 publication

(1 citation statement)

References 32 publications

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“…These functions of the ED and the enmeshment with the self may lead to fear and uncertainty about life without this vital part of life and sense of identity [157]. However, low motivation to change and being 'treatment resistant' are not synonymous [107,135] and 'treatment non-response' and 'lack of motivation' discourse may erase individuals' repeated attempts to recover and the difficulties and adversities they encounter [100,108,[158][159][160].…”

Section: When Is Ed Treatment Futile and Who Decides?mentioning

confidence: 99%

Discordant conceptualisations of eating disorder recovery and their influence on the construct of terminality

Elwyn,

Adams,

Sharpe

et al. 2024

J Eat Disord

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Eating disorders (EDs) are complex, multifaceted conditions that significantly impact quality-of-life, often co-occur with multiple medical and psychiatric diagnoses, and are associated with a high risk of medical sequelae and mortality. Fortunately, many people recover even after decades of illness, although there are different conceptualisations of recovery and understandings of how recovery is experienced. Differences in these conceptualisations influence categorisations of ED experiences (e.g., longstanding vs. short-duration EDs), prognoses, recommended treatment pathways, and research into treatment outcomes. Within recent years, the proposal of a ‘terminal’ illness stage for a subset of individuals with anorexia nervosa and arguments for the prescription of end-of-life pathways for such individuals has ignited debate. Semantic choices are influential in ED care, and it is critical to consider how conceptualisations of illness and recovery and power dynamics influence outcomes and the ED ‘staging’ discourse. Conceptually, ‘terminality’ interrelates with understandings of recovery, efficacy of available treatments, iatrogenic harm, and complex co-occurring diagnoses, as well as the functions of an individual’s eating disorder, and the personal and symbolic meanings an individual may hold regarding suffering, self-starvation, death, health and life. Our authorship represents a wide range of lived and living experiences of EDs, treatment, and recovery, ranging from longstanding and severe EDs that may meet descriptors of a ‘terminal’ ED to a variety of definitions of ‘recovery’. Our experiences have given rise to a shared motivation to analyse how existing discourses of terminality and recovery, as found in existing research literature and policy, may shape the conceptualisations, beliefs, and actions of individuals with EDs and the healthcare systems that seek to serve them.

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