‘It stopped you thinking about food’ – The experiences of mealtimes and attending a post‐meal support group for young people with anorexia nervosa

Abstract

Anorexia nervosa presents as an international public health concern as it is the mental health problem with the greatest risk of mortality, and the average age of onset is decreasing. For those experiencing anorexia nervosa, mealtimes have long been recognized as a difficult and distressing time when young people need additional support. However, the post mealtime period can be associated with even greater distress, yet there is little research on interventions to support young people in this vulnerable time, and even less on how young people experience these interventions. This study, therefore, explores young peoples' perceptions of mealtimes and a post mealtime support group. Using a qualitative descriptive design, telephone interviews were conducted with a purposive sample of six young people who participated in a post-meal support group while an inpatient in a Child and Adolescent Mental Health Unit. Using a semi-structured interview guide, participants were asked about their experiences of this support group and their perceptions of how to improve this intervention. Content analysis resulted in the development of three themes: 'The Challenges of Mealtimes and Post Mealtimes', 'The Benefits of Post-meal Support Groups', and 'Improving Unhelpful Aspects of Post-meal Support Groups'. Findings are reported in accordance with COREQ guidelines and suggest that for young people experiencing anorexia nervosa, post mealtimes are often more distressing than the meal itself and that participants found post-meal support groups to be a helpful intervention in reducing postmealtime distress. Post-meal support groups can be improved by ensuring a consistent approach from staff and providing staff with the training and knowledge required to support those affected by eating disorders.

Virtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa

“…Feeding failure is often the main indication for hospitalization, with consequent financial costs, disruption of routines, academic life, and family stress [38]. The availability of support programs for both families and patients has a vital role in managing EDs [39][40][41], especially in societies where access to treatment by specialized teams is scarce and expensive, with low coverage of mental health services.…”

Patient and clinician perspectives on supported mealtimes as part of anorexia nervosa treatment: A systematic review and qualitative synthesis

“…It was reflected that clinicians eating together with patients while engaging in casual conversations was helpful in making the "experience feel more normal" (Kezelman et al, 2016;Monaghan & Doyle, 2022;Offord et al, 2006;Zugai et al, 2013). Notably, certain topics of conversation were seen as triggering during mealtime support, such as talking about food, calories and comparison of portion sizes (Mitrofan et al, 2019;Monaghan & Doyle, 2022). Other unhelpful practices included rules such as "having to lick one's plate clean" or eating alone under intense supervision or in a "clinical silence" (Kezelman et al, 2016;Offord et al, 2006;Zugai et al, 2013).…”

“…Patients also explored that the post-meal period was associated with heightened anxiety and ED cognitions, highlighting the need for effective post-meal support et al, 2012b;Olsson & Landgren, 2020;Smith et al, 2014;Thabrew et al, 2019 Attribution to ED Holmes et al, 2021;Long et al, 2012b;Smith et al, 2014;Ramjan et al, 2012 Sense of normality Kezelman et al, 2016;Long et al, 2012b;Monaghan & Doyle, 2022;Offord et al, 2006;Zugai et al, 2013 Restrictions and punishment Colton & Pistrang, 2004;Escobar-Koch et al, 2010;Holmes et al, 2021;Long et al, 2012b;Matthews et al, 2019;Offord et al, 2006;Olsson & Landgren, 2020;Ramjan et al, 2012;Smith et al, 2014;Thabrew et al, 2019;Zugai et al, 2013Flexibility Babb et al, 2021Escobar-Koch et al, 2010;Long et al, 2012b;Offord et al, 2006;Zugai et al, 2013 Clinician conduct Kezelman et al, 2016;Long et al, 2012b;Matthews et al, 2019;Mitrofan et al, 2019;Monaghan & Doyle, 2022;Offord et al, 2006;Olsson et al, 2020;Smith et al, 2014;Thabrew et al, 2019;van Ommen et al, 2009;Zugai et al, 2013 Consistency of care Long et al, 2012b;…”

“…Long et al, 2012b;Matthews et al, 2019;Monaghan & Doyle, 2022;Nilsen et al, 2021;Offord et al, 2006;Thabrew et al, 2019ED behaviours Long et al, 2012bMatthews et al, 2019;Monaghan & Doyle, 2022;Nilsen et al, 2021;Offord et al, 2006;Smith et al, 2014;Thabrew et al, 2019 Peer support Monaghan & Doyle, 2022;Offord et al, 2006;Olsson & Landgren, 2020;Smith et al, 2014;van Ommen et al, 2009. (Monaghan & Doyle, 2022). Peer support, distraction techniques and debriefing sessions were seen as helpful (Monaghan & Doyle, 2022;Offord et al, 2006).…”

Anorexia nervosa through the lens of primary health care practitioners in the Kyrgyz Republic

“…The authors of the study emphasized the importance of confronting such perceptions and beliefs amongst medical workers in order to curb them. In other words, circumscribing and addressing perceptions and attitudes among healthcare workers regarding AN and developing more efficient evidence-based clinical guidelines regarding the subject matter is crucial if we want to improve the medical care that is available to persons with AN [4,14,15] .…”