“There’s nothing there for guys”. Do men with eating disorders want treatment adaptations? A qualitative study

Abstract Background Resilience research to date has been criticised for its consideration of resilience as a personal trait instead of a process, and for identifying individual factors related to resilience with no consideration of the ecological context. The overall aim of the current study was to explore the multi-level process through which adults recovering from EDs develop resilience, from the perspectives of clients and clinicians. The objective of this research was to outline the stages involved in the process of developing resilience, which might help to inform families and services in how best to support adults with EDs during their recovery. Method Thirty participants (15 clients; 15 clinicians) took part in semi-structured interviews, and responded to questions relating to factors associated with resilience. Using an inductive approach, data were analysed using reflexive thematic analysis. Results The overarching theme which described the process of developing resilience was ‘Bouncing back to being me’, which involved three stages: ‘Who am I without my ED?’, ‘My eating disorder does not define me’, and ‘I no longer need my eating disorder’. Twenty sub-themes were identified as being involved in this resilience process, thirteen of which required multi-level involvement. Conclusion This qualitative study provided a multi-level resilience framework for adults recovering from eating disorders, that is based on the experiences of adults with eating disorders and their treating clinicians. This framework provided empirical evidence that resilience is an ecological process involving an interaction between internal and external factors occurring between adults with eating disorder and their most immediate environments (i.e. family and social). Plain English summary Anorexia nervosa, bulimia nervosa and binge-eating disorder demonstrate high rates of symptom persistence across time and poor prognosis for a significant proportion of individuals affected by these disorders, including health complications and increased risk of mortality. Many researchers have attempted to explore how to improve recovery outcomes for this population. Eating disorder experts have emphasised the need to focus not only on the weight indicators and eating behaviours that sustain the eating disorder during recovery, but also on the psychological well-being of the person recovering. One way to achieve this is to focus on resilience, which was identified as a fundamental aspect of eating disorder recovery in previous research. This study conceptualises resilience as a dynamic process that is influenced not only at a personal level but also through the environment in which the person lives. This study gathered data from adults with eating disorders and their treating clinicians, to devise a framework for resilience development for adults recovering from eating disorders. The paper discussed ways in which these findings and the framework identified can be easily implemented in clinical practice to facilitate a better understanding of eating disorder resilience and to enhance recovery outcomes.

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The experiences and strategies of parents’ of adults with anorexia nervosa or bulimia nervosa: a qualitative study

BMC Psychiatry ◽

10.1186/s12888-021-03345-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jannike Karlstad ◽

Cathrine Fredriksen Moe ◽

Mari Wattum ◽

Berit Støre Brinchmann

Keyword(s):

Eating Disorders ◽

Anorexia Nervosa ◽

Qualitative Study ◽

Health Services ◽

Bulimia Nervosa ◽

Professional Support ◽

Adult Daughters ◽

Main Concern ◽

The Core ◽

Core Category

Abstract Background Caring for an individual with an eating disorder involves guilt, distress and many extra burdens and unmet needs. This qualitative study explored the experiences of parents with adult daughters suffering from anorexia nervosa or bulimia nervosa and the strategies they adopted. A subsidiary aim of the study was to explore the relationship between the caregivers’ perceived need for professional support and the support they reported receiving in practice from the health services. Methods Semi-structured interviews were conducted with 11 mothers and fathers from across Norway. Data collection, coding and analysis was conducted using the principles of constructivist grounded theory in an iterative process. The main concern shared by participants was identified by this process and their “solution” to the main concern then formed the content of the core category. Results ″Wearing all the hats″ emerged as the core category, indicating that the parents have to fulfil several roles to compensate the lack of help from health services. The three subcategories: “adapting to the illness”, “struggling for understanding and help” and “continuing to stay strong” described how the participants handled their situation as parents of adult daughters with eating disorders. Conclusions In daily life, the parents of adults with eating disorders have to attend to a wide range of caregiver tasks to help their ill daughters. This study suggests that the health services that treat adults with eating disorders should be coordinated, with a professional carer in charge. The parents need easy access to information about the illness and its treatment. They also need professional support for themselves in a demanding situation.

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