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The journey to recovery from eating disorders (EDs) remains a profoundly complex and individual experience, underscoring the inherent challenges in defining and measuring recovery. With recovery rates varying significantly between disorders and over time, the traditional biomedical models of recovery, which primarily focus on the absence of ED symptoms, have been called into question.
For this reason, Senior Author Vanessa Lawrence, Catherine McCombie and colleagues explore how recovery from eating disorders is experienced and maintained.
“I was interested in the research around recovery in eating disorders and how they reported recovery rates vary so much, alongside high relapse rates as well. This, alongside the research showing that recovery can be a long and highly individual process, made me think that we need to understand better what is actually going on in recovery from an eating disorder and what the day-to-day life of people in recovery from eating disorders is like, and how people maintain or manage recovery in the contexts of their daily lives,” McCombie shared.
Leveraging a qualitative digital diary approach, this study aimed to delve into the day-to-day realities of individuals navigating recovery from EDs. Participants who self-identified as having recovered from an ED documented their experiences using ExpiWell, noting their thoughts and feelings in a written or audio diary. The study's methodology embraced a relativist ontology and a social constructionist perspective, offering insights into the personal and social dimensions of ED recovery.
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The study unearthed four main themes that shed light on the lived experiences of individuals in ED recovery: the omnipresence of ED-related thoughts, the impact of social discourses, the precarious nature of recovery, and the ongoing effort to find balance.
"Our key findings were that firstly, eating disorder thoughts are still very present in the daily lives of those in recovery, even those in recovery for a long time and that participants were actively managing these thoughts day to day. Secondly, we found that the social discourses around food and bodies had a big impact on how persistent these eating disorder thoughts were for participants, often affecting them for days after an incident where these discourses came up. They presented a pretty much constant source of stress and anxiety," McCombie explained.
On top of the impact of social pressures and the pervasive thoughts, factors around comorbidities and other stressors had a big impact on recovery experiences.
"Thirdly, a combination of factors including other mental health stressors meant that recovery could be precarious, and there were many times within the diaries where participants had a period of struggle more with eating disorder thoughts coinciding with periods of stress, anxiety, or depression. Finally, our findings highlight that alongside these challenges, participants were engaged in a daily battle to find balance in their lives and focus on living full lives and achieving goals against, with food as something to help support this rather than as an adversary," McCombie added.
The findings illustrate that living in recovery from an eating disorder is a complex process with many daily impacts that must be navigated. While managing this remains part of daily life, the energy and time that can be spent on other aspects of living a full life is reduced.
Recovering from an eating disorder is not an endpoint but rather a lifelong journey. This study shows how people who suffer from ED can be vulnerable to negative thoughts about their eating habits. Other researchers can use these findings to look for ways to cultivate a more positive mindset and environment for a more supported healing process.
"The findings highlight the need for tailored recovery management and relapse prevention support in those finishing treatment, and offer suggestions as to what these need to focus on. Finally, the findings from this study really show how valuable diary data is in eating disorder research. They gave us a lot of insight into thoughts and emotions, and triggers and responses, that would be valuable in many different research contexts," McCombie added.
As the study needed a qualitative digital diary approach, the researchers needed a real-time platform to track participant experience. With this, they could have a more accurate picture of how patients experience recovery from eating disorders.
"We had such a good experience using Expiwell. Before starting the study, we had been searching for a while to find a platform that had all the features we needed to be able to do the study we wanted, like having audio recording without a time limit and different options for recording responses," McCombie shared.
The team led by McCombie experienced a significant enhancement in their research process upon adopting Expiwell, a versatile digital diary platform that met all their specific needs.
"Reviewing the data coming in on the website was so easy and made it so easy to keep track of participants. The Scheduling options were also excellent, and it enabled us to make custom schedules when needed. The support we had from the Expiwell team whenever there was a technical difficulty was very efficient and quickly solved any issues we encountered," McCombie added.
In summary, this qualitative diary study sheds light on the everyday lives of individuals recovering from eating disorders (EDs). It underscores their persistent obstacles and the continuous work needed to sustain health and equilibrium. Moving ahead, treatment and support for individuals in ED recovery must adapt to meet their comprehensive needs, recognizing recovery as a nuanced, multi-dimensional process instead of a finite endpoint.
The ExpiWell team is excited to have helped and facilitated research by Catherine McCombie and colleagues. We continue to work toward innovating and enhancing scientific discovery. We invite you to explore our Journal Publications section for a deeper dive into a range of insightful research studies and to discover how ExpiWell has facilitated critical experience sampling and ecological momentary assessment data collection.
If you're interested in harnessing the power of ExpiWell, don't hesitate to contact us with any queries or for support. You can contact us or email sales@expiwell.com to learn more about our platform and app.
Reference:
McCombie, C., Ouzzane, H., Schmidt, U., & Lawrence, V. (2023). Physically It Was Fine, I'd Eat What Normal People Do. But It's Never Like This In My Head’: A Qualitative Diary Study Of Daily Experiences Of Life In Recovery From An Eating Disorder. European Eating Disorders Review. https://onlinelibrary.wiley.com/doi/full/10.1002/erv.3018
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