Understanding Anorexia Nervosa: an online phenomenological approach

Abstract

Anorexia has often been theorised as a way of obtaining a sense of control and a sense of identity. Previous research has identified the positive functions anorexia plays for those who experience it. Healthcare professionals perceive anorexia as something to be treated whilst those experiencing it are often ambivalent and see it as something to maintain. Those who feel misunderstood in their offline environment can turn to the physically anonymous environment of the internet to discuss their experiences and opinions.

The aims of the research were (1) to determine the understandings of anorexia, recovery and treatment through participants' lived experiences, and (2) to identify how participants' understandings affected pathways to and through treatment.

An online phenomenological approach was used to explore the experiences of those recruited through online resources for anorexia. Data was collected using online focus groups and e-mail interviews and was analysed using Interpretative Phenomenological Analysis.

Results indicated a strong theme of maintenance of anorexia due to its egosyntonic and functional role. Anorexia was initially perceived as a solution to problems or crises but over time it became problematic. Nonetheless, strong psychosocial mechanisms such as feelings of ambivalence, an 'anorexic voice' and a sense of feeling addicted to anorexia affected its maintenance.

Recovery required the acceptance of anorexia as a problem. Recovery was interpreted as a sense of living rather than existing and required four main factors: self-acceptance, acceptance of and from others, the development of alternative, healthy behaviours and the ability to manage residual anorexic cognitions. Implications for treatment are discussed.

Online communication is considered a safe environment due to its physical anonymity, allowing people to feel more comfortable disclosing views and experiences that may be stigmatised or uncomfortable to discuss in an offline situation. Future research should utilise the internet in conducting studies with people with body image issues.