"Binge eating disorder is the slum of eating disorders": a qualitative study of Norwegian women with binge eating disorder in the encounter with the healthcare system.

Abstract

Background: Binge Eating Disorder (BED) is the most prevalent eating disorder, yet it remains under-recognized and insufficiently understood in both healthcare and society. This leads to a lack of appropriate treatment options and challenges of identification within somatic healthcare. Our study aims to elucidate effective treatment approaches for BED by exploring patients' personal understandings of their treatment needs.

Methods: We interviewed 6 individuals diagnosed with BED regarding their healthcare experiences and analyzed the data using a modified qualitative method combining thematic and interpretive phenomenological analysis.

Results: The analysis resulted in three main themes: Lack of understanding, Trapped in body shame and Hope and movement, each with belonging subcategories. These themes narrate a journey from being unrecognized with a psychological issue, feeling immobilized by body shame towards embarking on recovery. Particularly Trapped in body shame links the other main themes representing a barrier and a pivotal point in the recovery process.

Conclusions: Our study highlights that shame related to binge eating and body image is pervasive in participants, exacerbated by a healthcare system that often prioritizes weight and lifestyle. Such shame can block treatment access and prolong the disorder. We argue for a paradigm shift in clinical practice towards patient-centered care that prioritizes empathy and holistic support over weight-focused models. Group therapy can be beneficial in reducing shame, if the group composition is carefully considered. Effective BED treatment should involve creating a safe environment for discussing body shame, emphasizing the need to address this issue to improve treatment effectiveness and patient satisfaction.