"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.

IF 4.5 3区 医学 Q2 NUTRITION & DIETETICS Journal of Eating Disorders Pub Date : 2025-03-19 DOI:10.1186/s40337-025-01223-z
Julie Riise, Kjersti Solhaug Gulliksen, KariAnne Vrabel, Margrethe Seeger Halvorsen
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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.

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“暴食症是饮食失调的贫民窟”:一项关于挪威暴食症妇女与医疗保健系统接触的定性研究。
背景:暴食症(BED)是最普遍的饮食失调,但在医疗保健和社会中仍未得到充分认识和理解。这导致缺乏适当的治疗方案,并在体细胞保健鉴定的挑战。我们的研究旨在通过探讨患者对其治疗需求的个人理解来阐明BED的有效治疗方法。方法:对6名被诊断为BED的患者进行访谈,了解其医疗保健经历,并采用主题分析和解释现象学分析相结合的改进定性方法对数据进行分析。结果:分析得出三个主题:缺乏理解、受困于身体羞耻感和希望与运动,每个主题都属于子类别。这些主题讲述了一段从被心理问题忽视到因身体羞耻而无法行动到开始康复的旅程。尤其是困在身体上的羞耻感与其他主题联系在一起,代表了康复过程中的障碍和关键点。结论:我们的研究强调了与暴饮暴食和身体形象相关的羞耻感在参与者中普遍存在,而往往优先考虑体重和生活方式的医疗体系加剧了这种羞耻感。这种羞耻感会阻碍治疗,延长疾病的时间。我们主张在临床实践中转向以患者为中心的护理模式,优先考虑同理心和整体支持,而不是以体重为中心的模式。如果仔细考虑小组的组成,小组治疗对减少羞耻感是有益的。有效的BED治疗应该包括创造一个安全的环境来讨论身体羞耻,强调解决这个问题的必要性,以提高治疗效果和患者满意度。
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来源期刊
Journal of Eating Disorders
Journal of Eating Disorders Neuroscience-Behavioral Neuroscience
CiteScore
5.30
自引率
17.10%
发文量
161
审稿时长
16 weeks
期刊介绍: Journal of Eating Disorders is the first open access, peer-reviewed journal publishing leading research in the science and clinical practice of eating disorders. It disseminates research that provides answers to the important issues and key challenges in the field of eating disorders and to facilitate translation of evidence into practice. The journal publishes research on all aspects of eating disorders namely their epidemiology, nature, determinants, neurobiology, prevention, treatment and outcomes. The scope includes, but is not limited to anorexia nervosa, bulimia nervosa, binge eating disorder and other eating disorders. Related areas such as important co-morbidities, obesity, body image, appetite, food and eating are also included. Articles about research methodology and assessment are welcomed where they advance the field of eating disorders.
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