Improving adult inpatient eating disorder treatment: perspectives of a sample of individuals in Canada with lived experience.

Background: Eating disorders (EDs) are increasingly common, affecting over one million individuals in Canada. Canadian adults (i.e., age 18+) requiring medical stabilization for their eating disorder (ED) may be referred to adult inpatient (IP) ED treatment for care. Recent Canadian publications have brought attention to the need for improved approaches to Canadian ED treatment; urging researchers to seek perspectives of people with lived experience to determine how to best do so. This study explored the perspectives of a sample of individuals in Canada with lived experience to identify recommendations for improvement of adult IP ED treatment programs and processes.

Methods: Employing a transformative philosophical view and feminist standpoint theory, this study utilizes a qualitative hermeneutic phenomenological approach to fulfill the objectives. Eleven participants with lived adult IP ED treatment experiences from across Canada were interviewed individually, to discuss their experiences and recommendations regarding referral, transitions into and out of care, and treatment itself using an online video conference platform. Data were analyzed using interpretative phenomenological analysis. A comprehensive list of recommendations was drafted and brought back to participants for feedback. The feedback was implemented to create the final list of recommendations.

Results: Several limitations of referral, transitions, and treatment, facilitated and exacerbated by stigma at individual and societal levels, were identified by participants. These included guilt and shame upon referral, lack of respect and trust from healthcare providers during transitions, and lack of consideration of social determinants of health during treatment. Participant-informed recommendations, which can be categorized as interim support, individualized care, dignified treatment, resources, and stigma, were identified to ameliorate the experiences of those in Canada with EDs while also combatting stigma.

Conclusions: Adult IP ED treatment in Canada is in urgent need of significant change to meet the needs of those requiring care and to address harmful stigma. Implementing participant-informed recommendations may aid in achieving this goal. The meaningful inclusion of those with lived experience, particularly marginalized populations, will be paramount to the development of an approach to adult IP ED treatment that properly serves individuals in Canada who need it.