From Treatment to Recovery: Family, Health, and Sociocultural Implications of Anorexia Nervosa

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DavyRomano, Evie

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East Carolina University


Anorexia nervosa (AN) is a life-threatening biopsychosocial-spiritual illness that crosses all social locations (i.e., ages, gender identities, sexual orientation, races, ethnicities, socioeconomic status, and body sizes), negatively impacting couple/family systems. While family-based treatments have a well-established evidence base in treating AN, it is unknown how relationally-oriented treatments (i.e., couple and family-based) address the whole person with AN (i.e., biopsychosocial-spiritual) from a dyadic/family systems lens. Recovery is a process fraught with obstacles such as persistent mental health challenges and societal ideals/standards. Sociocultural risk factors such as diet culture (i.e., a system that elevates physical health and perpetuates myths and lies about food choices, eating behaviors, and body types) is an understudied phenomenon which may also complicate recovery. Since risk of relapse is highest following treatment, it is important to understand the biopsychosocial-spiritual health experiences of diet culture for individuals in recovery from AN. The purpose of this dissertation is to address gaps in relationally-oriented treatment and recovery research. This dissertation contains six chapters, including: (1) an introduction chapter to the history of AN diagnosis, treatments, and social location factors, (2) a literature review of biopsychosocial-spiritual health risks and symptoms associated with AN, (3) a systematic review of relationally-oriented treatment studies for AN and how they are addressing biopsychosocial-spiritual health and social location from a dyadic/family systems perspective, (4) a methodological chapter describing the mixed methods approach to the original qualitative study, (5) an original research study demonstrating the lived experience of diet culture for individuals in recovery from AN, and (6) a discussion chapter that pulls together the major findings to provide clinical resources for healthcare providers.