This thesis explores sociocultural factors and their influence on eating disorder recovery.
Chapter one is a systematic review of existing research which explores religion and spirituality in the treatment of, and recovery from eating disorders. It aims to answer three questions 1. How is religion and spirituality integrated into treatment for eating disorders? 2. How does religion and spirituality benefit treatment of and recovery from an eating disorder? 3. What challenges does religion and spirituality present to recovery from an eating disorder and are there any risks to incorporating religion and spirituality in recovery and treatment? Nineteen papers were identified which include a range or qualitative and quantitative methodologies, exploring a number of religions and spiritual orientations, though Christian-Judeo faiths are the most represented. Religion and spirituality within treatment were largely viewed as acceptable and beneficial to participants and patients, particularly where they possessed prior religious beliefs or spiritual orientation. Amongst those with no prior affiliation or orientation, findings were mixed in relation to both acceptability, and perceived effectiveness or supportiveness. A small minority of patients with entangled religious beliefs and symptomology presented an additional challenge to treatment teams, and incorporation of religious leaders in teams was helpful in addressing these. Results are discussed in relation to current conceptualisations of religion and spirituality and clinical implications and future research directions are discussed.
Chapter two is an investigation into the experiences of recovering from an eating disorder within the context of diet culture in the United Kingdom. Eight adults who self-identified as having an eating disorder and either recovered or in recovery shared their experiences. Narrative methodology was used to analyse their stories to identify a master narrative which captured the challenges and processes of recovery within a society that privileges thin bodies and encourages weight control whilst discriminating against those in bigger bodies. Narratives captured the additional challenges diet culture poses to the complex challenge of recovery and identifies how developing a critical awareness of diet culture supports people in changing their perspective to their eating disorder and increases motivation for recovery.
Chapter three is a discussion of the clinical and research implications of these findings. Particular attention is paid to the need to incorporate broader sociocultural factors into our understanding of eating disorder development, maintenance and recovery as encouraging people to become critical consumers of cultural forces and societal assumptions may go some way to addressing the common barriers of motivation and lack of insight in eating disorder recovery.