RecoverED: Toward a person-centered ecological model of eating disorder recovery

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University of Guelph

Eating disorders (EDs) are serious mental health conditions, which may be characterized by chronicity, comorbidity, and mortality. Despite this, there is a subset of individuals who make improvements and achieve what is typically referred to as ‘recovery.’ Researchers have suggested that better understanding recovery may allow for the identification of protective and risk factors, and it has been argued that in order to make such conclusions, there is a need for a consensus definition. Such definitions have typically emerged from positivist frameworks, which situate recovery as something which is knowable, consistent, and achievable. This however, ignores the tremendous insights provided by individuals with lived experience, as well as the context in which recovery is situated. Thus, the current program of research sought to better understand recovery language, definitions, and experiences from the perspectives of individuals with lived experience, with the goal of proposing a novel framework for ED recovery. Virtual interviews were conducted with 62 individuals who had or have had an ED (95.2% women). Transcripts were analyzed using codebook and reflexive thematic analysis. Results indicated that individuals with lived ED experience have mixed feelings about recovery terminology. Although aspects of recovery language fit for some people, the majority felt that it is a complicated construct and carries preconceptions. Similarly, participants had mixed views on an extant (and often-cited) recovery definition. While the proposed definition reflected some people’s experiences, the majority of participants reported concerns. When asked to talk about the experience of recovery, participants described a phenomenon that is much broader and deeper than what is included in research and clinical definitions. Moreover, participants highlighted the importance of process (e.g., non-linear nature) and context (e.g., systemic bias) factors. This led to the development of a person-centered and ecological model of recovery which is presented in Chapter 5. Ultimately, findings from this program of research situate recovery as a complex phenomenon that cannot be captured by a singular definition. This may in some ways be incompatible with positivist frameworks and suggests the need for a paradigm shift. Importantly, such a shift must include consideration of systemic factors that have resulted in recovery inequities.

eating disorder, recovery, lived experience, qualitative
Kenny, T. E., & Lewis, S. P. (2023). More than an outcome: a person-centered, ecological framework for eating disorder recovery. Journal of Eating Disorders, 11, 45.
Kenny, T. E., Trottier, K., & Lewis, S. (2022). Lived experience perspectives on a model of recovery in a sample of predominantly white women: A mixed method study. Journal of Eating Disorders. 10:149. DOI: 10.1186/s40337-022-00670-2