A framework to conceptualize personal recovery from eating disorders: A systematic review and qualitative meta-synthesis of perspectives from individuals with lived experience.

Sara Wetzler,Kathleen M Pike,Jody Silver,Elizabeth Magill,Margaret Swarbrick,Guy Peryer,Kristina Saffran,Donna Friedman,Kelsey Clayman,Corinna Hackmann,Eric F Van Furth

doi:10.1002/eat.23260

Abstract

An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); however, this body of knowledge is largely symptom-based and from a clinical perspective and thus limited in capturing perspectives and values of individuals with lived experience of an ED. In this study, we performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature. A systematic review and qualitative meta-synthesis approach was used. Twenty studies focusing on ED recovery from the perspective of individuals with lived experience were included. The studies were searched for themes describing the components of personal recovery. All themes were analyzed and compared to the established connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (CHIME) and Substance Abuse and Mental Health Services Administration (SAMHSA) frameworks of recovery, which are applicable to all mental disorders. Themes were labeled and organized into a framework outlining key components of the ED personal recovery process. Supportive relationships, hope, identity, meaning and purpose, empowerment, and self-compassion emerged as the central components of the recovery process. Symptom recovery and its relationship to the personal recovery process are also significant. Individuals with lived experience of EDs noted six essential elements in the personal ED recovery process. This framework is aligned with several of the key components of the CHIME and SAMHSA frameworks of recovery, incorporating person-centered elements of the recovery process. Future research should validate these constructs and develop instruments (or tools) that integrate the lived experiences into a measurement of recovery from an ED.

Highlights

An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); this body of knowledge is largely symptom-based and from a clinical perspective and limited in capturing perspectives and values of individuals with lived experience of an ED
We systematically selected and reviewed studies looking at the ED recovery process in order to develop a framework that applies and extends the CHIME and SAMHSA approaches to recovery
The results indicate that an ED’s personal recovery framework requires the additional dimension of self-compassion, and some of the subcomponents of the superordinate themes were distinct or held a slightly different focus

Summary

Introduction

An extensive literature exists describing treatment interventions and recovery from eating disorders (EDs); this body of knowledge is largely symptom-based and from a clinical perspective and limited in capturing perspectives and values of individuals with lived experience of an ED. We performed a systematic review to coproduce a conceptual framework for personal recovery from an ED based on primary qualitative data available in published literature. Twenty studies focusing on ED recovery from the perspective of individuals with lived experience were included. While the importance of symptom remission should not be understated, it does not fully capture the experiences of personal recovery for individuals with lived experience of an ED

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Discussion

Conclusion