Social comparisons in eating disorder recovery: Using PhotoVoice to capture the sociocultural influences on women's recovery.

Abstract

This qualitative study draws on a photo-elicitation method ("PhotoVoice") and semistructured interviews to examine the role of social comparison during the eating disorder (ED) recovery process. Thirty U.S. women in self-defined recovery, ages 18-35, used photography to capture personally meaningful social and cultural influences on their recovery, including factors supporting, and hindering their recovery process. Participants then shared these photographs with the research team, and described them in detail. Photographs and interviews were examined for social comparisons using thematic analysis, and two broad categories emerged: recovery-promoting and recovery-hindering comparisons. Across the 30 interviews, participants reported 143 recovery hindering comparisons and 100 recovery promoting comparisons. The vast majority of comparisons involved friends and media personalities, and took place in vivo or on social media platforms. The presence of "upward" and "downward" food and body comparisons that both support and hinder recovery suggests that social comparisons during the recovery process are more nuanced than previously known. The classically ascribed uses of comparison in social comparison theory do not appear to hold for women in ED recovery. Comparisons should be encouraged in treatment and interventions if and only if the comparisons are meant to support the recovery process.