What factors lead to self disclosure of bulimic women?

Abstract

Bulimia Nervosa (BN) is on the rise in almost every continent. Early identification and treatment is vital to improving health outcomes but recognition of women with bulimia by APNs is suboptimal. A major reason cited in the literature is the lack of disclosure associated with bulimic women. The purpose of this research is to describe factors that led or posed barriers to self-disclosure of BN. A descriptive, qualitative study was used with a convenience sample of fifteen women ages 20-62 who had disclosed their BN. Krippendorff’s method was used for content analysis. Factors facilitating disclosure included: possessing a “safety net” related to a relative, friend or HCP; feeling an intrinsic obligation to oneself to disclose; revealing BN as a result of provider “pull” on the patient; yearning to feel well; and relating to someone with a similar experience. Barriers included: shame, embarrassment, guilt and concern related to other’s perceptions. Some respondents had not disclosed to a HCP citing exposure might result in feeling forced to stop this behavior. Purging was described as personal and secretive where the seduction of the act itself far outweighed the risks associated with BN. This has important implications for APNs not only in recognizing the reasons underlying disclosure but in understanding how the act itself impacts on earlier detection.