A qualitative exploration of influences on the process of recovery from personal written accounts of people with anorexia nervosa

Less than half of people with anorexia nervosa achieve full recovery. Previous qualitative research has identified a "tipping point" for change in people who have experienced recovery. The present study's goal was to explore factors that might contribute to this time in personal published accounts, an alternate source for understanding lived experience. Using the 5-stage framework approach for thematic analysis, 31 individual (29 female) accounts were explored. These were purposively sampled from autobiographical accounts (during 1999-2011). In all the accounts a "tipping point" or change in the person's attitude toward treatment and recovery did appear. We identified four main themes: desire for recovery, positive experiences in treatment, an aspect of life outside work or study, and positive and helpful experiences with new or renewed relationships. The themes were a mix of internal and external themes, as well as themes independent of a treatment experience. The findings support other research that indicates experiences, such as personal and spiritual relationships, in addition to specific psychotherapies or treatments, are important in recovery. Further research into how to facilitate and integrate these external factors with formal treatment is indicated in order to improve understanding of outcomes in anorexia nervosa.