Social function in adolescent eating disorders: lived experience framework for clinical practice

Background Social function is increasingly demonstrated as a factor in risk, maintenance and outcome of eating disorders, but not emphasised in theoretical models of, and treatment approaches to, adolescent eating disorders. Aims To adapt Schmidt and Treasure’s cognitive interpersonal model of anorexia nervosa to incorporate developmental and transdiagnostic components. Method Qualitative interviews with young people aged 12–16 years (inclusive), who are in contact with child and adolescent community eating disorders services, and their parents, subjected to thematic analysis. Results Five key themes emerged that were mutually dependent on a sixth theme of emotion regulation and coping. These themes were: peer relationships, change and uncertainty, thinking styles, appearance and achievement-based values, and family relationships. Conclusions Peer relationships emerged as distinct from family relationships in this population, and a unifying theme was emotion regulation and coping. The framework could guide clinical assessment and the development or adaptation of interventions to address the themes identified. Research is needed to understand the role of the themes in treatment response and outcomes.