From Anorexia Nervosa Onset to Treatment Initiation: Experiences of Parents and Young People

OBJECTIVE: To explore how young people (YP) with anorexia nervosa (AN) and parents experience the period from illness onset to treatment initiation, focussing on perceived impacts on family life. METHOD: An exploratory qualitative study employing 15 interviews with YP (aged 13-17 years) and 20 interviews with parents analysed using reflexive thematic analysis. RESULTS: Four themes were developed. Evolving Doubt captured parents' uncertainty and doubts, from normalising early signs of AN to uncertainty about help-seeking and managing healthcare-related barriers. Living an Ordinary and Busy Life before AN described family life before AN as structured and activity-oriented, frequently framed by parents as 'normal'. From Trust to Tension reflected relational shifts following AN onset, commonly marked by strain and emotional distance, though some families experienced increased closeness. Making Sense of the Emergence of AN highlighted how parents and YP sought explanations, with parents drawing on broader interpretations and perceived vulnerabilities, whereas YP offered more concrete accounts related to body image or health. CONCLUSIONS: The four themes portray how family life develops from taken-for-granted normality and trusting relationships, through parental doubt and ambiguity, towards conflict and mistrust, and how both YP and parents strive to make sense of these changes.