A qualitative exploration of self-control, emotions, and interoception in anorexia nervosa

Anorexia nervosa (AN) is a prevalent condition associated with significant impairment across multiple domains of life and limited effective treatments. There is a need to refine theoretical frameworks of AN. There is also growing recognition of the value of incorporating first-person perspectives to inform researcher-derived models of mental disorders. Among individuals with lived experience of AN, this study aimed to explore the components of a previously proposed model that integrates self-control, emotions, and interoception. Using virtual semi-structured interviews, we asked ten adults (nine women, one non-binary individual) to describe their experiences of self-control, emotions, and interoception across different stages of their eating disorder. Interviews were recorded, transcribed, and analyzed using codebook thematic analysis. Five themes were identified: negative emotions, control to cope, salience of interoception, tension, and changes over time. Together, the findings highlight the dynamic and evolving nature of AN, as well as the coexistence of opposing experiences. Clinically, these results underscore the importance of attending to multiple interacting mechanisms rather than isolated symptoms, and of tailoring interventions to the stage and dominant processes of illness. Approaches that explicitly acknowledge ambivalence and shifting experiences of control may be particularly valuable.