Tackling mixed messages: Practitioner reflections on working with adolescents with atypical anorexia and their families

The treatment of atypical anorexia nervosa (AN) poses new research and practice challenges for the field of eating disorders. The objective of this study was to describe frontline practitioners' perceptions of differences between adolescents living with atypical versus typical AN, as well as th...

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Bibliographic Details
Published in:Eating disorders 2019-09, Vol.27 (5), p.436-452
Main Authors: Kimber, Melissa, Dimitropoulos, Gina, Williams, Emily P., Singh, Manya, Loeb, Katharine L., Hughes, Elizabeth K., Garber, Andrea, Elliott, April, Vyver, Ellie, Le Grange, Daniel
Format: Article
Language:English
Subjects:
Adolescent
Adolescents
Anorexia
Anorexia Nervosa - psychology
Anorexia Nervosa - therapy
Atypical
Body Weight
Content analysis
Eating disorders
Empathy
Family Therapy
Fear & phobias
Female
Humans
Intervention
Interviews as Topic
Male
Parents - psychology
Psychology
Qualitative Research
Teasing
Teenagers
Weight gain
Weight loss
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Summary:The treatment of atypical anorexia nervosa (AN) poses new research and practice challenges for the field of eating disorders. The objective of this study was to describe frontline practitioners' perceptions of differences between adolescents living with atypical versus typical AN, as well as the intervention challenges they experience when working with these adolescents and their families. We followed the principles of fundamental qualitative description and recruited a purposeful sample of practitioners treating adolescent eating disorders to complete a one-on-one semi-structured interview. Conventional content analysis and the constant comparison technique were used for data analysis. A total of 23 practitioners from four countries participated in this study. Practitioners described that adolescents with atypical AN present with higher pre-morbid weights and rates of weight-based teasing compared to their AN peers. Clinical challenges perceived by practitioners to be specific to working with adolescents with atypical AN included: addressing conflicting messages about eating disorders and weight loss, empathizing with a justified fear of weight gain, and increased risk for parental and therapist collusion with the eating disorder. Findings have implications for delivering interventions to adolescents seeking care for atypical AN.
ISSN:1064-0266
1532-530X
DOI:10.1080/10640266.2018.1542888