A new treatment for eating disorders combining physical exercise and dietary therapy (the PED-t): experiences from patients who dropped out

ABSTRACT

Purpose: Eating disorders (ED) are complex and severe illnesses where evidence-based treatment is needed to recover. However, about half of the patients with ED do not respond to treatments currently available, which call for efforts to expand the portfolio of treatments. The aim of this study was to explore experiences from patients who dropped out of a new treatment for bulimia nervosa and binge ED, combining physical exercise and dietary therapy (PED-t).

Methods: We conducted open-ended face-to-face interviews. The interviews were transcribed verbatim and the data were analysed with a phenomenological hermeneutical approach.

Results: Three themes emerged: “standing on the outside”, “unmet expectations” and “participation not a waste of time”. Feelings of standing on the outside were elicited by being different from other group members and having challenges with sharing thoughts. Unmet expectations were related to treatment content and intensity, as well as the development of unhealthy thoughts and behaviours. Finally, some positive experiences were voiced.

Conclusion: A need to clarify pre-treatment expectations and refining criteria for treatment suitability is indicated. The findings have contributed to the chain of clinical evidence regarding the PED-t and may lead to treatment modifications improving the treatment and thereby reducing drop out.

KEYWORDS:

• Eating disorders
• treatment
• qualitative analysis
• patient experiences
• dropout

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Maria Bakland

Maria Bakland is a PhD-student at Department of Health and Care Science, UiT - The Artic University of Norway, Tromsø, Norway. Her research focuses on eating disorder treatment.

Jan H. Rosenvinge

Jan H. Rosenvinge is a professor at the Department of Psychology, UiT - The Artic University of Norway, Tromsø, Norway. His research interests are within clinical psychology and health psychology.

Rolf Wynn

Rolf Wynn is a professor at the Department of Clinical Medicine, UiT - The Artic University of Norway, Tromsø, Norway and Division of Addictions and Mental Health, University Hospital of North Norway, Tromsø, Norway. His research focuses on e-health, health-services, health psychology and psychiatry.

Venke Sørlie

Venke Sørlie is a professor emeritus at the Center for Clinical Nursing Research, Lovisenberg Deaconal University College, Oslo, Norway. Her research interests are within fear in children and youth with cancer, as well as dementia care and existential needs and care.

Jorunn Sundgot-Borgen

Jorunn Sundgot-Borgen is a professor at the Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway. Her research focuses on weight regulation, eating disorders, menstrual irregularities and bone health.

Therese Fostervold Mathisen

Therese Fostervold Mathisen, PhD, is an associate professor at the Faculty of Health and Welfare, Østfold University College, Fredrikstad, Norway. Her research interests are within eating disorders, physical activity and nutrition.

Tove Aminda Hanssen

Tove Aminda Hanssen is a professor at the Department of Health and Care Science, UiT - The Artic University of Norway, Tromsø, Norway and Department of Heart Disease, University Hospital of North Norway, Tromsø, Her research focus on patient reported outcomes, complex health interventions and nursing science.

Franziska Jensen

Franziska Jensen is a PhD-student at the Department of Language and Culture, UiT - The Artic University of Norway, Tromsø, Norway, and Department of Education, UiT - The Artic University of Norway, Tromsø, Norway. Her research focuses on German as a foreign language and topological field analysis. She is a member in The Eating disorder Association “Spisfo”.

Kjersti Innjord

Kjersti Innjord is a member in The Eating disorder Association “Spisfo” and have years of experience with voluntary work in the local group.

Gunn Pettersen

Gunn Pettersen is a professor at the Department of Health and Care Science, UiT - The Artic University of Norway, Tromsø, Norway. Her research focuses on eating disorder treatment, Public Health and rehabilitation, recovery in mental health.