Exploring the primary care experiences of adult patients with eating disorders: a qualitative analysis

ABSTRACT

Eating disorders (EDs) are severe psychological conditions, often requiring specialized treatment. Patients with EDs generally first present in primary care before being referred to tertiary centres. Evidence suggests that family physicians do not identify most patients with clinical EDs. The objective of this study was to explore the primary care experiences of adult patients with EDs. Ten individual, semi-structured interviews with adult women with an ED were conducted. A qualitative descriptive approach was adopted using thematic analysis. The researchers identified codes, which were categorized into five major themes: 1) disparate patient experiences in primary care, 2) delayed diagnosis, 3) key family physician qualities for ED care, 4) individual and systemic barriers to recovery, and 5) patient needs in primary care. Most participants reported that their diagnosis was not timely, suggesting a need for improved screening and diagnostic procedures. Inconsistent treatment practices imply that family physicians would benefit from the development of standardized guidelines for ED diagnosis and treatment in primary care as well as additional training in ED care. Family physicians being empathic and nonjudgmental and facilitating access to resources are of particular importance to this patient population.

Acknowledgments

The authors would like to thank Drs. Fiona Webster and Blake Woodside for their review of our manuscript prior to submission for publication.

Conflicts of interest

Kimberly Lazare has no conflicts of interest to declare.

Adrienne Mehak has no conflicts of interest to declare.

Deanna Telner is a medical consultant for mdbriefcase, a Canadian CME provider.

Notes

1. Note. No participant reported that a FP identified her ED shortly after symptom onset. Of the remaining four participants, two received diagnoses from a mental health professional, one received a diagnosis as an adolescent when hospitalized at the behest of her parents, and one could not recall the circumstances of her diagnosis.

Additional information

Funding

Funding for this study was procured from a University of Toronto Practice-Based Research Network (UTOPIAN) Ideal to Proposal Grant.