title: Quality of life as a vulnerability and recovery factor in eating disorders: a community-based study.
abstract: BACKGROUND
  Emerging evidence suggests that changes in quality of life (QoL) predicts later changes in eating disorder (ED) symptoms. The objective of this study was to explore individual sufferers' perspectives on the influence of QoL on the onset, maintenance, and/or remission of ED symptoms.
  
  
  METHODS
  19 women from the community with a history of eating disorders (n = 13 currently symptomatic; n = 6 recovered) were interviewed about their observations on the relationship between QoL and ED symptoms over time in their own lives. Interviews were audio-taped and transcribed, and then thematically analysed.
  
  
  RESULTS
  Thematic analysis uncovered two major themes: 1. QoL as a Vulnerability Factor, and 2. QoL as a Recovery Factor. In relation to the first theme, onset of ED symptoms was discussed by women in this study as having been triggered by impairment in QoL, including a general sense of lacking control in life, stress, abusive intimate relationships, poor role modelling from family, physical impairment related to obesity, peer pressure, and weight-related teasing. On the other hand, and in relation to the second theme, subsequent improvement in QoL was nominated as central to symptom improvement and recovery. QoL improvement was described by participants differently, but included increased general satisfaction in life, emotional maturation, prioritising and improving physical health, the development of a supportive intimate relationship and social relationships, and having children.
  
  
  CONCLUSIONS
  Impairment in QoL may act as a trigger for the onset and maintenance of ED symptoms, whereas improvement in QoL may be central to eating disorder improvement and eventual recovery. Treatment should involve consideration of a core focus on QoL improvement as a potential 'backdoor' approach to improving ED symptoms.
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia. deborah.mitchison@mq.edu.au.|Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. deborah.mitchison@mq.edu.au.
authors.forename: Deborah
authors.initials: D
authors.lastname: Mitchison
authors.affiliation: School of Psychology, University of Sydney, Sydney, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dawson
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia.
authors.forename: Lucy
authors.initials: L
authors.lastname: Hand
authors.affiliation: School of Medicine, Western Sydney University, Sydney, Australia.|Research School of Psychology, Australian National University, Canberra, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mond
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.
authors.forename: Phillipa
authors.initials: P
authors.lastname: Hay
mesh_terms: D000328:Adult; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D065840:Protective Factors; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Community-Based study; Eating disorders; Onset; Qualitative; Quality of life; Recovery