“They should understand that the anorexia drives me to do anything”: Exploring how individuals with anorexia nervosa make sense of the experience of medical admissions

Objective
Anorexia nervosa (AN) is a complex disorder associated with significant morbidity and mortality. Some people with AN require medical admissions to manage physical complications. Currently, little is known about how these medical admissions are experienced, despite an increase in the number of individuals being hospitalised.

Method
Interpretative phenomenological analysis was employed to explore adults' lived experience of medical admissions for AN, with data collected through individual interviews. Ten individuals with experience of medical admissions directly related to a diagnosis of AN took part.

Findings
Six themes were identified. Admissions were often lifesaving. Gratitude was expressed for medical intervention and, for some, for an intensification of care. However, hospitalisation left many feeling scared and overwhelmed. Participants felt misunderstood and stigmatised and their illness identity continued to dominate. Mental and physical health services were experienced as disconnected and close others sometimes had to shoulder significant responsibility for care.

Conclusions
Recommendations are offered regarding the value of enhancing training on AN amongst medical professionals to improve care experiences and the potential importance of a more collaborative and holistic approach that considers patients' comorbidities and personal histories. Future research should explore whether therapeutic techniques may support development of a non-anorexic identity during or after medical admissions and what aspects of treatment can render hospitalisation harmful.

Key Points

Medical admissions were lifesaving yet psychologically challenging; limited psychological understanding of anorexia nervosa contributed to stigma and reinforced illness identity, highlighting the need for further training to improve care experiences and outcomes.

Care experiences during medical admissions varied widely, with humane, validating interactions supporting engagement, while compassion fatigue and limited resources hindered care; treatment was overwhelming and sometimes traumatic, underscoring the importance of psychologically informed practice.

Managing risk and detention in anorexia nervosa requires nuanced collaboration, with holistic assessment and close involvement of specialist eating disorder and liaison teams to integrate medical and psychological perspectives.