Eating disorders and subjective well-being: Symptoms and functional variables, as indicators of the subjective well-being of women suffering from eating disorders

Background. Eating disorders have become more commonin recent decades, particularly among women. While they are considered as mental disorders, their diagnosis, research and treatment largely focus  on physiological criteria, given the physical risk created by the mental state of people suffering from this disorder. Nonetheless,  this type of treatment has proven to be insufficient in supporting the long-term recovery from the disorder. In addition, , research studies into eating disorders have largely overlooked the role of functional skills in treatment of this illness, despite acknowledgment that they are connected to improvements in the emotional wellbeing of people with other mental disorders. Emotional wellbeing is a significant factor in the recovery process of people suffering from mental disorders, and is a significant measure of general  mental health .

Purpose of the research. To examine the relationship between emotional wellbeing of women dealing with eating disorders and symptoms of eating disorders, level of functional skills (social and daily functions), participation in activities (such as work, school, and volunteering activities) and level of meaningfulness derived from such participation –. This examination  was based on the World Health Organization’s International Classification of Functioning Disability and Health (ICF) model, which presents a theoretical framework for examining the level of functioning and wellbeing of people in relation to physical and mental disabilities stemming from their health condition.

Research methods. This research was a cross-sectional, correlational, quantitative study, conducted among  women aged 18 and above who self-defined as  suffering from eating disorders. A questionnaires was distributed online and at medical centers for eating disorders, for completion independently.

Research tool. Participants answered seven self-administered questionnaires. These included: The Eating Attitudes Test – 26 Item (EAT-26); the Mental Health Inventory (MHI); the Interpersonal Competency Questionnaire (ICQ); the Lawton Instrumental Activities of Daily Living Scale (IADL); the Engagement in Meaningful Activities Survey (EMAS); and a questionnaire concerning the degree of significance derived from participation in these activities(.

Findings. The study's findings determined that the higher level of eating disorder symptoms of participants, the lower their level of everyday functioning, indicated by their lower level of independence in functions such as meal preparation, housekeeping and mobility. Moreover, the higher the level of eating disorder symptoms, the lower the level of social functioning. In addition, a significant positive association was found between level of emotional wellbeing and not having a diagnosis of an eating disorder, higher level of education and social functioning, higher meaningfulness of participation in activities and lower levels of eating disorder symptoms.. Findings also showed that daily functioning and social functioning acted as moderators, influencing the association between level of eating disorder symptoms and emotional wellbeing. Contrary to hypotheses, no significant association was found between daily functioning and participation in activities, and emotional wellbeing. Additionally, the level of meaningfulness derived from participation in activities did not serve as a moderator influencing the association between participation in activities and emotional wellbeing, and participation in activities did not serve as a moderator influencing the association between level of eating disorder symptoms and emotional wellbeing.

Significance of the study. Studies regarding eating disorders have focused primarily on the physical symptoms and psychological circumstances of the illness, with insufficient attention given to the emotional wellbeing or functional skills of women coping with this illness. This is the case even though research has established that emotional wellbeing plays a significant role in the recovery process of people suffering from mental disorders, and rehabilitation of functional skills help achieve this wellbeing. Today, other than in  three rehabilitation homes in Israel, there is no framework for the rehabilitation of women coping with eating disorders in Israel. Treatment is usually conducted in clinics, consisting of psychological, psychiatric and nutritional interventions, with limited reference to the rehabilitation of personal functioning. In light of the significant attention given to the concepts of rehabilitation, recovery, and wellbeing in the field of mental health, and given that the current modes of treating eating disorders are insufficient, it seems that attention to the contribution of functional skills to the emotional wellbeing and recovery of people coping with eating disorders is lacking. This study can serve as an important source of knowledge for understanding the unique functional needs of this population, in order to develop unique rehabilitation services for them.