Exploring illness and recovery in eating disorders: a qualitative study of patients' group therapies experiences

Recovery in eating disorders (EDs) is often defined in terms of symptom remission, potentially overlooking the broader meanings individuals attribute to illness and recovery. Qualitative research has highlighted the multidimensional nature of recovery, yet less is known about how therapeutic contexts may shape how individuals make sense of illness, change, and recovery. This study aimed to explore how individuals with EDs conceptualize illness and recovery, and how these meanings may be shaped through participation in group psychotherapy.

A qualitative study was conducted within an interpretivist framework using reflexive thematic analysis. Ten adult outpatients with EDs participated in semi-structured interviews at the end of a group psychotherapy program integrated within a multidisciplinary treatment setting.

Participants described a shift from understanding the ED mainly through food, weight, body image, and symptom control toward a more emotionally and relationally informed understanding of distress. Recovery was increasingly constructed as a multidimensional and non-linear process involving emotional awareness, self-acceptance, agency, identity renegotiation, and connection with others. The group was experienced as a space that fostered recognition, belonging, and reflection, while also exposing participants to shame, fear of judgment, and emotional vulnerability.

Findings suggest that group psychotherapy may support a reconfiguration of how individuals with EDs understand illness and recovery, moving from a primarily symptom-centred perspective toward a more holistic, relational, and personally meaningful framework. Rather than operating mainly through direct behavioural change, the group appeared to function as a space for meaning-making, emotional reflection, and relational experimentation. This study highlights emotional awareness, identity renegotiation, self-acceptance, and interpersonal connection as potential targets for fostering recovery in EDs. Trial registration The study protocol (n. 0034565/i) was approved by the local Institutional Review Board.