Understanding stigma in the context of help-seeking for eating disorders

Summary & key facts

This study asked 333 people with high eating-disorder symptoms about stigma, shame, and whether they sought help. The research found that perceived stigma, self-stigma, and shame together were linked to help-seeking and “predicted 64% of help-seeking behaviour (p = .005)” after accounting for age and gender. The single stigma concern that stood out as a unique predictor of seeking formal help was worry that other people think eating disorders are not real illnesses. The authors say stigma matters but might not be the main reason people with eating disorders do not get care, and they note measurement limits and the need for more research on other barriers.

Key facts:

• The study sample included 333 people with elevated eating disorder symptoms and high clinical impairment (N = 333).
• Using binary logistic regression while controlling for age and gender, perceived stigma, self-stigma, and shame together "predicted 64% of help-seeking behaviour (p = .005)".
• The only stigma or shame item that was a significant unique predictor of formal help-seeking was: "Being concerned that other people believe eating disorders are not real illnesses."
• Most other individual stigma and shame items did not significantly predict help-seeking in this sample.
• The paper notes that rates of help-seeking for people with eating disorder symptoms are low and have remained unchanged in the last decade.
• The authors describe stigma as a complex issue with different types (perceived/public stigma, self/internalised stigma, and personal stigma) and point out that measurement differences make past findings hard to compare.
• The authors caution that, while stigma plays an important role, it may not be the primary reason people with eating disorders fail to access care, and they recommend studying other barriers to help-seeking.

Abstract

Stigma is a complex construct and its association with help-seeking among those experiencing eating disorders is not well understood. Rates of help-seeking are low for those with eating disorder symptoms and, therefore, determining the role of stigma and shame in this relationship is needed to help inform effective awareness campaigns aimed at improving prognostic outcomes. The current study examined the associations between perceived stigma, self-stigma, shame, and help-seeking behaviour in a community sample of individuals with elevated eating disorder symptoms. Participants completed an online survey that included measures of stigma and shame as perceived barriers to help-seeking for individuals with eating disorders. Those with elevated eating disorder symptoms and high clinical impairment were included in the study (N = 333). Using binary logistic regression models controlling for age and gender, results showed that perceived stigma, self-stigma, and shame predicted 64% of help-seeking behaviour (p = .005). The only significant unique predictor of formal help-seeking was “Being concerned that other people believe eating disorders are not real illnesses”. No other stigma or shame items were found to significantly predict help-seeking. The present findings suggest that while stigma plays an important role in help-seeking, it might not be the primary reason preventing individuals with eating disorders from accessing care. The field is encouraged to investigate these factors to promote help-seeking effectively. Eating disorders are highly prevalent worldwide and have severe mental health and medical consequences. While effective treatments for eating disorders exist, many of those who experience eating disorder symptoms do not reach out for help. Delays in help-seeking are associated with negative outcomes for affected individuals but also their families, caregivers, and the broader healthcare system. To better understand the factors preventing individuals with eating disorders from seeking help, we investigated the role of stigma and shame in this relationship. Participants completed a survey assessing their eating disorder symptoms, help-seeking behaviour, and barriers to seeking help. Those with elevated eating disorder symptoms (e.g., disordered eating and/or high weight and shape concerns negatively affecting their life) were included in the study. Participants reported that stigma and shame, specifically, “Being concerned that other people believe eating disorders are not real illnesses”, prevented them from seeking help. Our results help to clarify the types of stigma most relevant to help-seeking, which may be targeted in awareness campaigns to improve access to care for people with eating disorders. It would be beneficial for future studies to explore other prominent help-seeking barriers to improve clinical outcomes.

Topics

Eating Disorders and Behaviors Obesity and Health Practices Obsessive-Compulsive Spectrum Disorders

Categories

Clinical Psychology Psychology Social Sciences

Tags

Biology Clinical psychology Context (archaeology) Eating disorders Paleontology Psychiatry Psychology Psychotherapist Stigma (botany)