Date of Completion

5-1-2018

Embargo Period

4-27-2028

Keywords

anorexia nervosa, recovery

Major Advisor

Cheryl Tatano Beck, DNSc, CNM, FAAN

Associate Advisor

Juliette Shellman, PhD, APHN-BC

Associate Advisor

Thomas Van Hoof, MD, EdD

Field of Study

Nursing

Degree

Doctor of Philosophy

Open Access

Campus Access

Abstract

The adverse outcomes associated with a history of anorexia nervosa, combined with the stress of parenting, illustrates the need for research to understand the experiences of mothers recovered from anorexia nervosa and its impact on feeding their children. An estimated 2.4% of women of childbearing age have met criteria for anorexia nervosa or bulimia nervosa in their lifetime. While there is no one known cause of anorexia nervosa, evidence shows the disorder runs in families, identifying a strong genetic component. In addition, research has demonstrated that women with a history of an eating disorder face distinctive parenting challenges. Pregnant women with an eating disorder history are at greater risk for intrauterine growth restriction, preterm birth, miscarriage and stillbirth. After birth, maternal feeding patterns are ranked as one of the strongest predictors of childhood food intake. Mothers with a history of an eating disorder have demonstrated delayed transition to solid food, restrictive feeding patterns, greater maternal anxiety and depression, and a distorted perception on their child’s weight and shape. A history of an eating disorder can influence all facets of pregnancy, childbirth, and child feeding practices, and in doing so impact feeding and eating problems in their children.

The purpose of this study was to explore the experiences of mothers recovered from anorexia nervosa and how this affected feeding their children. A qualitative, descriptive phenomenological research design was utilized. The purposeful sample included sixteen mothers who self-identified as recovered from anorexia nervosa. All sixteen participants engaged in personal interviews. This qualitative research utilized Colaizzi’s (1978) phenomenological method revealing 1200 significant statements, which captured six overarching themes.

The outcome was the essence of the experiences of mothers recovered from anorexia nervosa feeding their children. Mothers’ history of anorexia nervosa was captured via self-report. Mothers instinctively reflected on their own interplay of genes and environment in expressing their fear of transmitting an eating disorder to their offspring. Furthermore, mothers revealed a myriad of emotions surrounding pregnancy and birth. The result was a sense of freedom and commitment to nourishing a growing baby during pregnancy contrasted with fear of stigma from healthcare providers and anxiety over the loss of control of an ever-expanding body. They experienced a conflicted need to compensate for years of restrictive eating by nourishing their children whether it was through overfeeding, portion control, lack of structure, or healthy choices. For mothers with a history of anorexia nervosa, feeding children is a complicated experience wrought with remnants of eating disorder thoughts and behaviors. Mothers reflected deeply on their own recovery journey sharing details that are often left unheard. The results of this study can inform other mothers they are not alone. In addition, healthcare providers can focus on the results of this study to open the door to screening and support in the prenatal and postpartum period to start the conversation about the potential impact a history of an eating disorder can have on maternal attachment and child feeding.

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Available for download on Thursday, April 27, 2028

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