Table 3.

The Perceived Influence of Quality of Life on Eating Disorder Development and Recovery

Quality of life domain	… as a vulnerability factor	… as a recovery factor
Mental Wellbeing	• Coping with stress through binge eating • Competing demands leading to restriction and binge eating • Loss of control leading to restriction	• Competing priorities leading to reduced weight/shape preoccupation • Reduced stress creating space to address symptoms • Perspective and self-acceptance leading to reduced overvaluation
Physical Health	• Weight gain and obesity leading to body image disturbance and both restrictive and bulimic behaviours • Menopause coped with through restriction and binge eating • Pain coped with through binge eating	• Prioritising physical health over appearance leading to reduced eating disorder behaviours • Becoming aware of the negative physical effects of the eating disorder leading to increased motivation to recover • Mortality shock/near-death experience leading to reduced overvaluation of weight/shape
Intimate	• Weight-related teasing from partner leading to eating disorder symptoms • Coping with neglect from partner through binge eating • Coping with over-controlling partner through restriction	• Acceptance from a loving partner leading to self-acceptance and reduced symptoms • Role modelling of a healthy relationship with body and food from partner leading to adoption of similar attitudes
Family	• Role-modelling of negative body image and dieting from mother leading to body image disturbance, restriction, and binge eating • Family overconsumption leading to obesity and poor body image • Family role-modelling the use of food to self-soothe leading to binge eating	• Desire to be a positive role model to own children as motivation to address symptoms • Support from family as an encouragement to address symptoms
Social	• Weight-related teasing from peers leading to symptoms • Validation from peers leading to maintenance of restriction • Mirroring of unhealthy attitudes and behaviours of friends/peers	• Development of new friendship groups with healthier attitudes leading to adoption of similar attitudes • Suggestion from friends to make positive changes • Support from others with mental illness to seek help • Gaining sense of fulfilment through social connection after a period of social isolation
Work/study	• Work overload resulting in restriction due to lack of time • Work overload resulting in stress resulting in self-soothing through binge eating	• Feeling productive and enjoying study and work leading to reduced stress and reduced binge eating
Finances	• Poor financial situation leading to gaining sense of control through restriction • Poor financial situation leading to poorer food choices, resulting in weight gain and body image disturbance	• Gaining financial stability leading to increased sense of control and reduced need for restriction to provide this
Leisure	• Symptoms arising from pressure to maintain ideal body shape for leisure activities, including modelling and dance	• Life modelling for drawing classes and engagement in contemporary dance leading to greater appreciation of diverse body shapes