Slavery to Addiction as Meaning of Dropout in Eating Disorders: Psychological Aspects among Women That Have Interrupted Treatment at a Specialized Service in Brazil

摘要

This study investigated the narratives of women who dropped out of treatment from a specialized outpatient unit for eating disorders (ED). Psychodynamics aspects involved were discussed regarding the issue of adherence and dropout, since it was found to be directly affected by addictive aspects. A qualitative approach was used to identify interpretative matrices that led to a broad understanding of the clinical phenomena observed. Our aim was to identify contributions to the clinical management of barriers to treatment regarding the challenge of adherence to addiction and eating disorders treatments. The sample consisted of eight in-depth interviews fully recorded and transcribed. The emergent categories indicated elements from the experience of the disorders in psychological meanings assigned to dropout by patients. Findings are discussed under a theoretical framework focused on anorexia and bulimia as addictions. The discussion aims to make a contribution to the ED treatment approach and also understand them in their addictive dimension in order to enhance compliance and retention in treatment. The psychodynamic elements from addictive experiences described by patients may contribute to supporting the discussion about eating disorders as “addictive behaviors” beyond the “addiction model of eating disorders” as a physiological model of “addictive” or “toxic” food dependence. Eating disorders experienced as addiction were found affecting the response to treatment.