Approximately 1.25 million people in the UK live with an eating disorder (ED). For many people with eating disorders, COVID-19 restrictions have heightened anxiety, exacerbated eating disorder symptoms, and generated intense feelings of loneliness and isolation. Feelings of loneliness and isolation can precede a return to disordered behaviours; therefore, it is essential that people in recovery are supported to stay socially connected. Since the UK’s first lockdown in March 2020, many have turned to online groups for support in coping with COVID-19. Beat, the UK’s eating disorder charity, reported a 73% increase in demand for their helpline services in June and consequently developed a new online group specifically to support people with eating disorders cope during the pandemic. This increase in online support group usage raises the question of how exactly do online recovery groups support those living with an eating disorder? Our research in this area conducted in collaboration with Bodywhys and Diabetics with Eating Disorders provides some insights to help us answer this question.
We know that feeling a sense of belonging to social groups has a positive impact on physical and mental health. This is because our social groups (e.g., family, community, work group, support group) provide a range of important practical and psychological resources to us, including, but not limited to social support, self-esteem, and a sense of meaning and purpose in life. For people with eating disorders, there is extremely limited research conducted on how online groups support recovery. Indeed, many believe that online groups might in fact maintain the disorder. However, we argue that it is important to examine the identity content of the group in question (namely, its norms and values) before considering its potential to enhance (or harm) individual health and well-being. Our research suggests three key areas in which support from similar others in an online recovery group can promote eating disorder recovery.
1. Successful eating disorder recovery involves social identity change
For many, recovery can be accompanied by intense feelings of fear as it requires people to let go of something that had come to inform their sense of who they are. Recovery therefore has direct implications for identity. Social psychological literature suggests that this challenge can be characterised as a shift from an ‘illness social identity’ to a ‘recovery social identity’. This shift is needed for a person to positively engage in the recovery process. Those with whom the person shares the recovery identity are usually the best equipped to provide the psychological support required at this time.
2. Online groups facilitate social identity change
Online groups can facilitate the transition from an illness identity to a shared recovery identity. People of varying ages who join such groups report that the group invested in a shared belief that recovery was possible. Group membership also encourages reconnection in positive ways with other social identities. For example, the social influence exerted by the online recovery group tends to encourage more positive interactions with clinicians and family members. This can encourage people to disclose their ED to supportive others. The evidence suggests that running online support group in parallel with healthcare services is likely to be highly beneficial.
3. Group norms need to be observed and monitored during online recovery group interactions
To ensure that online recovery groups remain focussed on the key goal of creating a shared recovery identity, it is important that the group’s norms and values are made explicit to all members. Certain conversation topics will be prohibited. For example, members of online support groups are asked to refrain from uniquely specifying the type of ED from which they suffer. They are also not to engage in conversations around food and specific ED-related behaviours, such as purging. It is important that members did not violate these ‘rules’. Doing so may prevent a sense of a shared recovery identity forming within the group or serve as a trigger for some group members
In summary, online recovery groups can help to combat feelings of isolation, provide advice, and promote recovery. Consequently, they are likely to be a key source of support during the COVID-19 pandemic. However, it is especially important that those in recovery access safe and appropriate support. This means avoiding online sources (e.g., groups, blogs, social media, forums) that exclusively focus on eating weight, and body image. The best support can be found from other people who are focused on recovery.
You can read the full versions of our research on social identities, online groups and eating disorder recovery by following the links below:
- McNamara, N., & Parsons, H. (2016). “Everyone here wants everyone else to get better: The role of social identity in eating disorder recovery. British Journal of Social Psychology, 55, 662-680. http://irep.ntu.ac.uk/id/eprint/28331/
- Hastings, A., McNamara, N., Allan, J., & Marriott, M. (2016). The importance of social identities in the management of and recovery from ‘Diabulimia’: A qualitative exploration. Addictive Behaviors Reports, 4, 78-86. http://irep.ntu.ac.uk/id/eprint/29150/
About the Author
Dr Niamh McNamara is a Social Psychologist and Associate Professor at Nottingham Trent University, UK. Her research explores the ways in which group memberships impact individual health and well-being. In particular, she is interested in the ways in which stigma undermines the ability of vulnerable groups in society to access the resources and services essential for good health. Dr. McNamara is a member of NTU’s Groups, Identities Health Research Group and you can follow @DrNiamhMcNamara and @GIHNTU on Twitter.
Psychology at Nottingham Trent University 