The role of food in family relationships amongst adolescents with bulimia nervosa: A qualitative study using photo-elicitation

Bulimia nervosa (BN) is a serious psychiatric disorder, with potentially dangerous complications. Family relationships play an important role in the way the condition develops or is perpetuated. The present study aims to better grasp the role of food in family interactions amongst teenagers with BN. Eleven interviews were carried out with five teenagers with BN aged from 16 to 18 and their parents, using photo-elicitation to carry out the qualitative investigation. A photograph of the table after a family meal, produced by the subject, was used as the basis for discussion. Interpretative Phenomenological Analysis was used to process the data. Our results were organised along two axes. The first describes the relationship between parent and child (the sharing of disarray about food between parent and child, food and the issue of children becoming autonomous from parents, food as a catalyser of conflict amongst other stressors). The second showcases relationships in the family as a group (the dining table as a likeness of family functioning, food at a crossroads between sharing and solitude). Our study showed that the dynamics in these families present differences from those of teenagers with anorexia nervosa, which must be taken into account. It confirmed the necessity of a systemic approach in addition to individual therapy (centred on the managing of emotions), and the benefits of creating occasions of family interaction which do not involve food to re-establish communication in the family relationships (including those with siblings).