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Slavery to Addiction as meaning of Dropout in Eating Disorders: psychological aspects among women that have interrupted treatment at a specialized service in Brazil


This study investigates the narratives of women who dropped out of treatment from a specialized outpatient unit for eating disorders (ED). Psychodynamics aspects involved are discussed regarding the issue of adherence and dropout since found as directly af-fected by the addictive dimension. A qualitative approach was used to identify interpretative matrices that lead 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 therapeutics in addiction and the eating disorders. 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 that discusses anorexia and bulimia as addictions. The discussion aims to contribute to the treatment approach of ED and also to 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 support the discussion of eating disorders as "addictive disorders" 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 relationship to the treatment. (AU)

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