ABSTRACT

Purpose: Eating disorders (ED) are complex and severe illnesses where evidence-based treatment is needed to recover. However, about half of the patients with ED do not respond to treatments currently available, which call for efforts to expand the portfolio of treatments. The aim of this study was to explore experiences from patients who dropped out of a new treatment for bulimia nervosa and binge ED, combining physical exercise and dietary therapy (PED-t).

Methods: We conducted open-ended face-to-face interviews. The interviews were transcribed verbatim and the data were analysed with a phenomenological hermeneutical approach.

Results: Three themes emerged: “standing on the outside”, “unmet expectations” and “participation not a waste of time”. Feelings of standing on the outside were elicited by being different from other group members and having challenges with sharing thoughts. Unmet expectations were related to treatment content and intensity, as well as the development of unhealthy thoughts and behaviours. Finally, some positive experiences were voiced.

Conclusion: A need to clarify pre-treatment expectations and refining criteria for treatment suitability is indicated. The findings have contributed to the chain of clinical evidence regarding the PED-t and may lead to treatment modifications improving the treatment and thereby reducing drop out.

摘要

目的：饮食失调（ED）是复杂且严重的疾病，需要循证治疗才能恢复。但是，大约一半的ED患者对目前可用的治疗方法无反应，这要求努力扩大治疗范围。这项研究的目的是探讨从谁的暴食症和狂欢ED的新疗法的退出患者的经验，结合p物质环境Ë xercise和d ietary牛逼herapy（PED-T）。

方法：我们进行了不限成员名额的面对面访谈。访谈逐字记录，并采用现象学的诠释学方法对数据进行分析。

结果：出现了三个主题：“站在外面”，“未达到期望”和“参与不浪费时间”。与其他小组成员不同，并在分享思想方面遇到挑战，从而引起了站在外面的感觉。未满足的期望与治疗内容和强度以及不健康的思想和行为的发展有关。最后，表达了一些积极的经验。

结论：需要明确治疗前的期望和治疗适应性的完善标准。这些发现为有关PED-t的临床证据链做出了贡献，并可能导致治疗修改，从而改善治疗效果，从而减少退学率。