Exploring illness and recovery in eating disorders: a qualitative study of patients’ group therapies experiences

Recovery in eating disorders (EDs) is often defined in terms of symptom remission, potentially overlooking the broader meanings individuals attribute to illness and recovery. Qualitative research has highlighted the multidimensional nature of recovery, yet less is known about how therapeutic contexts may shape how individuals make sense of illness, change, and recovery. This study aimed to explore how individuals with EDs conceptualize illness and recovery, and how these meanings may be shaped through participation in group psychotherapy. A qualitative study was conducted within an interpretivist framework using reflexive thematic analysis. Ten adult outpatients with EDs participated in semi-structured interviews at the end of a group psychotherapy program integrated within a multidisciplinary treatment setting. Participants described a shift from understanding the ED mainly through food, weight, body image, and symptom control toward a more emotionally and relationally informed understanding of distress. Recovery was increasingly constructed as a multidimensional and non-linear process involving emotional awareness, self-acceptance, agency, identity renegotiation, and connection with others. The group was experienced as a space that fostered recognition, belonging, and reflection, while also exposing participants to shame, fear of judgment, and emotional vulnerability. Findings suggest that group psychotherapy may support a reconfiguration of how individuals with EDs understand illness and recovery, moving from a primarily symptom-centred perspective toward a more holistic, relational, and personally meaningful framework. Rather than operating mainly through direct behavioural change, the group appeared to function as a space for meaning-making, emotional reflection, and relational experimentation. This study highlights emotional awareness, identity renegotiation, self-acceptance, and interpersonal connection as potential targets for fostering recovery in EDs. Trial registration The study protocol (n. 0034565/i) was approved by the local Institutional Review Board. Eating disorders are often understood mainly in terms of eating behaviours, weight, and body image. However, people with eating disorders may experience illness and recovery in broader and more personal ways, involving emotions, relationships, identity, shame, and self-acceptance. This study explored how adults with eating disorders understood their illness and recovery after taking part in group therapy within a multidisciplinary treatment setting. Ten adults were interviewed after completing a group therapy program. Before the group experience, participants often described their eating disorder mainly through symptoms such as food restriction, bingeing, purging, body dissatisfaction, and weight control. After the group, many described their difficulties in a broader way, linking the eating disorder to emotions, relationships, and personal experiences. Recovery was seen not only as reducing symptoms, but also as becoming more aware of emotions, accepting oneself, developing personal agency, and connecting with others. The group helped some participants feel understood and less alone, but it could also involve shame, fear of judgment, and emotional vulnerability. Overall, group therapy appeared to support broader and more personally meaningful understandings of recovery.