Behind the ‘Social mask’: a phenomenological study of loneliness and social disconnection in women with Eating disorders

Eating disorders (EDs) are chronic psychiatric conditions characterized by significant impairments in psychosocial functioning. This study utilizes an interpretative phenomenological analysis (IPA) to explore the lived experiences of social functioning and loneliness among women diagnosed with Eating Disorders (n = 8). Semi-structured interviews focused on early interpersonal patterns, experiences of social interactions, and the role of social support in recovery. Four superordinate themes emerged: Roots of Impaired Social Functioning, highlighting adverse childhood experiences; The Worsening Spiral, describing the reliance on a social mask and perceived lack of family care; The Self-Perpetuating Cycle of Loneliness, where isolation acts as a catalyst for symptom escalation; and Reconnecting and Recovering, emphasizing the healing role of sustained social support. Findings illustrate that social disconnection is not merely a byproduct but an active mechanism maintaining ED chronicity. Loneliness and the strategic use of a social mask reinforce withdrawal, while meaningful reconnections facilitate symptom reduction. These results underscore the necessity of integrating relational, interpersonal and trauma focus into ED treatment frameworks to break the vicious cycle of loneliness.