Family member’s perceived impact of anorexia nervosa and bulimia nervosa on family dynamics: a qualitative systematic review and meta-synthesis

Eating disorders configure a growing and complex public health issue which hinders implementing targeted policies. Global health policies emphasize tailored interventions for reducing eating disorders harms among vulnerable people. This systematic literature review and meta-synthesis interprets the synthesized findings from primary qualitative studies on the experience of family living with the diagnosis of anorexia nervosa and bulimia nervosa. The study was conducted based on the SPIDER search strategy and PRISMA guidelines on nine databases: Academic Search Premier, CINAHL, LILACS, MEDLINE, PubMed, PsycINFO, SocINDEX, Scopus, and Web of Science. Two independent reviewers performed the article screening and selection processes. Of the 2,269 studies initially identified, 28 met the inclusion criteria and were selected. Four descriptive themes emerged: (1) Anorexia nervosa/bulimia nervosa within the family environment: meanings attributed to the symptoms; (2) Anorexia nervosa/bulimia nervosa dominance within the family system: care that also harms; (3) Challenges in accessing care: individual and social barriers; and (4) Pathways to coping: supporting the whole family - a public health issue. The study shows that family dynamics and the health-illness process are closely linked, forming a cyclical, mutually reinforcing relationship that highlights the need for a more comprehensive approach to supporting the whole family. These findings corroborate the need for global policies that emphasize tailored interventions to reduce eating disorders harms and suffering within families.