Exploration of Friendship Experiences, before and after Illness Onset in Females with Anorexia Nervosa: A Qualitative Study

PLoS One. 2016 Sep 27;11(9):e0163528. doi: 10.1371/journal.pone.0163528. eCollection 2016.


Background: Difficulties with social relationships have been implicated in both the development and maintenance of Anorexia Nervosa (AN) but the friendship experiences of individuals with AN have not been explored in depth.

Method: Ten adults with AN took part in a semi-structured interview about their friendship experiences both before and since the onset of their illness.

Results: Five principle themes were identified through thematic analysis: Social Concern; Impact of AN; Social Connectedness; Inflexibility and Preferred Social Activity. Difficulties with friendship were present prior to the onset of AN in all cases, with participants experiencing anxiety in relation to various aspects of their friendships. Participants described mixed experiences of how their AN has affected their friendships but most participants described having less contact with their friends since becoming unwell.

Conclusion: This research highlights the role that social difficulties may play in the development of AN, whilst also emphasising the importance of addressing problems with friendship in the course of inpatient treatment.

Grants and funding

This work was supported by the MRC/IoPPN excellence studentship, Swiss Anorexia Foundation (36-14), and the Psychiatry Research Trust. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.