Table 1 Themes, subthemes, frequencies and representative quotes

THE UNEVEN JOURNEY OF RECOVERY

1a. The ongoing process of change

17 (89.47%)

“It was slow, but I don’t mean in terms of years, I mean in terms of the overall process. It was a slow thing because you’d think, “Okay, I feel better,” but then the thoughts come back, and you start again. So, in my opinion, the process is truly slow” (part. 4)

“There were always periods when things were a bit better and periods when they were worse, but over time, it gradually stabilized” (part. 6)

“It’s a process where you almost don’t realize, as you work on yourself, that you might be starting to detach. Yet, at the same time, this thing still keeps you somewhat tied to it” (part. 15)

1b. The sudden realisation of how far you have come

17 (89.47%)

“When I started feeling good and right with myself—in the sense that I no longer cared about judgments, what people said, the “buts” or the “ifs”—because I was who I was, and I am who I am” (part. 1)

“There was a very beautiful and special moment, about two years ago, when one day I looked in the mirror and felt nothing. I wasn’t searching for flaws or problems anymore” (part. 8)

“They took my measurements, weighed me, and literally, when they said, “Your blood pressure is good, your weight is good,” I gave the same importance to my blood pressure as to my weight. It was like I had forgotten about it, and that’s what matters” (part. 11)

1c. Recovery as a personal narrative to be shared

10 (52.63%)

“Then I started looking at them and thought, “No, wait, I want everyone to see this, I want them to know how much I struggled.” But since the struggle isn’t something you show, it’s something you share, I wanted them to see this. So that desire to share that I had healed really filled me up” (part. 5)

“I’m aware that I’m the same as yesterday, and tomorrow I’ll be the same as today. Nothing changes” (part. 8)

“By giving a voice to these things, because every time I have the chance, I participate. I’m glad that, compared to a few years ago, I did an interview—not one like this, but still about eating disorders” (part. 15)

POSITIVE CHANGES IN THE RELATIONSHIP WITH FOOD, THOUGHTS AND EMOTIONS

2a. Flexibility and positive emotions around eating

11 (57.89%)

“The journey that a person often goes through in their approach to food and the meaning it takes on, because, of course, for me, the meaning has changed” (part. 2)

“Accepting the ability to allow yourself something that makes you feel powerful by depriving yourself of it— for me, that was a turning point” (part. 7)

“There was a precise moment when I changed the need… the craving for bingeing into “I just want to eat something in front of a movie,” and that was the key moment for me” (part. 15)

2b. Less frequent and fewer eating-disorder thoughts and new ways of relating to them

14 (73.68%)

“In the moment when your voice comes back, you think, “Wow, but in my life, I have everything: I do the things I love, I have people who care about me, I’m at peace. Why should I ruin it?” (part. 4)

“I think the important thing is not giving it the same weight you did before and knowing that there’s more to life than how we appear aesthetically” (part. 6)

“I realized that food, which once seemed enormous, was becoming smaller and smaller every day” (part. 10)

2c. Finding new (non-eating disorder-related) ways to deal with difficult emotions

11 (57.89%)

“When something happens, it’s the most critical moment when one can revert to using certain strategies learned when they were younger. It helps me a lot, maybe I do it without even realizing, like listening to things that were said to me often” (part. 2)

“I’ve learned to manage those ups and downs that appeared both in life and in the illness—meaning in the healing process—differently” (part. 7)

“Now, when things happen that make me angry, or when I overreact, I always try to pause for a moment […]. It’s about accepting the crappy moments and embracing the very beautiful ones” (part. 8)

THE CATALYST ROLE OF THERAPY AND SOCIAL SUPPORT

3a. The importance to let others in

14 (73.68%)

“You can’t do it alone; that’s something you have to get out of your head because, unfortunately, it’s not something possible. You need the right support” (part. 3)

“Family helped, friends who were there for me […]. It’s about fully trusting the people around you who truly want to help you heal” (part. 6)

“The help of others, of loved ones, whether family, friends, or acquaintances, I think that in various contexts, if you’re lucky, you can find warmth, which is important to get through difficult moments” (part. 16)

3b. Psychological therapy: a tool for symptom management and self-discovery

14 (73.68%)

“Definitely therapy […]. But we worked on me […]. It’s really about healing the deep wounds” (part. 8)

“The psychotherapy journey,

in particular, because it helped me find the source, the initial reason. […] We started to also modify the coping mechanisms for my problems” (part. 15)

“The first moment I felt free to let out everything I had inside without fear, despite the questions I was asked or the process of delving into particularly painful aspects, which wasn’t always pleasant—quite the opposite—I realized that being asked uncomfortable questions is part of the process. And what happens afterward is gaining much greater self-awareness” (part. 16)

THE NEW SELF

4a. Increased appreciation for life

16 (84.21%)

“I took the wheel of my life because I only have this one” (part. 1).

“Discovering that there’s life beyond the disorder” (part. 6).

“After going through that difficult period, I realized that, yes, I needed to be seen and everything, but it wasn’t that I really wanted to die. That was definitely a confirmation” (part. 17).

4b. Meaningful social connections

14 (73.68%)

“I’m more aware in my relationships with others, which have obviously become more genuine” (part. 2)

“It’s improved, but not in the sense that we’re more attached; it’s a bit more balanced, we’ve found a healthy relationship” (part. 6)

“So, definitely, the relationships I have now are helping me a lot. It’s an experience that has allowed me to find deeper relationships and connections” (part. 7)

4c. Personal strength

12 (63.16%)

“Definitely, I’m more confident in myself now” (part. 8)

“It’s something that strengthens you a lot. For me, the fact that I noticed it on my own, that I went to therapy and came out of it, gives me incredible strength” (part. 10)

“If I set my mind to it, I can even help myself. I can do that kind of work” (part. 17)

4d. New possibilities

15 (78.95%)

“Before, during the period of illness, I had no future perspective. Everything was very focused on the present or small future actions, so it was a projection that could only go to the next day. Now, future perspectives have opened up in many ways” (part. 3)

“I realized I had healed when I started making plans for the future, saying, “Okay, tomorrow, okay, in a week, but where will I be in a year?” I began to put things in perspective—reaching tomorrow, starting to hope again, looking ahead” (part. 11)

“During the period of the eating disorder, I couldn’t see a future, so I would’ve been dead then, I couldn’t see any future at all. But now I have a clear goal in mind, I know what I want to do, and I see a future ahead of me” (part. 13)

4e. Letting go of control and perfectionism to embrace failures and uncertainties

15 (78,95%)

“Another thing that weighed heavily on me was accepting the fact that there was no longer that part of me that controlled things” (part. 4)

“You make mistakes, it’s important to accept the mistake, which doesn’t mean you’ve thrown everything away. On the contrary, you analyze the mistake, see what happened, the causes of the mistake, and move forward. These mistakes will become fewer and fewer. You really learn” (part. 10)

“Not having control over things… it was definitely something that, at the time, I didn’t like, but it helped me. I still put myself in the mindset that I don’t have to be able to do everything, to handle it, to patch it up. It’s okay to feel bad sometimes; it’s okay to need help” (part. 17)

4 f. Cultivating self-awareness and self-acceptance to live more authentically

10 (52.63%)

“But little by little, you accept yourself, you say, “This is how I am, what can I do?” (part. 4)

“It allowed me to heal the wounds little by little; to accept the things I don’t like, learn to embrace them, and change how I relate to those things” (part. 8)

“I like myself, I’m happy with who I am, and I think that everything I’ve gone through, the difficulties, the pain, has led me to become the person I am now. I also appreciate those parts of me that once may have been seen as flaws, but now I know they are very important aspects I’m proud of” (part. 16)