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. 2022 Sep 6;10(1):134.
doi: 10.1186/s40337-022-00655-1.

Silent witnesses: the experience of having a sibling with anorexia nervosa

Suzanne Hutchison  1 , Jennifer House  1 , Beth McDermott  2 , Mima Simic  2 , Julian Baudinet  3   4 , Ivan Eisler  1   2
Affiliations

Silent witnesses: the experience of having a sibling with anorexia nervosa

Suzanne Hutchison et al. J Eat Disord. .

Abstract

Background: This study explored the experience of having a sibling with anorexia nervosa and the sibling perspectives on service provision.

Method: Four focus groups were conducted with 14 siblings (8 female, 6 male, age 11-19 years) of adolescents with anorexia nervosa or related restrictive eating disorders. Group discussions were transcribed and analysed using thematic analysis.

Results: Four themes and eight sub-themes were generated. These illustrated siblings feel greatly affected by the way the family needs to change to support someone with anorexia nervosa. Feelings of ambivalence and acceptance were also evident. They described silencing their own emotions and needs so as not to trouble others, and distancing themselves from their families in order to cope. Some female (but no male) siblings identified an impact on their own perceptions of eating and body image. Siblings generally felt that services had not attended to their needs, and that they had not been appropriately included in treatment.

Conclusions: Data from this study suggest the sibling experience needs to be more carefully considered and included in treatment. This may include a more explicit invitation to sessions and a more active discussion about their own needs and useful involvement in treatment sessions. Findings point to ways siblings may be better supported, such as peer support groups.

Keywords: Anorexia nervosa; Family based treatment; Family therapy; Maudsley family therapy; Sibling.

Plain language summary

This study investigated the experience of having a sibling with anorexia nervosa, and the sibling perspectives on the treatment they get. Four focus groups were held with siblings (11–19 year-olds) of adolescents with anorexia nervosa. Group discussions were written down word-for-word and analysed using thematic analysis. Four themes and eight sub-themes were identified. These illustrated siblings feel very affected by the way the family needs to change to support someone with anorexia nervosa. Feelings of ambivalence and acceptance were also evident. Siblings said they silenced their own emotions and needs so as not to trouble others, and distanced themselves from their families in order to cope. Siblings generally felt that services had not attended to their needs, and that they had not been appropriately included in treatment. Findings from this study point to ways siblings may be better supported, such as peer support groups.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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