"It Didn't Feel Like They Cared": Exploring Factors That Influence Privacy and Disclosure in Eating Disorders and Disordered Eating (DEEDs)

Background Disordered eating (DE) affects millions of individuals each day as they are exposed to diet culture, normalization of restricting foods, and public perception of a "healthy" body and diet. Persistent DE behaviors may progress in severity and frequency, leading to harmful behaviors that result in physical and psychological health outcomes, ultimately meeting the diagnostic criteria for an eating disorder (ED). The purpose of this study was to identify what factors influence disordered eating and eating disorders (DEED), why individuals do not disclose their experiences, and what could have been done to help them with their DEED. Methods Using the Communication Privacy Management theory to develop questions, qualitative semi-structured interviews were conducted with 15 participants. A thematic analysis was conducted from interview transcripts to develop overarching themes. Results Five key themes emerged from participant interviews: family influence and comments, social media influence, healthcare influence, justification factors, and comorbidities. These themes reflect influences on participants developing DEEDs and barriers to getting help such as stigma associated with mental health issues and healthcare providers' unwillingness to discuss their DEED. Many participants also noted that family influences, particularly mothers, were a contributing factor to their DEED as well as playing sports and social media like Tumblr or "What I eat in a day" videos on TikTok. Conclusion These findings highlight the complex social, cultural, and structural factors that shape privacy management and the development and disclosure of DEED. Public health professionals can use these results to help bridge the gap between education, policy reform, and accessible healthcare to address the often-overlooked public health issues of DEED.