The Vicious Cycle of Loneliness: Social Functioning in Eating Disorders – A Qualitative Study

Background Eating disorders are serious psychiatric conditions with increasing prevalence, typically characterized by chronicity and substantial impairment in physical and psychosocial functioning. This study explores the role of social functioning in eating disorders, aiming to identify the roots of its impairment, examine its influence on illness progression, and understand how loneliness perpetuates the disorder, while also investigating the role of social support in recovery. Methods Using an interpretative phenomenological approach, semi-structured interviews were conducted with eight participants diagnosed with Anorexia Nervosa, Bulimia Nervosa, or Binge Eating Disorder. Interviews explored personal experiences of social functioning, loneliness, and recovery. Data were analyzed to generate themes that captured both shared and individual experiences. Results Four superordinate themes were identified: Roots of Impaired Social Functioning – Adverse childhood experiences, including neglect, abuse, early social isolation, and a pervasive sense of being a “lonely child,” shaped participants’ early interpersonal patterns. The Worsening Spiral: Impaired Social Functioning and Illness Progression – A perceived lack of family care and the tendency to interact from behind a “social mask” deepened interpersonal disconnection and exacerbated illness severity. The Self-Perpetuating Cycle of Loneliness and Eating Disorders – Loneliness emerged as a catalyst for symptom escalation, while deliberate withdrawal and self-imposed isolation formed a “closing circle” that reinforced the disorder. Reconnecting and Recovering: The Healing Role of Social Support – Improvements in family, peer, or therapeutic relationships were linked to symptom reduction, highlighting the centrality of sustained social support in the recovery process. Conclusions The findings illustrate that impaired social functioning often originates in adverse early experiences and contributes to the development and maintenance of eating disorders. Loneliness plays a pivotal role in intensifying symptoms, while self-imposed isolation further entrenches the disorder. Conversely, meaningful social connections act as a protective factor, facilitating recovery. These results underscore the importance of integrating social functioning enhancement and sustained support networks into eating disorder treatment and prevention strategies.