1. health and fitness
2. disorders

“It just seems so hard”
Growing up while your sibling has an eating disorder: A thematic
analysis
OBJECTIVES
This study looked at what it is like to have a sister with Anorexia Nervosa. Siblings have been
presented as ‘forgotten victims’ of eating disorders and have featured very little in the research
literature. We know that caring for someone with an eating disorder can impact negatively on
physical and mental health. Any similar impact on adolescent siblings would come at a time of their
own developing identity and warrants further investigation.
METHOD
8 Adolescents who had sisters diagnosed with Anorexia Nervosa were interviewed over the
telephone. They were asked about how things had been for them since their sisters’ diagnosis. The
topics discussed and were determined by what they thought was relevant. The interviews were
analysed using thematic analysis.
FINDINGS
Whilst everyone’s experience is different, there were some common themes. Brothers and sisters
talked about how the eating disorder was ‘everywhere’; affecting all areas of their lives. Many noticed
that it changed their families and that, at times, their parents were struggling to cope. These changes
included; more arguments at home, feeling as though their sister had completely changed since she
developed the eating disorder and sometimes feeling closer to parents, but sometimes feeling further
away.
What’s going on?
Every brother and sister, at one time or another, took time to watch what was going on at home and
try to understand it. Many siblings tried to find out more about eating disorders, sometimes through
‘sibling days’ at hospital, talking to their parents or reading books, but some felt that their parents kept
them in the dark about it all. Whatever their situation, every brother and sister in this study had an
idea of what an eating disorder was, although it was sometimes really difficult to understand why their
sister acted that way. Each brother and sister saw the eating disorder as separate from their sister,
for example not blaming her for her behaviour, “It wasn’t her… it was her illness.”
Who am I?
With everything going on at home, there were times when, for some siblings, it became a bit
confusing as to who they were and who they were supposed to be. Some siblings seemed to get
really involved with trying to help their sister and almost became like parents whereas others seemed
to prefer to keep out of it as much as possible. Sometimes brothers and sisters had a choice about
whether to get involved or not, but some they felt that they just had to. When they did get involved it
was tricky to know what the ‘right’ thing to do was and it felt awful when they got it ‘wrong’.
Sometimes to avoid getting it ‘wrong’ brothers and sisters felt that they had to pretend that they
weren’t feeling particular things e.g. angry. Some siblings also felt that they needed to pretend to
their friends that everything was actually alright at home because they worried that their friends might
‘judge’ them or treat them differently if they knew. In amongst all of this, siblings sometimes felt a bit
forgotten by their parents, as though they were less important than their sister who had the eating
disorder.
How will I cope?
Every sibling that I interviewed had found a way to cope with the eating disorder. Many found that the
best way to do this was to try to forget all about it (although this was not always possible). Sometimes
brothers and sisters told themselves that everything was going to be alright or that they would just
have to get used to it. Sometimes people would not let siblings forget about the eating disorder and
made them talk about it e.g. going to family therapy. It was really hard for siblings because
sometimes they wanted to know what was going on and at other times they didn’t. They also worried
about talking to their parents about how hard it was because they didn’t want to make things even
harder for their parents. Some of the most helpful times where when siblings got the chance to meet
with other brothers and sisters. It was at these meetings that they found out that they weren’t the only
ones feelings confused, scared, angry… Teachers and friends were often really supportive and it was
best when they just knew about everything at home, but didn’t force siblings to talk about it all when
they didn’t want to.
CONCLUSION
Parents and professionals are in a strong position to help siblings by offering a variety of supportive
options including space to talk, psychoeducation, reassurance, sibling support groups and by
challenging stigma.
Thank you very much to everyone who has supported this project and, in particular, to those who
agreed to be interviewed.
If you would like any more information then please do not hesitate to contact me.
Jenny Grunwald
Trainee Counselling Psychologist
University of Surrey
[email protected] (contact address Until December 2014)