Abstract
BACKGROUND: Eating disorders are complex conditions, with aetiological factors and impacts across multiple domains. Religion and spirituality are areas of individual diversity that may represent a source of strength or struggle for those experiencing mental illness. However, there is limited and mixed evidence regarding the influence of religion and spirituality in eating disorders, and this is not well integrated within healthcare. AIM: To explore the interplay between Christian religion and spirituality and eating disorder development, experience and recovery, from the perspectives of Australians and New Zealanders with lived experience. METHODS: Qualitative methodology using reflexive thematic analysis and selected grounded theory techniques. Data is based on semi-structured interviews with 23 participants who had a Christian background and self-identified as having partially or fully recovered from an eating disorder. Trustworthiness was supported by investigator reflexivity and triangulation. RESULTS: Analysis highlighted an overarching experience of eating disorders and Christian spirituality as two non-linear, interwoven journeys. Three themes and seven subthemes elucidated this dynamic. Themes included (1) "Not enough"-A sense of not being "good enough" and/or "safe enough" in an eating disorder could be exacerbated or alleviated by Christian religion and spirituality; (2) "Wrestling"-Eating disorders often triggered religious and spiritual, which could change spiritual trajectories; and (3) "Help to heal"-Some participants found comfort, hope, and a foundation for eating disorder recovery in their Christian religion and spirituality, often experienced as embracing God's grace (that is, God's unmerited love and favour). CONCLUSION: This study highlights previously under-recognised religious and spiritual influences upon protective and predisposing factors for eating disorders, including perfectionism, attachment and identity formation. Results could inform more personalised approaches to caring for Christians experiencing eating disorders. Findings also suggest a need for similar research with other religious and spiritual traditions.