Inflammatory Bowel Disease and Unhelpful Eating Behaviours
Research type
Research Study
Full title
A Grounded Theory of the Interplay between Inflammatory Bowel Disease (IBD) and Unhelpful Eating Behaviours
IRAS ID
307597
Contact name
Emma Darrington
Contact email
Sponsor organisation
Canterbury Christ Church University
Clinicaltrials.gov Identifier
n/a, n/a
Duration of Study in the UK
1 years, 1 months, 3 days
Research summary
Research Summary
The project aims to qualitatively explore the prevalence of problematic eating behaviours in people living with inflammatory bowel disease, to identify drivers for these behaviours from the patient's perspective. Psychological theory will be developed around this.
Gastro psychology is a relatively new area in clinical services, and the project aims to contribute to psychological perspectives on how to understand and support people with IBD who may be developing maladaptive eating behaviours.
Between 15-20 participants of adult age will be recruited by advertising the study in clinics within Guys and St Thomas' gastroenterology department. (See A13 for full eligibilty criteria). These people will identify as having IBD and to experiencing eating behaviours which they recognise as being in some way problematic for them.
Following provision of informed consent, completion of a screening questionnaire and subsequent participation in a 90 minute online interview with the researcher will complete their participation.
As is usual practice in grounded theory methodology, interview recordings will be transcribed and analysed by the chief investigator concurrently to conducting interviews. As themes arise from the data, these may inform minor alterations to sampling and/or questions asked in subsequent interviews, as is true to grounded theory methodology. However, these changes will remain within the eligibility criteria stated here and within the broad areas of questionning outlined in the interview schedule (see appendices).
Upon completion of interviewing and analysis findings will be written up to form a final research report, which will be submitted as a doctoral dissertation for clinical psychology training.
Summary of results
Background: The prevalence of disordered eating (as opposed to diagnosed eating disorders) amongst IBD populations poses implications for systemic physical health outcomes and disease management. Statistics suggest a prevalence of anxiety and depression in development of disordered eating in IBD, and psychological theory has implicated identity challenges in chronic illness in the development of disordered eating. However, there exists little research exploring motivations and function in the development of such eating behaviours, and previous studies have highlighted the need to explore potentially modifiable psychological aspects of the interplay between IBD and disordered eating.
Aims: The study aimed to explore the interplay between IBD and disordered eating by addressing the following research questions:
a. How do participants experience the relationship between their IBD and their eating patterns?
b. How do participants with IBD view their eating patterns, including helpful and unhelpful aspects?
c. How do participants experience any effects of their eating patterns on their lives and wellbeing?
d. What is the interplay between participants eating behaviours and how they view themselves?
Methodology: Twelve participants who self-identified as having an IBD diagnosis and experiencing unhelpful eating approaches were recruited from within an NHS Trust and also via social media. A modified version of social constructivist grounded theory methodology was utilised in qualitative exploration of the topic through semi-structured interview.
Results: The emergent conceptual model indicated that people with IBD experience a process of control navigation in their eating experiences. This process is characterised by movement between a sense of loss of control resulting from IBD related eating challenges, and reclaiming control via employment of responsive eating strategies. Each of these eating strategies carried relative pros and cons, and as such brought unhelpful elements to participants lives on occasion. The process of control navigation occurred within the wider contexts of shifting identity and eating as a social practice.
Conclusions: The conceptual model presented in the current study extends existing literature, and furthermore suggests the presence of potentially modifiable psychological and behavioural aspects in the relationship between IBD and disordered eating behaviours. Suggestions are made in terms of clinical and research implications, and study limitations noted.Has the registry been updated to include summary results?: No
If yes - please enter the URL to summary results:
If no – why not?: not on a register
Did you follow your dissemination plan submitted in the IRAS application form (Q A51)?: Pending
If yes, describe or provide URLs to disseminated materials:
If pending, date when dissemination is expected: 01/05/2024
If no, explain why you didn't follow it:
Have participants been informed of the results of the study?: Yes
If yes, describe and/or provide URLs to materials shared and how they were shared: Study summary was emailed to all participants upon completion of the study as previously agreed. See below:-A Grounded Theory of the Interplay between Inflammatory Bowel Disease (IBD) and Unhelpful Eating Behaviours: Study Summary Dear Participant, Thank you again for your valued participation in the above research study, which is now complete. As expected, I am today providing a summary of the study findings for your interest.
This study interviewed twelve participants about their experiences of unhelpful eating in the context of living with IBD. The following main themes emerged from the data:
• A sense of loss of control arising from the changes to people’s ways of eating imposed by IBD. This was discussed in terms of its impact across a range of aspects of people’s daily lives, including ability to work, travel, socialise, date and carry out leisure pursuits.
• A sense of reclaiming of control via implementation of new eating strategies. Restricted eating (skipping meals, avoiding food groups, banking all nutritional intake for the evening meal etc) was a particularly common strategy featured. There was a sense that strategies carried their own pros and cons that needed to be weighed up in considering whether to stick with or discard the strategy, and whether participants regarded them as helpful or unhelpful.
• A sense of shifting identity since living and eating with IBD. People discussed how their sense of self had changed since experiencing IBD related eating changes. This was discussed in relation to self-concept, occupational identities, illness identities (and “disablement”), protective identities and also positive aspects of self-development.
• Eating around other people (“Eating as a social practice”) was a theme present in all other aspects discussed, which seemed to have a big impact on participants experiences.
Following analysis of interviews, a diagrammatic model (fig X) was proposed to represent the experiences described by participants. This included the main themes outlined above, as well as additional subcategories.
As a result of the findings recommendations for future research are made within the report. Importantly, suggestions for clinical service developments are also proposed, which focus on improving integration of and increasing provision of support for psychological aspects of eating with IBD, as well as addressing the shortfalls in practical, dietary advice and support in NHS IBD services.
The full (anonymised) study report including detailed explanation of the model and associated recommendations will be made publicly available at Canterbury Christ University’s online research repository at some point from spring 2024 onwards. If you wish, you will be able to view this by visiting: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu2790089.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DXv3JSvJ-2B3M71ppf7N9agbU6ZZfm6kI0eADTe8RyRDMqHPT91UD9nFyrrCGLckHbngktHcO5Ht4jLRI8Q4oNw4Uy0JwQldYo0PcFXm7qu5ACLn0b-2FbL4XQTPXzobqy3X-2BgDIo2CZluINI2JkFCJ7xZg-3D-3DqN6x_E1aO2-2BZlVOSJJV-2FajQqskegTd6IRomHYTi-2Fbt8SH3YLEy8Z8xCCx1hG4xMlJkWyfKR91i-2FNNGzhY8b-2BlVyWGofDhK4fcZVpuewO-2Fd9u2ccpMIzXGRS2ve8zkE-2FHjRvbZxnaPdHS5BqRf7NuCfoqRLuovIL49RiwWfPjFLOrx8NQ2GJsts2OEuvOBpE7bn514cEUPQaAA-2BuzjB6CK-2BcSxPw-3D-3D&data=05%7C01%7Cstanmore.rec%40hra.nhs.uk%7C7bd015e4877b41e824ab08dbf57af96a%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638373680769906312%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=h2yOJ76F5WPrOuuTno0zpAFAH3oJYRNqXmyS%2F1%2Be9Qg%3D&reserved=0If pending, date when feedback is expected:
If no, explain why they haven't:
Have you enabled sharing of study data with others?: No
If yes, describe or provide URLs to how it has been shared:
If no, explain why sharing hasn't been enabled: Full datasets were not shared, to protect participant anonymity, given that data was qualitative.However, the full study report and findings will be made publicly available via the university research repository one the University uploads it next year, and we also aim to publish in a medical journal.
Have you enabled sharing of tissue samples and associated data with others?: No
If yes, describe or provide a URL:
If no, explain why: n/aREC name
London - Stanmore Research Ethics Committee
REC reference
22/LO/0401
Date of REC Opinion
29 Jul 2022
REC opinion
Further Information Favourable Opinion