The relationship between shame, eating disorders and disclosure in treatment

Background. This study considered shame in 68 women who had received treatment for eating disorders (EDs) compared to 72 non-clinical controls, and shame in relation to disclosure in treatment. Method. All participants completed questionnaires on ED and depressive symptoms, and bodily, behavioural and characterological shame and shame around eating. ED women also answered questions on disclosure in treatment. Results. The ED group scored significantly higher than controls on all shame areas when depression was controlled. ED women who were currently symptomatic and those who had recovered scored higher than controls on bodily and characterological shame and shame around eating. Non-disclosure in treatment was reported by 42% of the ED group and was associated with higher shame in all areas except bodily shame. Conclusions. The study is the first to show a relationship between shame and ED in a clinical sample. It supports existing evidence regarding the importance of bodily shame in women with EDs, and extends the literature in terms of the importance of other shame aspects for ED symptomatology and disclosure. Implications for treatment are discussed.