The study focused on Australia and New Zealand, contexts that the authors note are underrepresented in a literature dominated by American data. Participants included 21 people with a Christian background and lived experience of an eating disorder, and 16 eating disorder healthcare providers, with six individuals belonging to both groups. Recruitment proceeded through media announcements, professional organisations and personal contacts. All participants first completed an initial survey, from which 31 were purposively selected to ensure demographic diversity and invited into semi-structured interviews averaging 73 minutes in length. The transcripts were then subjected to thematic analysis, a qualitative method that identifies recurring patterns of meaning across accounts rather than testing predetermined hypotheses. The result is not a measure of how often faith matters in eating disorders, but a rich map of how, when and why it does, and why clinicians so often avoid the topic altogether.

Three major themes emerged from the analysis, and the first was labelled by the researchers with an evocative phrase: relevance, or ‘an elephant in the room’. For many, though not all, participants, religion and spirituality were deeply intertwined with personal identity, worldview, and the risk and recovery dynamics of their eating disorder. Some patients described faith as a source of guilt or perfectionism that fed disordered eating; others described it as a wellspring of hope, meaning and unconditional worth that sustained them through treatment. The study’s central contention is that when clinicians overlook this dimension entirely, they may miss opportunities to personalise care and may even create miscommunication, for example by dismissing values that a patient regards as central to who they are. Importantly, the authors are careful to note that not every participant considered religion relevant to their illness or care, a nuance that guards against any suggestion that faith should be imposed on treatment conversations.

The second theme, reservations, captured under the phrase ‘wearing gloves’, describes the barriers that keep religion and spirituality out of clinical dialogue. These barriers operated at multiple levels. Patients and providers alike reported uncertainty about whether such topics were appropriate to raise at all, and if so, how to raise them without crossing professional or personal boundaries. Some clinicians worried about lacking the training or language to discuss faith competently, or feared that raising religion might be experienced as proselytising. Systemic factors compounded the hesitation: time-pressured consultations, treatment frameworks that do not include spiritual assessment, and institutional cultures that treat faith as private rather than clinical territory. The metaphor of wearing gloves captures a defensive posture, a handling of a sensitive subject at arm’s length that protects the clinician but may leave the patient’s actual struggles unexplored.

The third theme, responses, described as ‘working with’ faith, documented the occasions when religion and spirituality did find their way into care. Participants described experiences in which clinicians explored a patient’s religious and spiritual struggles and supports, and in some cases integrated explicitly Christian resources into treatment. These could include conversations about guilt, forgiveness and body image framed within a patient’s own theological commitments, engagement with faith communities as recovery supports, or collaboration with chaplains and spiritually integrated psychotherapists. Accounts of such integration were mixed, with participants reporting both helpful and unhelpful experiences, but the study suggests that when done respectfully and at the patient’s initiative, attention to faith could strengthen therapeutic alliance and address suffering that standard protocols did not reach.

The technical backdrop to these findings is a growing body of evidence that the authors situate their work within. Emerging research indicates that many patients would like healthcare providers to enquire about their religious and spiritual beliefs, and that spiritually integrated psychotherapies may be as effective as traditional therapies for a range of mental health conditions. Eating disorder care currently leans heavily on structured modalities such as cognitive behavioural therapy and dialectical behaviour therapy, which are powerful but not universally effective, and which rarely include formal space for spiritual concerns. The study’s abbreviations list, spanning anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder and other specified feeding or eating disorders, underscores the diagnostic breadth across which this gap may matter. The authors argue that for a subset of patients, faith is not an optional extra but a load-bearing structure of the self, and that treatment which ignores it is, by definition, less individualised than it could be.

On the strength of their findings, the researchers propose a clinical framework designed to support healthcare providers in considering religion and spirituality, and in some cases incorporating Christian resources, in eating disorder care. While the published version details the framework’s steps, its logic follows directly from the three themes: first, establish relevance by asking open, non-presumptive questions about whether faith matters to the patient; second, address reservations by normalising the conversation, clarifying consent and boundaries, and acknowledging the clinician’s own uncertainty; and third, where appropriate, work with the patient’s faith, drawing on their own religious supports and, where requested and suitable, Christian resources. The framework is explicitly patient-led, distinguishing respectful exploration from religious imposition, and it is intended to be usable by general practitioners, psychologists, dietitians and other members of multidisciplinary eating disorder teams rather than only by chaplains or specialist pastoral carers.

The study’s limitations and scope deserve emphasis. It examined Christian religion and spirituality specifically, in Australian and New Zealand settings, and its 31 interviewees were recruited partly through personal and professional networks, so the findings are exploratory rather than representative. Qualitative thematic analysis illuminates mechanisms and meanings, not prevalence, and the authors do not claim that faith is relevant to most patients with eating disorders. Nor do they claim that religious involvement is uniformly protective; the accounts collected include ways in which religious contexts can heighten struggle, for instance through perfectionism, shame or unhelpful teachings about the body. What the study does establish is that for a meaningful subset of patients, the intersection is clinically significant in both directions, and that the current silence around it is a choice of the system rather than a reflection of patients’ lived reality.

The broader significance of the work lies in its challenge to whole-person care. Eating disorders devastate health through medical, psychological and social pathways, and treatment guidelines increasingly call for individualised, multidisciplinary approaches. This study adds a dimension to that agenda: if identity, meaning and worldview shape both illness and recovery, then a healthcare system that never asks about them is operating with an incomplete map. The authors suggest that acknowledging and exploring individual religious and spiritual perspectives may enhance care for some patients, and their framework offers a concrete starting point for clinicians who have lacked both permission and method. As eating disorder services grapple with demand that outstrips capacity and outcomes that remain stubbornly poor, the study’s message is that some of the missing leverage may lie in conversations that medicine has been too cautious to begin, conducted with the gloves off, at the patient’s own pace, and on the patient’s own terms.

Subject of Research: The role of Christian religion and spirituality in eating disorder healthcare

Article Title: A missing dimension? Christian religion, spirituality and eating disorder healthcare: a qualitative study

Article References: Thomas, H., O’Callaghan, C., Best, M., Bräutigam, M., Kimber, T., Wade, T., & Sturman, N. (2026). A missing dimension? Christian religion, spirituality and eating disorder healthcare: a qualitative study. Journal of Eating Disorders. https://doi.org/10.1186/s40337-026-01770-z

Image Credits: AI Generated

DOI: 10.1186/s40337-026-01770-z

Keywords: eating disorders, Christianity, religion, spirituality, qualitative research, whole-person care, spiritually integrated psychotherapy, anorexia nervosa, healthcare providers, patient-centred care, missing, dimension