Overweight and obesity Phenomenology

Research Article Reviewed

Lyons, M.A. (1998). The phenomenon of compulsive overeating in a selected group of professional women. Journal of Advanced Nursing 27, 1158/1164. 7

Article Summary

• Introduction

Overweight and obesity is presently considered a healthcare related epidemic as it is known to advance the prevalence of other numerous ailments like diabetes and cardiovascular complications (Taylor, Curtis & Davis, 2010). As such, it is closely associated with contemporary lifestyles considered as unhealthy but societal members seem to be oblivious of the future consequences of such actions. In 1998, the Journal of Nursing published an article authored by Lyon M. A. the article titled The phenomenon of compulsive overeating in a selected group of professional women sought to offer insights into the rising incidences of binge eating or compulsive overeating among female professionals in the US (Lyons, 1998). Lyon’s research endeavor focused on female professionals in the south-central region of the US (1998). The author opted for a qualitative research methodology on which to base her work. Given the fact that little validated research data on the subject matter was lacking, the author sought through the work to verify the meaning of the term compulsive eating and its effects on the lives of professional women within the US.

• Assumptions

The core assumption of this article is that prior to its publishing, the American Psychiatric Association did not consider compulsive overeating as a valid diagnostic entity in its Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Lyons, 1998; American Psychiatric Association, 2013). The study therefore aimed at looking into means through which the phenomenon could be included in the APA DSM-IV manual or subsequent manuals in future.

• Participants/ Respondents

This particular research study only incorporated six professional women from a relatively petite metropolitan region in south-central US. All participants were Caucasian females aged between 25 and 55 years (Lyons, 1998). All were professional women in that they were either in employment or were previously employed in a professional capacity. Lyon (1998) recruited participants well known to her as well as those sourced from a neighboring self help group for weight watchers. All of the selected participants indicated that their food consumption was abnormal or could be associated with binge eating behaviors (Curtis & Davis, 2014). The sample size was indeed kept small in an effort to minimize incidences of redundancy or saturation in the data collections process. To ensure the research study adhered to ethical research guidelines, the participants were informed of the work’s purpose, confidentiality of identity and data collected as well as their right to opt to withdraw from the research process (Lyon, 1998). As such, all participants were required to duly sign a consent form.

• Measures and Instruments

The primary instrument of measure employed by Lyon was open ended interview questions which were tape recorded and subsequently converted into verbatim (1998). The interview questions were designed to disclose seven groupings considered as characterizing common participant life experiences associated with binge eating or compulsive eating disorders. The groupings associated with binge eating included: descriptions of most habitually consumed foods in the participant’s adulthood; childhood experiences; known incidences of observed lack of control; eating behaviors in the participant’s adult years; compensatory behaviors; reasons behind binge eating; and associated emotional consequences (Lyons, 1998). As such, the open ended questions were employed in an effort to enable participant’s present meaning of the responses in a clear manner. The other measure employed in the analytical part of the research process was the Giorgi method commonly employed in phenomenological qualitative research (Lyons, 1998). The Giorgi method informed the manner through which the data could be analyzed comprehensively. A number of techniques as suggested by Field and Morse were employed to limit possible threats to the project’s reliability and validity (Lyons, 1998). These included peer examination in the data analysis process, review of findings by participants and the application of descriptors with low inferences.

• Question and Hypothesis

The first hypothesis of this particular study was to ensure a concise meaning is assigned to what compulsive eating entails (Lyons, 1998). The second hypothesis was to use the research finding to enable for APA to recognize binge eating as descriptive of some form of mental disorder. The third and most significant hypothesis of the study was to gain insights into the life experiences of professional women with compulsive overeating behaviors (Lyons, 1998).

• Design and Procedure

The study employed the phenomenological research design referred to as the Giorgi method first postulated in 1979 (Lyons, 1998). It is important to point out that the research design used in the study was predominantly qualitative (Hussein, 2015). Given that very little research studies had been previously conducted relative with this particular phenomenon, it is only through a small sized sample size that the phenomenon could be looked into and assigned a meaning and related experiences to inform future research. The study relied on a distinctively small sample size aimed at limiting incidences where redundancies could serve to invalidate the collection and analysis of participant responses (Hussein, 2015).

The procedure employed in this study simply involved a careful selection of appropriate participants who in this case were women with a professional background or duty (Curtis & Davis, 2014). More so, the participants included individuals who confessed to exhibiting binge eating or compulsive eating behaviors (Lyons, 1998). All were duly required to fill in a consent form that could serve to validate the ethical aspects of the research process (Davis, 2013). Conversely, data collected from the participants was instantaneously recorded on tape and subsequently converted to verbatim. This allowed for the researcher to comprehensively assess responses from the participants in line with the grouping informed by the Giorgio method for phenomenological research (Hussein, 2015).

• Analysis

Data collected from the six participants, recorded and later converted into verbatim was analyzed via the Giorgi method (Lyons, 1998; Giorgi, 2012). As such, the binge eating phenomenon as the subject matter remained the central theme and allowed for the research to gain novel psychological insights associated with it relative to the participant’s life experiences. The study also employed guidelines postulated by Morse and Field in1985 to appraise the reliability as well as validity of the project (Lyon, 1998).

• Results, Discussion, Limitation, Conclusions and Summary of Themes

The results of the Lyon (1985) project through the application of the Giorgi method pointed that binge eating or compulsive eating is attributed psychological distress. For instance, some of the participants revealed troubled childhood experiences which they sought to evade through binge eating (Yates, 2013. Similarly, some of the study’s participants attributed the constant urge to consume large volumes of food to some negative experiences in their adulthood (Lyons, 1998). The emotional consequences associated with binge eating were described by the researcher upon examination of the results as having both physical and emotional outcomes. The physical outcomes were predominantly associated with overweight and obesity. The emotional consequences included shame, guilt, denial, blaming and rationalization.

The research study indicated that all the participants sought to engage in a variety of compensatory behaviors (Lyons, 1998). Commonly identified compensatory behaviors included dieting, exercising, committing to self help groups, confiding with close friends or relatives, and even seeking religious intervention to curb the vice. As such, some of the identified intervention strategies included the support of self help associations like weight watchers as well as education on proper lifestyle changes beginning from childhood and prosing throughout adulthood (Bryant-Waugh, 2000). Such intervention strategies were perceived as vital in ensuring modality was adhered to with respect to eating.

The conclusion section of this particular article noted that the outcome of the study was of great significance relative to nursing education (Lyons, 1998). As such, the article encourages on more research endeavors associated with binge eating. With regard to nursing practice, the author pointed out that as nurses have the ability and knowledge to detect and more so address eating disorders, the research findings would indeed present significant benefits to patients with binge eating behaviors (Lyons, 1998). The recurrent themes were well addressed via the Giorgi method (Giorgi, 2012). These themes included compensatory behaviors, overeating reasons, associated emotional consequences, loss of self control, eating behaviors during childhood and adulthood as well as commonly adopted prevention strategies.

2. Article Evaluation

2.1 Problem Statement and Significance

The author seeks to engage in a critical qualitative research study that appropriately gives due meaning to the phenomenon referred to as binge eating or compulsive overeating relative to the lives of adult female professionals in the US (Curtis & Davis, 2014; Caldwell, Henshaw & Taylor, 2005). More so, Lyon (1998) sought to use the research study as a means through which more information concerning the subject matter could be made available and by extension encourage for greater research. On the same note, the article points out that the accredited APA DSM-IV manual available at the time of the research failed to address the issue as a diagnostic tool for psychiatric evaluation. As such, the author aimed to use the project to seek ways through which APA could in its future DSM-IV manuals associate binge eating or compulsive overeating as a tool for ascertaining psychiatric disorders (Lyons, 1998). On the same note, the author sought to further empower educators and practitioners in the nursing profession to pro-actively develop intervention strategies among patients with attributes associated with compulsive overeating behaviors. As such, the article seeks to be of great significance to the nursing profession towards a greater understanding of why overweight and obesity has come to be perceived as an epidemic affecting modern societies. The core aim of the study is therefore to offer a compressive meaning to the phenomenon referred to as binge eating or compulsive overeating and by extension, the manner with which it impacts on individuals with such behavior.

2.2 Review of Literature

The author provides that there was limited information concerning binge eating or compulsive overeating. Lyon (1998) however, does provide a comprehensive literature review associated with known eating disorders among the youth and adolescent populations in the US. The article addresses eating disorders like bulimia and anorexia pointing out that much research has been carried out on them (Lyons, 1998). With regard to binge eating or compulsive overeating, the literature review provides that it has only been investigated relative to its association with obesity.

The article does make a concerted attempt to discuss all elements under investigation in the literature review section (Caldwell, Henshaw & Taylor, 2005). For instance, it points out that the lack of a clear description of the life experiences associated with binge eating or compulsive overeating fuels the author’s endeavor to proceed with the project. As such, being a phenomenon at the time of the project commencement, the literature review seeks to offer greater insights as to what the term binge actually entails (Curtis & Davis, 2014). The author positively relates people with obesity rates that can be termed moderate to severe by qualified nursing professionals as those most likely to engage in binge eating or compulsive overeating (Lyons, 1998). The study indeed offers good working definitions associated with eating disorders and goes further to offer insights concerning some of the theories that can be associated with compelling individuals to engage in binge eating. The issue of binge eating as psychological, culturally reinforced trait, psychiatric disorders as well as affective and cognitive responses is well described in this article.

2.3 Underlying Theory

Lyon (1998) employed an underlying theory in this particular work that revolved about binge eating or compulsive overeating behaviors may present signs of psychological distress or psychiatric disorders in individuals. This is founded on the literature research used in the article which points out that individuals engaging in binge eating or compulsive overeating may be suffering emotionally either as a result of a childhood event or event occurring during adulthood (Carlier, Marshe, Cmorejova, Davis & MÃller, 2015; Wardle, 1987).

Previous research studies on the phenomenon under investigation have been meager and thus the great need to establish a comprehensive meaning for binge eating and overeating. As such, the author attempts to fill the gaps in research on the subject matter creating new avenues for further and future research (Caldwell, Henshaw & Taylor, 2005). On the same note, the author envisages that greater research on the phenomenon will be of significant benefit to nursing practitioners and educators. The rationale of the study is primarily concerned with offering a working description of the phenomenon and thus furthering research on how the lives of people indulging in binge eating are affected.

2.4 Hypotheses

The hypotheses presented in this particular article are not well labeled or stated and as such, only an engaged reader can be able to discern them with ease (Caldwell, Henshaw & Taylor, 2005). However, the hypotheses are testable as shown through the application of the Giorgi method employed in phenomenological investigations (Giorgi, 2012).

2.3 Participants/Respondents

The participants were all female professionals working in a region in south-central US. The women from a metropolitan area were aged between 25 and 55 years (Lyons, 1998). To qualify for the selection each participant had to have either worked as a professional either as an educator, marketer, business analyst or nurse. The sampling method employed involved a markedly small pool of participants. The participants were sampled from individuals who openly confided that they confess to engage in binge eating or compulsive eating behaviors (Hawkins & Clement, 1984). The participants were either individuals known to the author or those associated with a self help group aimed at enabling them work away from the phenomenon.

The author provides that the small sample size was necessary to eliminate redundancies relative to data collection subject to qualitative research (Lyons, 1998; Caldwell, Henshaw & Taylor, 2005). As such, this is a qualified perspective aimed at offering a workable description to the phenomenon in question.

2.4 Measures and Instruments

The instruments and measurements were well described and by extension, explicitly stated (Caldwell, Henshaw & Taylor, 2005). For instance, the author categorically provided that the qualitative research study would look to open ended questions to get responses which could be analyzed using the Giorgi method (Giorgi, 2012). The article provides that the Giorgi method was the most ideal instrument for analysis in an effort to gain meaning to the term binge eating and compulsive overeating (Lyons, 1998). In an effort to ensure validity as well as reliability, the measures employed included the Field and Morse technique (Creswell, 2013). It is important to point out that the Field and Morse technique was not well stated in the paper.

2.5 Design and Procedure

The article provides an above average description of the design employed in the project (Caldwell, Henshaw & Taylor, 2005). However, the manner with which the Giorgio method was described and implemented in the data analysis section followed a step by step procedure such that, there was a good correlation between the hypothesis and the research design and procedure (Lyons, 1998).

In the data collection section of the article, one of the weaknesses noted is that the questions employed in the open ended interviews were not listed in the article (Caldwell, Henshaw & Taylor, 2005). On the same note, collecting data via voice recording not only enabled the researcher to capture change in tone from the participants at various instances during the interview (Lyons, 1998). This implies that the researcher was able to gain more knowledge on the phenomenon in a more comprehensive manner.

2.6 Results and Analysis

The audit-ability of the article can be challenged by the fact that the open ended questionnaire remains unavailable (Caldwell, Henshaw & Taylor, 2005). However, the procedures and design elements can be described as aptly testing the hypotheses stated therein (Lyons, 1998). The finding for each mentioned condition are analyzed independently making it for the readers to easily and understand each of the groupings under investigation.

Being a qualitative research endeavor there were no statistical results and differences present in the article (Caldwell, Henshaw & Taylor, 2005). The research study was purely of a descriptive nature employed only through textual avenues. It is however important to point out that the article’s discussion section provides a very clear association between the results and the hypothesis under observation. As such, the interpretations of the findings clearly conform and subsequent interpretations of the results are indeed consistent. The conclusions offered in the article are not only appropriate and practical but also evidence based. For instance, the article provides that results from the project could play a fundamental role in enabling nursing educators as well as practitioners be better equipped with the knowledge to use evidence from the research endeavor to offer clinical interventions to subjects with compulsive overeating behaviors.

2.7 Conclusions and Recommendations

The article provides recommendation for future research endeavors with regard to the binge eating phenomenon and how it affects the lives of populations within the US. The recommendations offered are explicitly detailed in the conclusions section of the article. They are not only appropriate and practical but also evidence based. For instance, the article provides that results from the project could play a fundamental role in enabling nursing educators as well as practitioners be better equipped with the knowledge to use evidence from the research endeavor to offer clinical interventions to subjects with compulsive overeating behaviors. Concerning recommendations, the author encourages other nursing researchers to work towards establishing how binge eating affects the lives of individuals from other ethnic backgrounds, genders and socioeconomic groups. The article, however fails to outline any limitations associated with the study.

3. Personal Analytics Statement

I have found this particular article to be highly insightful into how the Giorgi method is employed in phenomenological research. As such, the author is indeed a credible researcher who dares to venture into previously un-researched scientific issue. The research work by Lyon (1998) is a worthy example of pioneering research.

The article is well prepared with good flow and information on a community health issue that is presently affecting numerous people, both children and adults across the US. Binge eating or compulsive eating disorders undoubtedly contribute to the prevalence of ever increasing obesity rates in the US. The author has taken the initiative to suggest that as much as the nursing fraternity is best suited to alleviate the challenges faced by such individuals, support groups play an important role as an intervention strategy. I deem it acceptable that the author opted to opt for a small sample of professional Caucasian women as participants. This is founded on the fact that this particular demographic set has the socio-economic capacity to indulge in binge eating or compulsive overeating behaviors than other demographic groupings. It is therefore my opinion that this article is an excellent example of the significance of qualitative research towards advocating for further research endeavors in future for a relatively new phenomenon.

References

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Lyons, M. A. (1998). The phenomenon of compulsive overeating in a selected group of professional women. Journal of Advanced Nursing, 27(6), 1158-1164.

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Yates, A. (2013). Compulsive exercise and the eating disorders: Toward an integrated theory of activity. London, UK: Routledge.