New hope for eating disorder recovery through early intervention
Findings and research from Consultant Psychiatrist Professor Ulrike Schmidt suggest that full recovery from an eating disorder can be achieved at any stage of the illness.
For many people living with an eating disorder, the possibility of recovery can feel uncertain but research from Professor Ulrike Schmidt, Consultant Psychiatrist at our eating disorders unit finds that recovery is achievable, particularly when the condition is recognised and treated early.
Why early intervention can make a difference
Professor Schmidt led the development of FREED (First Episode Rapid Early Intervention for Eating Disorders), an early intervention service that supports 16–25-year-olds who have experienced an eating disorder for three years or less. The programme has since been rolled out nationally across England and adopted in Canada and Australia.
Research has shown that early intervention can:
- Increase the likelihood of recovery
- Reduce the need for intensive hospital treatment
- Improve the experiences of people living with eating disorders and their families
“Early intervention is at the heart of everything we do and needs to continue to be,” said Professor Schmidt. “Thinking about the problem from the beginning helps prevent people from becoming more unwell. By identifying eating disorder beliefs and behaviours early on, we can help people understand why they think this way and develop effective strategies to challenge those thoughts and behaviours.”
More than a weight disorder
Eating disorders can take many forms and develop for a variety of reasons. To ensure they are identified and treated early, it is important to recognise that eating disorders can affect anyone, regardless of their shape, size, age, gender or ethnicity.
An early intervention research programme called EDIFY works with young people who have lived experience of eating disorders to demonstrate just how nuanced these conditions can be. EDIFY brings together experts from the arts and humanities, engineering and neuroscience, psychiatry and psychology to develop a broader and more inclusive narrative around eating disorders. This approach looks beyond anorexia to consider other eating disorders, as well as the experiences of people at a higher body weight and those from minoritised communities.
Treatment should not focus solely on weight restoration or changes in eating habits. Recovery also involves addressing the thoughts, emotions and behaviours that shape a person’s beliefs about themselves, food and their body.
New treatments bring new hope
One area in which EDIFY is driving innovation is through research into the relationship between health wearables and eating disorders.
By following more than 800 young people over the course of a year using smartphones and wearable devices, researchers are for the first time able to examine psychological and physiological recovery patterns and behavioural trends. This data is promising for the development of Just-in-Time Interventions, which are brief online interventions that may help people who are struggling with symptoms in the moment to reduce risk or distress.
This data will also help researchers better understand why some people recover more quickly than others and how treatment can be adapted to support different recovery journeys.
Another promising area of research explored in the context of the EDIFY programme involves use of non-invasive brain stimulation (NIBS) as a potential brain targeted treatment for young people where first line psychological treatments have not led to full recovery (the RAISE trial).
Professor Schmidt said: “RAISE used a specific NIBS technique called intermittent theta-burst stimulation (iTBS). An area in the frontal part of the brain was stimulated which is involved in regulation of emotions and of different behaviours, including decisions around what foods to eat. By strengthening these functions, iTBS may provide support for recovery. The RAISe trial has now concluded, and early outcomes among young people with persistent anorexia appear very promising.”
Looking ahead
The future of support around eating disorders is hopeful, with more treatment offers being made available to those who may have previously felt stuck or offered the same approaches with minimal success.
Professor Schmidt concluded: “We now have a much better understanding of the importance of early intervention than we had ten years ago, and we know that it works. Recovery is possible. With the right support and treatment, people can challenge and reshape long-held beliefs about their body image, eating habits and exercise behaviours, no matter how long those thoughts have been present.”
Find out more about EDIFY and FREED here:
EDIFY - shaping a fresh approach to eating disorders
FREED: First Episode Rapid Early Intervention for Eating Disorders