Treatment Targets and Strategies for Eating Disorders Recovery: A Delphi Consensus With Lived Experience, Carers, Researchers, and Clinicians.

Hanegraaf L., Anderson A., Neill E., Giddens E., Boon E., Bryant E., Calvert S., Carroll B., Fernandez-Aranda F., Ikin S., Luna M., Mitchell F., Murphy R., Phillipou A., Robinson J., Wierenga C., Wilksch S., Maguire S., Verdejo-Garcia A.

OBJECTIVE: Long-term recovery rates following eating disorders (EDs) treatment remain low. This might be partly due to a lack of agreement between key stakeholder groups, including people with lived experience, carers, clinicians, and researchers, regarding optimal therapeutic targets and strategies. We aimed to reach a consensus across these diverse groups on the most valued treatment targets and strategies for fostering ED recovery. METHOD: We used the Delphi method with two phases: (i) Survey development and (ii) Expert rating. The survey development phase included the design of an initial set of items through scoping review and feedback from a committee of 14 experts. During the survey rating, we engaged a larger panel of 185 experts who comprised the stakeholder groups: Individuals with lived ED experience (n = 49), carers (n = 44), researchers (n = 46), and clinicians (n = 46). RESULTS: Thirty-one targets and 29 strategies reached consensus (> 70% agreement over three rounds). Psychological-emotional-social targets including quality of life, sense of purpose, and emotion regulation, along with ED behaviors, reached the highest agreement (> 90%). Strategies reflecting an individualized approach to treatment (i.e., considering diversity, assessing comorbidities, and enhancing rapport) achieved the highest agreement (> 90%). Responses across groups were similar, except researchers leaning more towards consideration of weight- and eating-related targets. DISCUSSION: Holistic targets and individualized therapeutic strategies have consistent support from the different stakeholder groups involved in ED treatment. The agreed set of targets/strategies may be used, in triangulation with other sources of evidence, to design and evaluate coproduced and personalized interventions.

DOI

10.1002/eat.24304

Type

Journal article

Journal

Int J Eat Disord

Publication Date

12/2024

Volume

57

Pages

2494 - 2507

Keywords

eating disorders, lived experience, recovery, strategies, treatment, Humans, Delphi Technique, Feeding and Eating Disorders, Caregivers, Consensus, Female, Adult, Male, Research Personnel, Surveys and Questionnaires, Quality of Life, Stakeholder Participation

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