Our Research - Interventions for disordered eating

About this research pillar

Struggles with disordered eating can be lifelong and sometimes life ending. Our research is forming a comprehensive picture of the causes of disordered eating. We are also engaged in preventative, evidence-based community programs and consulting with government and relevant organisations to help prevent and treat disordered eating.

Our research covers areas such as:

Body image
Eating behaviour
Risk factors
Healthier eating

Prevention and treatment
Perfectionism
Early intervention
Improving treatment experience and outcomes

Our research in practice - Flinders University Service for Eating Disorders (FUSED)

The journey to help people overcome disordered eating requires a fresh look at effective therapies and Flinders University Institute for Mental Health and Wellbeing is leading the way with a program that promotes a supportive “can-do” approach for clients to change their behaviours.

Matthew Flinders Distinguished Professor Tracey Wade has worked with international colleagues to develop a 10-session cognitive behaviour therapy (CBT-T) for non-underweight eating disorders that has been successfully trialled and evaluated at the Flinders University Service for Eating Disorders (FUSED).

As the first program to introduce CBT-T into Australia for disordered eating interventions, it is proving to be very successful through encouraging people to embrace and enact behavioural change early in their therapy process.

“We are telling the clients they are capable of a lot more than they believe they can do,” says Professor Wade, co-creator of the program. “We push them to do things they don’t really want to do, and they come away amazed at how strong and resilient they really are.”

“It’s a revelation for the clients. Many of these people have been beaten down by a very difficult disease, so seeing the effect of immediate change as they are going through therapy gives them great confidence and self-belief. It’s also very affirming for the therapists, because it’s a very difficult area to work in.”

The therapy is the culmination of a 5-year project by a team of international collaborators, although a majority of the therapy’s 10 evaluations were conducted at the FUSED clinic before the CBT-T manual was created and website launched, which has since attracted serious international attention. “I won’t push out a therapy until we have done evaluations, to make sure it is effective,” says Professor Wade, “and we were very thorough in our evaluations.”

People with disordered eating who have received CBT-T at Flinders University’s FUSED facility have been fulsome in their praise of the therapy.

“I firmly believe it is due to this program that I am still in remission,” explained one client in an anonymous testimonial. “There are still times that I want to binge and purge but I’m able to put it out of my mind until the urge leaves. I do believe the bulimia will stay with me, to some degree, for the rest of my life, but after 29 years of battling this illness, I am the one in control now. It no longer has control over me.”

Several of the responses are profound and dramatic. “Thank you for helping me regain my life back, and helping me realise that I still had some sense of worth outside of my illness,” wrote one client.

“I firmly believe it is due to this program that I am still in remission”

Professor Wade believes the new program has been so successful because it promotes an idea of firm empathy. “We work with the person to set some ambitious goals for change, and then give them support so they can work through difficulties to effect those changes.”

“The new CBT-T program has been built on good knowledge about what is most effective with the original cognitive behavioural therapy approaches, in addition to adding newer techniques. This has resulted in an emphasis on people making early changes as they go through therapy – and this idea is built on the evidence that if they don’t make early changes, they don’t have a good outcome.”

There is now widespread use of the new therapy program in 15 countries. Primary mental health providers have also implemented CBT-T within the national training core curriculum provided by NHS Health Education England for evidence-based treatment of eating disorders. Since November 2020, this scheme has delivered CBT-T training to more than 300 clinicians and 160 supervisors.

The research conducted at FUSED is also informing cutting-edge issues such as the use of motivational techniques in therapy, how to treat people with atypical anorexia nervosa, and the importance of providing input on waitlists to retain people in therapy.

FUSED has now embarked on a new research trial of how to increase the impact of waitlist interventions on therapy outcome, which will reduce waiting lists and improve the effectiveness of treatment. The clinic is also noting increasing demand among Australian therapists for CBT-T workshops, fuelled by the fulsome praise from its clients.

“A whole variety of people are getting excited by this therapy – and we are seeing an increasing trend for it to be included on the menu of available treatment options for disordered eating,” says Professor Wade. “It’s having an effect and, as a clinician and an academic researcher, I’m so delighted this outcome is making a difference to help people change their lives for the better.”

Our researchers in this area:

Professor Tracey Wade – prevention and treatment of eating disorders, perfectionism interventions
Professor Sarah Cohen-Woods - integrating environmental factors including social determinants of health, with genetic predictors in a range of phenotypes: disordered eating, depression, psychosis (bipolar disorder and schizophrenia) and cognition
Associate Professor Ryan Balzan - prevention and treatment of serious mental illnesses (e.g., psychosis), digital mental health interventions
Professor Eva Kemps - eating behaviour, healthier eating interventions
Dr Catherine Johnson - wellbeing education programs in industry partnerships with schools
Dr Laura Edney – a health economist with an interest in the application of economic evaluation methods to support mental health research and inform mental health policy decisions
Dr Simon Wilksch - eating disorder risk factors, prevention, early intervention and improving treatment experience and outcomes for patients and their families
Dr Mia Pellizzer - co design research