@article{19a14a1bdc60453c8d9ecf5dc6f815c1,
title = "Management of eating disorders for people with higher weight: clinical practice guideline",
abstract = "Introduction: The prevalence of eating disorders is high in people with higher weight. However, despite this, eating disorders experienced by people with higher weight have been consistently under-recognised and under-treated, and there is little to guide clinicians in the management of eating disorders in this population. Aim: The aim of this guideline is to synthesise the current best practice approaches to the management of eating disorders in people with higher weight and make evidence-based clinical practice recommendations. Methods: The National Eating Disorders Collaboration Steering Committee auspiced a Development Group for a Clinical Practice Guideline for the treatment of eating disorders for people with higher weight. The Development Group followed the {\textquoteleft}Guidelines for Guidelines{\textquoteright} process outlined by the National Health and Medical Research Council and aim to meet their Standards to be: 1. relevant and useful for decision making; 2. transparent; 3. overseen by a guideline development group; 4. identifying and managing conflicts of interest; 5. focused on health and related outcomes; 6. evidence informed; 7. making actionable recommendations; 8. up-to-date; and, 9. accessible. The development group included people with clinical and/or academic expertise and/or lived experience. The guideline has undergone extensive peer review and consultation over an 18-month period involving reviews by key stakeholders, including experts and organisations with clinical academic and/or lived experience. Recommendations: Twenty-one clinical recommendations are made and graded according to the National Health and Medical Research Council evidence levels. Strong recommendations were supported for psychological treatment as a first-line treatment approach adults (with bulimia nervosa or binge-eating disorder), adolescents and children. Clinical considerations such as weight stigma, interprofessional collaborative practice and cultural considerations are also discussed. Conclusions: This guideline will fill an important gap in the need to better understand and care for people experiencing eating disorders who also have higher weight. This guideline acknowledges deficits in knowledge and consequently the reliance on consensus and lower levels of evidence for many recommendations, and the need for research particularly evaluating weight-neutral and other more recent approaches in this field.",
keywords = "Atypical anorexia nervosa, Binge-eating disorder, Bulimia nervosa, Guideline, Obesity, Other specified feeding or eating disorder",
author = "Ralph, {Angelique F.} and Leah Brennan and Sue Byrne and Belinda Caldwell and Jo Farmer and Hart, {Laura M.} and Heruc, {Gabriella A.} and Sarah Maguire and Piya, {Milan K.} and Julia Quin and Trobe, {Sarah K.} and Andrew Wallis and Aj Williams-Tchen and Phillipa Hay",
note = "Funding Information: This guideline received funding from the Australian Government Department of Health. Funding Information: We would like to acknowledge the following individuals for their contributors to this guideline: Phillip Aouad, Katrina Baikie, Zoe Bower, Megan Bray, Emma Bryant, Liz Dale, Rosiel Elwyn, Annemarie Hindle, Jordan Martenstyn, Kate Mellody, Anita Raspovic, and Emily Unity. We also acknowledge the following organisations for their external reviews of Version 2 of this guideline: Australian & New Zealand Academy for Eating Disorders (ANZAED), Australian & New Zealand Academy for Eating Disorders Weight Stigma and Social Justice Special Interest Group (ANZAED WS&SJ SIG), Australian & New Zealand Metabolic and Obesity Surgery Society (ANZMOSS), Australian Psychological Society (APS), Centre of Excellence in Eating Disorders (CEED), Dietitians Australia, Healthy at Every Size Australia{\textregistered} (HAES{\textregistered}), National Association of Clinical Obesity Services (NACOS), The Obesity Collective, and The Royal Australian College of General Practitioners (RACGP). We would also like to thank the following external expert reviewers of Version 2: Catherine Bacus, Jennifer Conway, Susan Hart, Nic Kormas, Richard Newton, Elizabeth Rieger, Andrea Ryan, Amanda Salis, Fiona Willer, and Gary Wittert. Funding Information: Leah Brennan: La Trobe University—Employee; Nourish Psychology (Centre for Eating, Weight and Body Image)—Director; NEDC—Steering Committee member; Australian Psychological Society—Member; Australian and New Zealand Academy of Eating Disorders—Member; SAX Institute—Past tender recipient; NHMRC, Diabetes Australia— Past grant recipient. Susan Byrne: NEDC—Steering Committee member; Australian Medical Council—Contracted employee; Takeda Pharmaceuticals—Sponsored speaker 2018; NHMRC, Healthway, Rotary—Past grant recipient; Butterfly Foundation—Clinical Advisory Committee. Belinda Caldwell: Eating Disorders Victoria—CEO; Eating Disorders Families Australia—Past board director/deputy chair; Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T)—Past executive director. Jo Farmer: Justice Connect—Contracted employee (until 9 April 2021); Beyond Blue—Consultant (until March 2021); Department of Social Services—Consultant (until June 2021); Mental Health Coordinating Council (NSW)—Consultant (until July 2021); National Mental Health Commission—Member, National Workplace Initiative Evaluation Working Group (ongoing); Queensland Mental Health Commission—Consultant (until December 2021); Zero Suicide Institute of Australasia—Faculty member; deliver training (ongoing); Australian Evaluation Society—Member; Blog editor. Laura Hart: University of Melbourne—Employee; La Trobe University—Honorary appointment; STRIPED Harvard/Boston Children{\textquoteright}s Hospital—Honorary appointment; NEDC—Steering Committee member; Victorian Eating Disorders Research Network—Founder, Convenor; Body Confident Collective—Founder, Director; Australia New Zealand Academy for Eating Disorders—Member; Academy for Eating Disorders—Member; Society for Mental Health Research—Member; Comonground—Member; NHMRC, Australian Rotary Health—Current and past grant recipient. Phillipa Hay: Western Sydney University—Employee; Wesley Hospital Ashfield—Contracted Director Eating Disorder service; South Western Sydney Local Health District—Employee; NEDC—Chair Steering Committee; Australian Medical Council—Contracted employee; HETI/NSW Institute of Psychiatry—Contracted employee; NHMRC—Member Assigners Academy (occasional); Royal Australian and New Zealand College of Psychiatrists—Fellow; Academy for Eating Disorders—Fellow; Australian Medical Association—Member; Takeda Pharmaceuticals—2017 Contracted report, sponsored speaker 2018; BMC publishers—Editor in Chief (honoraria) and Assoc Editor; World Health Organization—Member ICD 11 Eating Disorders Working Group; Department of Health—Member MBS Review—Eating Disorders Working Group 2017; NHMRC, Australian Research Council, CAPES Foundation—Past grant recipient; Australian Medical Council—Contracted employee. Gabriella Heruc: Northern Sydney Local Health District—Employee; Appetite for Change—Director and head clinician of private practice; Australia and New Zealand Academy for Eating Disorders—Past-President and Executive Committee Member; Western Sydney University—Adjunct Fellow; NEDC—Steering Committee Member; Dietitians Association of Australia—Member; Department of Health—Member MBS Implementation Committee—Eating Disorder Management Plans 2019. Sarah Maguire: University of Sydney—Employee; Sydney Local Health District—Employee; NHMRC—External Reviewer; Academy for Eating Disorders—Member; NSW Health—Advisor; NEDC—Steering Committee member; BMC publishers—Editor; Department of Health—Member MBS Review—Eating Disorders Working Group 2017, Funded project lead. Milan Piya: Western Sydney University—Employee; South Western Sydney Local Health District—Employee; Royal Australasian College of Physicians—Fellow; Australian Diabetes Society—Paid Member; Australian and New Zealand Obesity Society—Paid Member; Diabetes UK—Paid Member; Journal of Eating Disorders (BMC Publishers)—Senior Editor; Nutrients Journal (MDPI Publishers)—Guest Editor for special issue 2020–2022; Diabetes, Nutrition and Dietetics (Frontier Journals)—Associate Editor; Takeda Pharmaceuticals—Sponsored speaker 2019 and 2021; Novo Nordisk—Sponsored speaker 2020, 2021 and 2022; Johnson and Johnson Medical Pty Ltd—Advisory focus group 2021; Inova Pharmaceuticals—Sponsored online conference 2021; Eli Lilly and Company—Sponsored Speaker 2021; UCB Pharmaceuticals—Sponsored speaker 2020. Julia Quin: Eating Disorders Victoria—Carer Coach; EDV Rally Parent Support Group—co-facilitator; International Eating Disorders Family Support (IEDFS)—IEDFS—Facebook Group Administrator. Angelique Ralph: NEDC—Employee; Mind Plasticity—Sub-contractor; La Trobe University—Adjunct Research Fellow; Australian Clinical Psychology Association—Member; ANZAED—Member; NHMRC—Past grant recipient. Sarah Trobe: NEDC—Employee; The Victorian Centre of Excellence in Eating Disorders—Past employee; Royal Children{\textquoteright}s Hospital—Past employee. Andrew Wallis: Sydney Children's Hospital Network—Employee; NEDC—Steering Committee member; ADW Training and Supervision—Director; Australian Association of Social Workers—Member. AJ Williams-Tchen: MHFA—Mental Health First Aid Australia—Current MHFA Instructor, Former employee; Butterfly Foundation—Reconciliation Action Plan Member; Reference Group, Ambassador; Beyond Blue—Reconciliation Action Plan Member; Consultant; ANZAED—Cultural Consultant; Royal Australian College of General Practitioners—Continuing Professional Development (CPD) Provider; College of Midwives—CPD Provider; Australian College of Rural and Remote Medicine—CPD Provider; Australian Association of Social Workers—Mental Health Accreditation; CPD Provider; South Eastern Melbourne Primary Health Network (PHN), North Western Melbourne PHN, Eastern Melbourne PHN, Gippsland PHN—Funding recipient 2020; Girraway Ganyi Consultancy—Director; Fellowship Victorian Indigenous leadership—Emerging Leader 2015–2016; Victorian Aboriginal Community Health Organisations across Victoria—Contractor for MHFA training; Cancer Council Victoria—Cultural Mentor since 2012, Independent Schools Victoria— CPD Provider; Cultural Consultant. Publisher Copyright: {\textcopyright} 2022, The Author(s).",
year = "2022",
month = dec,
doi = "10.1186/s40337-022-00622-w",
language = "English",
volume = "10",
journal = "Journal of Eating Disorders",
issn = "2050-2974",
publisher = "BioMed Central",
number = "1",
}
