Treatment Of Eating Disorders Research Articles

Eating Disorder Treatment Access in the United States: Perceived Inequities Among Treatment Seekers.

Although eating disorders are associated with high rates of psychological and physical impairments and mortality, only about 20% of individuals with eating disorders receive treatment. No study has comprehensively assessed treatment access for those with these disorders in the United States. The authors examined access to eating disorder treatments and how it might vary among some populations. Seekers of treatment for eating disorders (N=1,995) completed an online assessment of clinical demographic and anthropometric characteristics, barriers to eating disorder treatment access, and eating disorder symptomatology. Analyses were conducted to identify treatment access barriers, compare barriers to treatment access across demographic groups, and investigate relationships between barriers to treatment access and eating disorder symptoms. Financial barriers (e.g., lack of insurance coverage) were the most frequently reported barrier to treatment access. Participants with historically underrepresented identities and with a diagnosis of other specified feeding or eating disorder (OSFED) reported more barriers related to financial challenges, geographic location, eating disorder identification, sociocultural factors, and treatment quality compared with those with historically represented identities (e.g., White and cisgender persons). Higher frequencies of reported barriers to treatment access were associated with more severe eating disorder symptoms and poorer illness trajectories. Financial barriers were the most significant impediment to accessing treatment among individuals seeking eating disorder treatment. Barriers to treatment access disproportionally affected underrepresented groups and those with an OSFED diagnosis.

Improvements in Quality of Life and Readiness for Change After Participating in an Eating Disorder Psychoeducation Group: A Pilot Study

ABSTRACT Psychoeducation groups are an integral part of eating disorder treatment in community programs, yet research on their efficacy remains limited. This study examines the impact of participating in a 10-week psychoeducation group on changes in quality of life and in readiness and motivation. Seventy-five adults who had eating disorders were included in the study. We administered the Eating Disorder Quality of Life Scale (EDQLS) and Readiness and Motivation Questionnaire (RMQ) before and after the group. After participation, respondents reported an 11-point increase in the EDQLS score and 9-, 8-, and 9-point increases, respectively, in the total action, confidence, and internality components of the RMQ score. In group exit evaluations, participants reported that the psychoeducation group improved their quality of life and their readiness and motivation to recover.

Social communication and restricted, repetitive behavior as assessed with a diagnostic tool for autism (ADOS-2) in women with anorexia nervosa.

In anorexia nervosa (AN), the traits of autism spectrum disorder (ASD) are associated with poor outcomes. However, the subtle nature of these characteristics remains poorly understood. We investigated the in-depth patterns of ASD traits using Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) in women with AN. Of 28 women with ICD-10 AN, 16 (age 19-30 years) participated in the ADOS-2, a video-recorded, semistructured diagnostic assessment for social communication and interaction and restricted, repetitive behaviors and interests related to ASD. None of the participants had previously been diagnosed with ASD. Other measurements included the Eating Disorder Examination Questionnaire and the Wechsler Abbreviated Scale of Intelligence-IV. Five individuals (18% of all, 31% of those assessed) scored above the cutoff for autism in ADOS-2. They had challenges in social communication and interaction, manifesting as sustained difficulties in social relationships and deficits in conversation skills. Few described being frequently misunderstood by others, including in the eating disorder treatment settings. Three individuals showed prominent restricted and repetitive behaviors such as ritual seeking, eating-related routines, sensory sensitivity related to food texture and selective eating, and intense interest in specific topics. The mean duration of AN in women above the cutoff was twice as long compared with those below (12.3 vs. 6.2 years). The ASD-related characteristics and behavior appear to contribute to the manifestation and duration of AN in a subgroup of women. Among these women, the traits of ASD appear to be mixed with eating disorder symptoms, which should be taken into account in the treatment.

Eating disorders among queer and trans individuals: Implications for conceptualization, assessment, and treatment.

Eating disorders (EDs) have been traditionally viewed as a disorder affecting cisgender, heterosexual women. Yet, the prevalence of EDs among queer and trans (QnT) individuals, coupled with the lack of interventions that attend to contextual factors related to sexual orientation and gender identity, underscore a critical health disparity issue requiring urgent attention. Here, we first review factors pertaining to QnT individuals' minoritized sexual and gender identities that are important to consider in ED conceptualization for this population (e.g., minority stressors, identity-based body image standards). Next, we describe problematic assumptions present in existing ED assessment and propose more inclusive approaches. Lastly, we provide suggestions for practices that providers can implement within their treatment of EDs among QnT individuals.

Association between the frontoparietal network, clinical symptoms and treatment response in individuals with untreated anorexia nervosa

BackgroundAnorexia nervosa (AN) has been characterised as a psychiatric disorder associated with increased control. Currently, it remains difficult to predict treatment response in patients with AN. Their cognitive abilities are...

LGBTQ+ outpatients present to eating disorder treatment earlier and with more severe depressive symptoms than cisgender heterosexual peers

ABSTRACT Community evidence indicates high eating disorder (ED) and comorbid symptom severity among LGBTQ+ compared to cisgender heterosexual (CH) individuals. Little is known about such disparities in ED treatment samples, especially in outpatient treatment. We aimed to descriptively characterize and investigate baseline group differences in symptom severity between LGBTQ+ and CH ED outpatients at treatment intake. Data from 60 (22.3%) LGBTQ+ and 209 (77.7%) CH ED outpatients were used to examine: (1) demographic and diagnostic differences; (2) differences in ED, depressive, and emotion dysregulation symptoms. Objectives were tested using Fisher-Freeman-Halton exact and independent samples t-tests, and analyses of covariance adjusted for age and diagnosis, respectively. Most LGBTQ+ outpatients were bisexual (55.2%), and 6.5% identified as transgender and non-binary. LGBTQ+ outpatients presented to treatment at younger ages (Mean Difference [MD] = -3.39, p = .016) and reported more severe depressive symptoms (MD = 5.73, p = .004) than CH patients, but endorsed similar ED symptom and emotion dysregulation severity. Groups did not differ in other demographic or diagnostic characteristics. LGBTQ+ individuals may develop more severe depression and similarly severe EDs at earlier ages but seek outpatient care sooner than CH peers. Managing depressive symptoms may be particularly important for LGBTQ+ ED patients.

Early change in gastric-specific anxiety sensitivity as a predictor of eating disorder treatment outcome.

Eating disorders (EDs) are often accompanied by gastrointestinal (GI) distress. Anxiety sensitivity is the tendency to interpret sensations of anxiety as threatening or dangerous, and includes both broad physical symptoms (e.g., elevated heartrate) and GI-specific symptoms. Physical and GI-specific anxiety sensitivity may be important risk and maintaining factors in EDs. This study tested the hypothesis that greater reductions in both types of anxiety sensitivity during the first month of treatment would predict lower ED symptoms and trait anxiety at discharge and 6-month follow-up. Patients (n=424) in ED treatment reported physical and GI-specific anxiety sensitivity, ED symptoms, and trait anxiety at treatment admission, 1-month into treatment, discharge, and 6-month follow-up. Analyses were conducted with hierarchical linear regression with imputation, controlling for relevant covariates. Results indicated that early reduction in GI-specific but not general physical anxiety sensitivity predicted both lower ED symptoms and lower trait anxiety at discharge and 6-month follow-up. These findings demonstrate the importance of GI-specific anxiety sensitivity as a potential maintaining factor in EDs. Developing and refining treatments to target GI-specific anxiety sensitivity may have promise in improving the treatment not only of EDs, but also of commonly co-morbid anxiety disorders.

Comparing changes in eating disorder psychopathology and comorbid symptoms over treatment in anorexia nervosa and atypical anorexia nervosa in a partial hospitalization program.

The objective of this study is to compare treatment trajectories in anorexia nervosa (AN) and atypical AN. Adolescents and adults with AN (n = 319) or atypical AN (n = 67) in a partial hospitalization program (PHP) completed diagnostic interviews and self-report questionnaires measuring eating disorder (ED), depression, and anxiety symptoms throughout treatment. Premorbid weight loss did not differ between diagnoses. Individuals with atypical AN had more comorbid diagnoses, but groups did not differ on specific diagnoses. ED psychopathology and comorbid symptoms of depression/anxiety did not differ at admission between groups nor did rate of change in ED psychopathology and comorbid symptoms of depression/anxiety from admission to 1-month. From admission to discharge, individuals with atypical AN had a faster reduction in ED psychopathology and comorbid symptoms of depression and anxiety (ps < 0.05; rs = 0.01-0.32); however, there were no group differences in ED psychopathology or depression symptoms at discharge (ps>.50; ds = .01-.30). Individuals with atypical AN had lower anxiety at discharge compared to individuals with AN (p = 0.05; d = .4). Length of stay did not differ between groups (p = 0.11; d = .21). Groups had similar ED treatment trajectories, suggesting more similarities than differences. PHP may also be effective for AAN. This study supports previous research that individuals with AN and atypical AN have more similarities than differences. Results from this study indicate that individuals with AN and atypical AN have similar treatment outcomes for both ED psychopathology and depressive symptoms; however, individuals with atypical AN have lower anxiety symptoms at discharge compared to individuals with AN. AN and atypical AN also have more symptom similarity at admission and throughout treatment, which challenges their current designation as distinct disorders.

Weight gain and eating disorder symptoms among individuals with atypical anorexia nervosa.

The purpose of this study was to examine the association between weight gain and eating disorder (ED) symptoms among adults receiving treatment for atypical anorexia nervosa (AAN), to determine whether those who had a higher percent of expected body weight (%EBW) at discharge exhibited lower ED symptoms than those who gained less weight, and to compare this group to a matched sample of patients with anorexia nervosa (AN). Participants were 96 adults receiving treatment at an ED treatment facility between December 2020 and May 2023. The Eating Disorder Examination-Questionnaire (EDE-Q) was completed at admission and discharge, and %EBW was obtained at admission and discharge. All EDE-Q subscale scores improved from admission to discharge for patients with AAN and patients with AN. Neither %EBW at discharge nor weight gain were associated with EDE-Q subscale scores for those with AAN. For patients with AN, %EBW at discharge and weight gain were associated with EDE-Q Restraint at discharge. Weight restoring to a higher level and gaining more weight were not associated with EDE-Q scores at discharge for AAN. Further research is needed to determine how weight restoration using intensive treatment settings affects remission and recovery in patients with AAN.

Management of eating disorders during pregnancy: A survey of Australian dietitians in clinical practice.

Eating disorders (EDs) are estimated to affect 5.2%-7.5% of pregnant women, equating to 15,800-23,000 births in Australia annually. In pregnancy, an ED increases the risk of complications for both mother and child. Heightened motivation and increased utilisation of healthcare services during pregnancy present an opportunity to identify and commence ED treatment. Dietetic management of EDs differs from nutrition guidelines for pregnancy. This study aimed to assess current practice, confidence and training needs of dietitians to manage EDs in pregnancy. A cross-sectional survey of Australian dietitians with past year exposure to ED and/or antenatal fields was completed using Microsoft Forms between November 2022 and January 2023. One hundred and seventeen responses were analysed. Confidence was less for assessment of a woman with an active ED in pregnancy than a pregnant woman with a history of an ED, pregnancy or an ED alone (p < 0.001). Greater than 5 years of experience as a dietitian, but without recent exposure to the patient population, was associated with increased confidence (p < 0.01). Almost half provided descriptions of treatments and interventions used to treat a pregnant woman with an ED, some of which conflict with ED or antenatal guidelines. Dietitians were more likely to weigh a person with an ED in pregnancy. Most respondents indicated further training (93%) and guidelines (98%) would be helpful. This is the first investigation into the dietetic management of EDs in pregnancy, and it highlights a need for guidelines and training for dietitians.

A case for integrating self‐compassion interventions targeting shame and self‐criticism into eating disorder treatment: Commentary on Paranjothy and Wade

A case for integrating self‐compassion interventions targeting shame and self‐criticism into eating disorder treatment: Commentary on Paranjothy and Wade

A pilot study evaluating online training for therapist delivery of interpersonal psychotherapy for eating disorders.

Individuals with eating disorders (EDs) often do not receive evidence-based care, such as interpersonal psychotherapy (IPT), partly due to lack of accessible training in these treatments. The standard method of training (i.e., in-person workshops) is expensive and time consuming, prompting a need for more scalable training tools. The primary aim of this pilot and open trial was to examine the effects of an IPT online training platform on training outcomes (i.e., IPT fidelity, knowledge, and acceptance) and, secondarily, whether online training was different from in-person training (using a comparative sample from a separate study) in terms of training outcomes and patient symptoms. Participants were therapists (N = 60) and student patients (N = 42) at 38 college counseling centers. Therapists completed baseline questionnaires and collected data from a student patient with ED symptoms. Therapists then participated in an IPT online training program and completed post-training assessments. Following online training, acceptance of evidence-based treatments, therapist knowledge of IPT, therapist acceptance of IPT, and treatment fidelity increased; acceptance of online training was high at baseline and remained stable after training. Using the 90% confidence interval on outcome effect sizes, results suggested IPT online training was not different from in-person training on most outcomes. Results are based on 60% of therapists who originally enrolled due to high dropout rate of therapist participants. Findings from this preliminary pilot study support the use of IPT online training, which could increase access to evidence-based ED treatment and improve patient care. Lack of accessible therapist training has contributed to many therapists not delivering, and therefore many patients not receiving, evidence-based treatment. This study evaluated a highly disseminable online training and compared outcomes to traditional in-person training and found that training and patient outcomes were not different. Online training has the potential to enhance access to evidence-base care, which could in turn optimize patient outcomes.

Eating Disorders: A Historical Perspective and Analysis of Current Treatment Approaches

Eating disorders are severe mental health conditions that are associated with a high level of illness and death. These disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder, have complex causes that involve a combination of genetic, psychological, and sociocultural factors. The treatment for eating disorders focuses on restoring weight and establishing healthy eating habits, while also addressing underlying issues related to emotional regulation and distorted thoughts. Over time, the approach to treating eating disorders has evolved, with changes in both psychiatry and clinical psychology. In the past, these disorders were often seen as unexplainable forms of hysteria and were treated with rest cures and confinement in asylums. The introduction of psychoanalysis, behaviorism, and pharmacology brought about an expansion in the range of therapeutic options available, although their effectiveness remained limited. Progress was made through the establishment of specialized inpatient programs and the implementation of standardized treatment protocols, leading to improved outcomes. Presently, evidence-based protocols incorporate psychological therapy, nutrition rehabilitation, and medical monitoring that are tailored to meet the individual needs of patients. Among the various treatment approaches, family-based treatment has shown the strongest empirical support for young individuals, while enhanced cognitive behavioral therapy has proven effective for adults. Despite the significant advancements made, eating disorder interventions still face challenges such as high relapse rates, indicating the need for further evolution in intervention strategies to enhance prevention and accessibility. This paper aims to examine the historical development of eating disorder treatments while providing a critical analysis of the current gold standard interventions. The discussion will address the persisting challenges in reducing eating disorder morbidity and mortality by exploring innovative therapeutic targets, modalities, and methods of dissemination.

Weight gained during treatment predicts 6-month body mass index in a large sample of patients with anorexia nervosa using ensemble machine learning.

This study used machine learning methods to analyze data on treatment outcomes from individuals with anorexia nervosa admitted to a specialized eating disorders treatment program. Of 368 individuals with anorexia nervosa (209 adolescents and 159 adults), 160 individuals had data available for a 6-month follow-up analysis. Participants were treated in a 6-day-per-week partial-hospital program. Participants were assessed for eating disorder-specific and non-specific psychopathology. The analyses used established machine learning procedures combined in an ensemble model from support vector machine learning, random forest prediction, and the elastic net regularized regression with an exploration (training; 75%) and confirmation (test; 25%) split of the data. The models predicting body mass index (BMI) at 6-month follow-up explained a 28.6% variance in the training set (n = 120). The model had good performance in predicting 6-month BMI in the test dataset (n = 40), with predicted BMI significantly correlating with actual BMI (r = .51, p = 0.01). The change in BMI from admission to discharge was the most important predictor, strongly correlating with reported BMI at 6-month follow-up (r = .55). Behavioral variables were much less predictive of BMI outcome. Results were similar for z-transformed BMI in the adolescent-only group. Length of stay was most predictive of weight gain in treatment (r = .56) but did not predict longer-term BMI. This study, using an agnostic ensemble machine learning approach in the largest to-date sample of individuals with anorexia nervosa, suggests that achieving weight gain goals in treatment predicts longer-term weight-related outcomes. Other potential predictors, personality, mood, or eating disorder-specific symptoms were relatively much less predictive. The results from this study indicate that the amount of weight gained during treatment predicts BMI 6 months after discharge from a high level of care. This suggests that patients require sufficient time in a higher level of care treatment to meet their specific weight goals and be able to maintain normal weight.

The Cultural Formulation Interview as a clinical tool in the assessment of eating disorders: a pilot study.

The Cultural Formulation Interview (CFI) in the DSM-5 is a person-centered instrument for systematically appraising the impact of sociocultural factors in psychiatric assessment. The CFI has been shown to be feasible, acceptable, and useful in various clinical contexts. However, to this date there is only one published report describing the use of the CFI with patients with eating disorders. To explore the potential benefits and challenges of utilizing the CFI in the assessment of eating disorders. As an addendum to an ongoing qualitative study about barriers to treatment for eating disorders for individuals with a migration background in Sweden, we utilized the CFI in the assessment of adult patients (n=8) in specialist eating disorder treatment. Interview data were analyzed employing a thematic analysis framework. Participants provided feedback using a standard form for evaluation of the CFI. Certain CFI questions proved especially meaningful in this context. In response to the CFI question about patient explanatory models, previously unrecognized ideas about causation emerged. These included perfectionism-a known risk factor for eating disorders-based on immigrant parents' career expectations and experiences of strict family control over life choices. In response to the CFI questions on cultural identity and its impact, the participants provided rich descriptions including important themes such as religion, racism, and ambiguities associated with being a second-generation immigrant. The final CFI question, eliciting concern about the patient-clinician relationship, revealed numerous examples of prejudice and unfamiliarity with migrant groups among healthcare providers. The CFI can be useful in the assessment of patients with eating disorders and should be further explored as a standard tool in specialist eating disorder services.

Dietary interventions in family-based treatment for eating disorders: results of a randomized comparative effectiveness study

ABSTRACT Family-based treatment (FBT) is a first-line treatment for adolescents with eating disorders (ED’s) for which weight gain early in treatment and caregiver empowerment are predictive of success. A variety of dietary interventions are used in practice, but little is known about their effectiveness. We compared clinical outcomes of patients (N = 100) undergoing eating disorder treatment, and user experience across two virtually delivered interventions: (1) Daily calorie target and (2) Plate-by-Plate™ approach. The calorie group gained more weight on average, though the difference was small (β = 1.62 [−0.02, 3.26]). Participants in both groups improve their eating disorder symptoms at roughly the same rate (β = 0.09 [−0.83, 1.04]). Caregivers in the Plate-by-Plate group increased confidence at a slower rate (β = 0.05 [−0.002, 0.09]). Caregivers rated the daily calorie target as more effective (β = 2.18 [0.94, 3.6]), and rated the two approaches equally for ease of use (β = -0.73 [−1.92, 0.48]). The daily calorie target approach was rated as more effective and was preferred overall by caregivers and dietitians. Findings challenge long-standing assumptions underlying FBT and suggest that clinicians should consider using a calorie framework with caregivers to guide renourishment efforts.

Attachment, Mentalization, Emotion Dysregulation, and Empathy in Eating Disorders: Comparing Anorexic and Bulimic Patients.

Eating disorders (EDs) represent a wide range of clinical symptoms related to food intake, body image, and weight issues, and include anorexia nervosa-restricting type (AN-R), anorexia nervosa-binge-purge type (AN-BP), and bulimia nervosa (BN). The aim was to investigate the characteristics of attachment, mentalization, emotion dysregulation, and empathy in a sample of 102 patients with EDs. A sample of 102 patients and therapists completed a series of measures for the assessment of ED pathology, mentalization, empathy, and emotion dysregulation. Pearson correlations and analysis of variance were used to test the characteristics of the variables among the groups. In relation to attachment and emotion dysregulation, no significant differences were found. In relation to mentalization, significant difference in good mentalization was found in AN-R subtype compared with the BN subtype. In relation to empathy, results showed significantly lower scores in BN subtype on affective empathy compared with the AN-BP subtype, and in AN-R subtype on cognitive empathy. Finally, we used Z-scores for each item ranked by value (higher to lower) to develop different clinical prototypes for each group. Our results point toward the clinical need to address the assessed variables, specifically mentalization, emotion dysregulation, and empathy, in the diagnosis and treatment of EDs.

Pragmatic clinical trials to advance research in children and adolescents with eating disorders.

To discuss the utility of pragmatic clinical trials (PCTs) to help advance research in eating disorders (EDs). We describe challenges associated with traditional explanatory research trials and examine PCTs as an alternative, including a review of the PRECIS-2 tool. There are many challenges associated with the design and completion of traditional RCTs within the field of EDs. Pragmatic clinical trials are studies that closely align with conditions available in everyday practice and focus on outcomes that are relevant to patients and clinicians. Results of PCTS maximize applicability and generalizability to clinical settings. Available therapies established for the treatment of EDs provide remission rates that rarely exceed 50%, implying a need for additional research on new or adjunctive treatments. In addition to a general overview of PCTs, we draw upon published literature and our own experiences involving adjunctive olanzapine for the treatment of children and youth with anorexia nervosa to help highlight challenges associated with randomized controlled trial (RCT) design and implementation, and offer pragmatic suggestions that would allow patients greater choice in treatment trials, while at the same time capturing outcomes that are most likely to advance treatment efforts. Pragmatic clinical trials provide alternatives to RCT design that can help bolster research in EDs that aims to explore real-world effects of interventions. Available therapies established for the treatment of eating disorders (EDs) in children and adolescents provide remission rates that rarely exceed 50%, implying a need for additional research on new or adjunctive treatments. In this article, we discuss the utility of pragmatic trials to help promote research that can help advance knowledge that is relevant to clinical care settings.

Clinician perspectives of the implementation of an early intervention service for eating disorders in England: a mixed method study

BackgroundThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service has been shown to reduce the wait for care and improve clinical outcomes in initial evaluations. These findings led to the national scaling of FREED in England. To support this scaling, we conducted a mixed method evaluation of the perceptions and experiences of clinicians in the early phases of scaling. The Normalisation Process Theory (NPT) was used as a conceptual lens to understand if and how FREED becomes embedded in routine practice.MethodsThe convergent mixed method evaluation included 21 semi-structured interviews with clinicians from early adopter sites and 211 surveys administered to clinicians before, immediately after and 3 months after the FREED training. The interview guide and survey included questions evaluating attitudes towards early intervention for eating disorders (EDs) and NPT mechanisms. Interview data were analysed using an inductive thematic analysis. The NPT was applied to the inductively derived themes to evaluate if and how NPT domains impacted the implementation. Survey data were analysed using multilevel growth models.ResultsSix themes and 15 subthemes captured barriers and facilitators to implementation at the patient, clinician, service, intervention, implementation and wider system levels. These interacted with the NPT mechanisms to facilitate or hinder the embedding of FREED. Overall, clinicians were enthusiastic and positive towards early intervention for EDs and FREED, largely because of the expectation of improved patient outcomes. This was a considerable driver in the uptake and implementation of FREED. Clinicians also had reservations about capacity and the potential impact on other patients, which, at times, was a barrier for its use. The FREED training led to significant improvements in positive attitudes and NPT mechanisms that were largely maintained at the 3-month follow-up. However, negative attitudes did not significantly improve following training.ConclusionsPositive attitudes towards early intervention for EDs increased enthusiasm and engagement with the model. Features of the model and its implementation were effective at developing adopter commitment and capabilities. However, there were aspects of the model and its implementation which require attention in the future (e.g., capacity and the potential impact on the wider service).

One Sheet Does Not Fit All: The Dietetic Treatment Experiences of Individuals with High Eating Disorder Symptomatology Attending a Metabolic and Bariatric Clinic; an Exploratory Mixed-Methods Study

This study aimed to explore the dietetic treatment experiences of individuals with high eating disorder (ED) symptomatology attending a metabolic and bariatric clinic. An exploratory mixed methods cross-sectional study was conducted. Eighteen participants completed the survey, which included an adapted version of the Eating Disorders Treatment Experience Survey (EDTES), the Eating Disorder Examination Questionnaire Short (EDE-QS), and quantitative and qualitative questions relating to the roles and helpfulness of a dietitian in treatment. Data regarding the most and least helpful dietitians were collected. Differences between groups were tested with the Wilcoxon signed ranks test. A reflexive thematic analysis was used to analyse open-ended responses. The mean EDE-QS score reported by participants was 20.9 (SD = 6.0). The dietitians who were perceived as the most helpful were those who took into consideration an individual’s treatment preferences and choices (Z = −1.96, p = 0.05). Three themes were constructed: (1) nutrition knowledge and skills, (2) person-centred care, and (3) roles of the multidisciplinary team. Although further research is required, our findings suggest that the role of a dietitian in this setting may extend beyond weight-loss advice, and with additional training, could include individualised and collaborative supportive care that overlaps with ED treatment.