Management of eating disorders for people with higher weight : Clinical practice guideline

Journal article


Ralph, Angelique F., Brennan, Leah, Byrne, Sue, Caldwell, Belinda, Farmer, Jo, Hart, Laura M., Heruc, Gabriella A., Maguire, Sarah, Piya, Milan K., Quin, Julia, Trobe, Sarah K., Wallis, Andrew, Williams-Tchen, A. J. and Hay, Phillipa. (2022). Management of eating disorders for people with higher weight : Clinical practice guideline. Journal of Eating Disorders. 10(1), p. Article 121. https://doi.org/10.1186/s40337-022-00622-w
AuthorsRalph, Angelique F., Brennan, Leah, Byrne, Sue, Caldwell, Belinda, Farmer, Jo, Hart, Laura M., Heruc, Gabriella A., Maguire, Sarah, Piya, Milan K., Quin, Julia, Trobe, Sarah K., Wallis, Andrew, Williams-Tchen, A. J. and Hay, Phillipa
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 ‘Guidelines for Guidelines’ 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.

Keywordsguideline; atypical anorexia nervosa; bulimia nervosa; binge-eating disorder; other specified feeding or eating disorder; obesity
Year2022
JournalJournal of Eating Disorders
Journal citation10 (1), p. Article 121
PublisherBiomed Central Ltd
ISSN2050-2974
Digital Object Identifier (DOI)https://doi.org/10.1186/s40337-022-00622-w
PubMed ID35978344
Scopus EID2-s2.0-85136508059
PubMed Central IDPMC9386978
Open accessPublished as ‘gold’ (paid) open access
Page range1-42
FunderDepartment of Health, Australian Government
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online18 Aug 2022
Publication process dates
Accepted24 Jun 2022
Deposited08 May 2025
Additional information

© The Author(s) 2022.

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Permalink -

https://acuresearchbank.acu.edu.au/item/91vzv/management-of-eating-disorders-for-people-with-higher-weight-clinical-practice-guideline

Download files


Publisher's version
OA_Ralph_2022_Management_of_eating_disorders_for_people.pdf
License: CC BY 4.0
File access level: Open

  • 12
    total views
  • 2
    total downloads
  • 12
    views this month
  • 2
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Child and caregiver perspectives on access to psychosocial and educational support in pediatric chronic kidney disease : A focus group study
Zhang, Yifan, Gutman, Talia, Tong, Allison, Craig, Jonathan C., Sinha, Aditi, Dart, Allison, Eddy, Allison A., Gipson, Debbie S., Bockenhauer, Detlef, Yap, Hui-Kim, Groothoff, Jaap, Zappitelli, Michael, Webb, Nicholas J. A., Alexander, Stephen I., Furth, Susan, Samuel, Susan, Blydt-Hansen, Tom D., Dionne, Janis, Michael, Mini, ... Hanson, Camilla S.. (2023). Child and caregiver perspectives on access to psychosocial and educational support in pediatric chronic kidney disease : A focus group study. Pediatric Nephrology. 38(1), pp. 249-260. https://doi.org/10.1007/s00467-022-05551-z
The experiences and impact of being deemed ineligible for living kidney donation : Semi-structured interview study
Ralph, Angelique F., Chadban, Steven J., Butow, Phyllis, Craig, Johnathan C., Kanellis, John, Wong, Germaine, Logeman, Charlotte and Tong, Allison. (2020). The experiences and impact of being deemed ineligible for living kidney donation : Semi-structured interview study. Nephrology. 25(4), pp. 339-350. https://doi.org/10.1111/nep.13628
Identifying important outcomes for young people with CKD and their caregivers : A nominal group technique study
Hanson, Camilla S., Gutman, Talia, Craig, Jonathon C., Bernays, Sarah, Raman, Gayathri, Zhang, Yifan, James, Laura J., Ralph, Angelique F., Ju, Angela, Manera, Karine E., Teixeira-Pinto, Armando, Viecelli, Andrea K., Alexander, Stephen I., Blydt-Hansen, Tom D., Dionne, Janis, McTaggart, Steven, Michael, Mini, Walker, Amanda, Carter, Simon, ... Tong, Allison. (2019). Identifying important outcomes for young people with CKD and their caregivers : A nominal group technique study. American Journal of Kidney Diseases. 74(1), pp. 82-94. https://doi.org/10.1053/j.ajkd.2018.12.040
Patient-reported outcome measures for life participation in kidney transplantation : A systematic review
Ju, Angela, Chow, Bi Yang, Ralph, Angelique F., Howell, Martin, Josephson, Michelle A., Ahn, Curie, Butt, Zeeshan, Dobbels, Fabienne, Fowler, Kevin, Jowsey-Gregoire, Sheila, Jha, Vivekanand, Locke, Jayme E., Tan, Jane C., Taylor, Quinetta, Rutherford, Claudia, Craig, Jonathon C. and Tong, Allison. (2019). Patient-reported outcome measures for life participation in kidney transplantation : A systematic review. American Journal of Transplantation. 19(8), pp. 2306-2317. https://doi.org/10.1111/ajt.15267
Identifying outcomes that are important to living kidney donors : A nominal group technique study
Hanson, Camilla S., Chapman, Jeremy R., Gill, John S., Kanellis, John, Wong, Germaine, Craig, Jonathon C., Teixeira-Pinto, Armando, Chadban, Steve J., Garg, Amit X., Ralph, Angelique F., Pinter, Jule, Lewis, Joshua R. and Tong, Allison. (2018). Identifying outcomes that are important to living kidney donors : A nominal group technique study. Clinical Journal of the American Society of Nephrology. 13(6), pp. 916-926. https://doi.org/10.2215/CJN.13441217
Child and parental perspectives on communication and decision making in pediatric CKD : A focus group study
Gutman, Talia, Hanson, Camilla S., Bernays, Sarah, Craig, Jonathan C., Sinha, Aditi, Dart, Allison, Eddy, Allison A., Gipson, Debbie S., Bockenhauer, Detlef, Yap, Hui-Kim, Groothoff, Jaap, Zappitelli, Michael, Webb, Nicholas J. A., Alexander, Stephen I., Goldstein, Stuart L., Furth, Susan, Samuel, Susan, Blydt-Hansen, Tom, Dionne, Janis, ... Tong, Allison. (2018). Child and parental perspectives on communication and decision making in pediatric CKD : A focus group study. American Journal of Kidney Diseases. 72(4), pp. 547-559. https://doi.org/10.1053/j.ajkd.2018.05.005
Patient-reported outcome measures for fatigue in patients on hemodialysis : A systematic review
Ju, Angela, Unruh, Mark L., Davison, Sara N., Dapueto, Juan, Dew, Mary Amanda, Fluck, Richard, Germain, Michael, Jassal, Sarbjit Vanita, Obrador, Gregorio, O'Donoghue, Donal, Tugwell, Peter, Craig, Jonathon C., Ralph, Angelique F., Howell, Martin and Tong, Allison. (2018). Patient-reported outcome measures for fatigue in patients on hemodialysis : A systematic review. American Journal of Kidney Diseases. 71(3), pp. 327-343. https://doi.org/10.1053/j.ajkd.2017.08.019
Donor and recipient views on their relationship in living kidney donation : Thematic synthesis of qualitative studies
Ralph, Angelique F., Butow, Phyllis, Hanson, Camilla S., Chadban, Steven J., Chapman, Jeremy R., Craig, Jonathan C., Kanellis, John, Luxton, Grant and Tong, Alison. (2017). Donor and recipient views on their relationship in living kidney donation : Thematic synthesis of qualitative studies. American Journal of Kidney Diseases. 69(5), pp. 602-616. https://doi.org/10.1053/j.ajkd.2016.09.017