The Discrepancies Between Researchers and the Community When Identifying Intervention Targets for Eating Disorders

Objective: To understand the discrepancies between people with lived experience, significant others, clinicians specializing in the treatment of eating disorders, and eating disorder researchers in the endorsement of transdiagnostic processes (mechanisms that are either a risk or maintaining factor across psychiatric disorders) hypothesized as being important to target in interventions for eating disorders. We examined processes of relevance to early intervention and treatment augmentation. Method: A secondary data analysis of a modified Delphi study was conducted. Participants (N = 138) across all four panels were mostly female, White, heterosexual, and residing in Australia with a mean age of 38 years. Participants completed three rounds of consultation seeking to reach consensus on the importance of 49 transdiagnostic processes for both early intervention and augmentation of evidence-based eating disorder treatment (98 items). χ² analyses were conducted to explore the differences in endorsement rates between panels across the three rounds. Results: Post hoc analyses demonstrated that researchers had significantly lower rates of endorsement for 70 (71%) of the items, while people with lived experience had significantly higher rates of endorsement for 25 (26%) items. Consensus was impacted by lower endorsement rates by one panel only for 16 items (16%), with researchers contributing to this for 12 of the impacted items. Discussion: Findings suggest a marked discrepancy between lived experience and researcher perspectives on what is important to target in interventions for eating disorders. We encourage researchers to lean into this dissent to support rigorous best practice in the development and refinement of mental health interventions.