EDANN members have identified knowledge gaps and issues in service provision that create barriers to the effectiveness of prevention and treatment approaches to eating disorders. In particular, they have noted the need for further research evidence and coordination or collaboration across the sector, to establish more effective methods of early intervention and maintenance/recovery support.

These are some of the current issues that impact on the effectiveness of approaches to eating disorders that have been identified by EDANN members:

Research Evidence

• The need for more evidence for family based treatments for adolescent early intervention to prevent hospitalisations and chronicity;
  
• The need to identify reliable markers for the early diagnosis of people at risk of development an eating disorder;
  
• The need to increase research efforts to better understand the molecular basis of eating disorders to identify potential therapeutic targets for treating and curing the disease;
  
• The need for developing and testing new treatments for eating disorders (particularly anorexia nervosa);
  
• Developing and testing prevention efforts for both eating disorders and obesity.

Coordinated Cross Sector Approaches

• Key partnerships between acute health and mental health in the treatment of eating disorders;
  
• evidence based practice in the treatment of eating disorders, embedded within a national framework for care;
  
• Addressing anorexia requires a multi-dimensional approach that recognises that a conflation of factors and processes contribute to the development and maintenance of, and recovery from, anorexia;
  
•  An integrated approach that focuses on both treatment but also early intervention and the prevention of eating disorders;
  
• Need to 'close the gap' and ensure people with eating disorders have access to their preferred evidence based intervention(s) whatever their life circumstances, including access to services in rural areas;
  
•  Integration of prevention and interventions for obesity and eating disorders to improve outcomes and reduce prevalence of both;
  
• Consistency and coordination in the provision of eating disorder services at a State and National Level and between primary and tertiary care;
  
• Continuums of care:  There is a critical need for comprehensive management across different dimensions of care.  Currently there is a major disconnect between inpatient, outpatient and community based care with minimal step-down planning, consultation and handover.  This sets the patient up for relapse with an exacerbation of symptoms following a hospital discharge and leads to recurrent hospital admissions and an entrenching of the underlying psychopathology.  The best case scenario would be for patients to access a continuum of care within the one service.

Prevention & Early Identification

• Early identification of pre adolescents developing eating disorders and options for effective treatment;
  
• Prevention programs in schools;
  
• Prevention programs for pregnant and menopausal women - the times of considerable vulnerability for women are when their body shape is changing for reasons 'beyond their control' which can lead to excessive dieting;
  
• Need for schools, health providers and the medical profession to understand and take account of the perspectives and experiences of sufferers, their parents and families;
  
• Early intervention and treatment increases recovery and reduces medical consequences of nutritional and weight disorders;
  
• Resources for assessment education and early intervention in vulnerable populations.

Consumer Inclusion

• Consumer and carer representation - these people need to have a voice, and need to be heard, in what is provided for them and we can provide that;
  
• The importance of engaging and working with young people to find a solution to eating disorders, this may include the development of media guidelines, the provision of information and online support and the development of services that are appropriate for young people.

Maintenance & Recovery Support

• Ongoing support for recovery - eating disorders are chronic illnesses, and recovery is only just beginning when people exit clinical treatment services.  Average recovery time from anorexia is 7 years.  Unless both sufferers and carers are adequately supported during this period, we will continue to see the 'revolving door syndrome';
  
• Sophisticated and useful support services and information for carers and families of those suffering from an Eating Disorder, including services for siblings.