Exploring emotional and disordered eating within obesity – insights from an international audience

In May 2023, members of the Obesity Institute attended the 30^th European Congress on Obesity, held in Dublin. Researchers from the Institute presented various pieces of work, including invited talks and posters. Professor Louisa Ells and Dr Jordan Marwood delivered a symposium as part of the launch of the EASO Psychology, Behaviour and Mental Health Working Group titled ‘Can we align the stars: bringing together eating disorders and weight management services to support people living within obesity and emotional or disordered eating’.

The symposium was chaired by Dr Amy Ahern (University of Cambridge) and Professor Jason Halford (University of Leeds and President of EASO) and featured insights from research and practice with speakers from Australia (Professor Tracy Burrows), Ireland (Emma Murphy) and the UK (Dr Laura McGowan and Dr Dasha Nicholls). We also were privileged to hear from Ken Clare (Obesity UK, ECPO and Leeds Beckett University) and Susie Birney (ECPO, ICPO) about their experiences living with obesity and disordered eating.

The event was oversubscribed, with fantastic attendance and engagement from the audience. As well as a live Q&A session, the audience were polled on a range of questions relating to the presentation topics to gather their views on research priorities and barriers to better integration between weight management and eating disorder fields. Below is a summary of responses from these polls.

• The audience felt that there was a need to in commissioning and that a focus on overall health rather than just weight is important. They suggested that this could be achieved by a name change away from focus on weight i.e. food and mood / improving relationship with food / physical activity and body image. The main barrier to this is the lack of cost-effectiveness data based on these outcomes, which is needed to persuade commissioners of the benefits of a move away from weight outcomes
• The distinction between emotional and disordered eating needs to be clearer, with screening and triage for both within weight management services. There was a suggestion that focus on symptom severity rather than diagnostic binaries may be more beneficial and appropriate.
• Several priorities were identified. These included:
  • Providing person-centred care
  • Helping people to have the correct tools to manage their own mental health
  • Changing the focus of services from weight loss to supporting people to improve their relationship with food and make more supportive decisions for their own health
  • Helping people to identify their own motivations for eating, including boredom and loneliness
  • A need to embed therapeutic mental health interventions with weight management services
• Identified barriers included:
  • Poor availability of mental health services / therapeutic support
  • Limited funding for integration of weight management and eating disorder support, rather than lack of wanting or understanding
  • Eating disorder services have very narrow criteria for entry and weight management services have huge waiting lists with inadequate staffing to support the numbers
  • Lack of widespread integration or regard for the psychological aspect of living with obesity

The symposium and the presence of Obesity Institute researchers at the conference has led to several new collaborations and potential avenues for projects. This includes the creation of the Obesity and Disordered Eating Coalition which aims to create a likeminded network of people who want to improve awareness of disordered eating in obesity, identify gaps in provision, and explore synergies and tensions across the fields of weight management and disordered eating. The network will be formally launched later in the year, along with a mailing list and newsletter. Please follow the Coalition on Twitter to keep up to date with our work in this area.