Eating disorders, such as anorexia nervosa and bulimia nervosa, are complex mental health conditions that affect how people think and feel about eating as well as their body weight and shape. These individuals often find mealtimes challenging and require support during this time. Supported mealtimes, a predominantly nurse-led intervention, form a crucial part of eating disorder treatment.

 

During supported meals, clinicians offer guidance and encouragement to patients within a structured environment, such as a dining hall. Supported mealtimes often involve a set of rules, which vary across organisations, and can include fixed meal durations and restrictions on certain clothing items to prevent concealment of food, amongst others. While this intervention is known to be an effective part of treatment, there is limited evidence on how the intervention works, who benefits most, and how it might be adapted to suit the needs of different patients.   

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Supported mealtimes have been described as anxiety-provoking by both patients and clinicians, and both parties have noted an unhelpful power-dynamic in the dining room. Similarly, there are significant variations in how the intervention is delivered across sites and staff members. There are currently no best practice guidelines for supported mealtimes and limited understanding on how current practices can be adapted to meet the needs of individual patients, such as those with co-occurring psychiatric or neurodevelopmental conditions.  

 

This study aims to develop best best-practice guidelines for this intervention by exploring how supported mealtimes work, for whom they work best, and in what circumstances. Guidelines will inform professional training and empower clinicians to provide high-quality support, ultimately improving treatment experience and outcomes for people with eating disorders. Over the course of this preparatory fellowship, I plan to develop the current research plan further by working closely with the potential research sites, experts by experience, and a clinician advisory group.   

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