The Eating Disorder (ED) Recovery Hubs pathway is embedded within the core teams across Barnet, Enfield, Haringey, Camden and Islington. Each borough has a clinician responsible for offering treatment and consultation within the core team. This is overseen by the Eating Disorder Recovery Hubs Lead who will clinically supervise the clinician.

The pathway offers treatment to a wider range of individuals with an ED, particularly those adults with a primary presentation of ED of mild-moderate severity, who do not reach the threshold for St Ann's moderate-severe ED service.

Two forms of Cognitive Behavioural Therapy (CBT) are on offer:

• CBT-T (where the T stands for ten): A brief 10-session intervention suitable for adults with an ED who are not underweight. This will be the first-line treatment for most cases seen.
• CBT-E (enhanced CBT for EDs): This is a longer course of treatment lasting up to 20 sessions. It is more suitable for anorexia-like presentations, for individuals who haven't responded to CBT-T, and for cases with added complexity or comorbidities.

Both interventions support individuals to improve their eating patterns, beliefs about food, and body image, while addressing related emotional difficulties. Treatment will involve weekly, individual, face-to-face sessions.

Eligibility Criteria

Inclusions

• Individuals must meet diagnostic criteria for an ED.
• The ED must be primary rather than symptomatic of other difficulties (such as trauma), which should be the focus of treatment

Anorexia nervosa

• Individuals with a prior diagnosis of anorexia nervosa and at risk of relapse
• Individuals who have completed treatment for AN, have restored their weight, but restrictive eating, body image concerns and other anorexic cognitions/behaviours remain

Bulimia nervosa 

• Individuals binge eating one to three times a week for the past month and
  • Binges are associated with loss of control and are distressing
  • Compensatory behaviours (such as vomiting, using laxatives, over-exercising) one to three times a week for the past month
  • Body image concerns that influence self-worth

Binge eating disorder 

• Individuals binge eating one to three times a week for the past month and
  • Binges are associated with a loss of control, may be a way to manage difficult emotions, and are very distressing
  • Body image concerns that influence self-worth

Exclusions

• Individuals with subclinical disordered eating
• Individuals with anorexia nervosa who are underweight (BMI <18.5)
• Individuals with significant medical risk (e.g. underweight, deficiencies). Those who need close medical monitoring or dietetics are more suitable for St Ann's service
• Clients who have an ED but are pregnant or have Type 1 diabetes are more suitable for St Ann's service
• Clients with psychosis, active drug/alcohol dependence, or active suicidal risk 

How to Refer

GPs should complete the screening tool and refer to the core team via borough specific email addresses

Locations

Springwell Centre

Margarete Centre

Silver Street Centre

Halliwick Centre, St Ann's Hospital

Southwood Smith Centre