The Eating Disorder (ED) Recovery Hubs pathway is embedded within the core teams across Barnet, Enfield, Haringey, Camden and Islington. 

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

ARFID (Avoidant/Restrictive Food Intake Disorder)

• Individuals that experience a lack of interest in food or food avoidance, accompanied with distress and impaired psychosocial functioning in the past month.
• Individuals experience sensory aversion to food which causing psychological distress and impacts psychosocial functioning.
• Individuals do not experience shape and weight concerns and their difficulties are not better explained by food availability or another mental health condition.
• Insufficient variety or quantity of food. 

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