Recent advances and future directions in the management of eating disorders

The aim of this paper is to describe recent and future advances in eating disorder treatment. The development of new treatments represents a pressing issue, given that current treatments, which are predominantly forms of psychotherapy or inpatient treatment (for those at high medical risk), have variable and limited efficacy, with short-term recovery levels between 30% to 50% for the first stage of treatment. If initial treatment efforts fail, there is uncertainty about what strategy should be next considered. Developments in aetiological understanding, through defining biomarkers, working with animal models and neurobiological investigations, have encouraged the consideration of a broader range of treatments. Brain-directed strategies such as neurostimulation, exposure-based learning, psychedelics, metabolically targeted treatments including leptin and incretin receptor agonists, and the therapeutic use of the arts have been recently investigated. New technologies such as virtual reality–based and brain training–based interventions have been found to enhance standard forms of treatment. Unfortunately, the limited funding for eating disorder research has meant that advances into clinical practice have been limited. However, given the size of the problem and its protracted nature, it is important that work to progress and evaluate new treatment pathways, such as that in depression or schizophrenia, is prioritised.