1 - (SYM 103) Human-centered Design of a Therapeutic Session for Discussing Expected Body Weights in Eating Disorder Treatment

Treatment for restrictive eating disorders (EDs) typically includes the establishment of expected body weights for physical recovery, which are often based on population-based norms (e.g., 50th percentile body mass index). A large and growing body of research supports individualized markers of weight status as key predictors of risk and recovery for restrictive EDs. However, individualized approaches to defining EBWs are currently not standardized nor are they widely used. Furthermore, the acceptability of an individualized approach to EBWs is unclear, and there is inconsistent clinical guidance on if, when, and how to best discuss EBWs (regardless of their estimation procedure) with patients. Human-centered design, which centers the experiences of stakeholders, can enhance dissemination, implementation, and sustainability of interventions in practice. Therefore, this study will take a human-centered design approach to (1) comprehensively understand patient and provider perspectives regarding calculations and discussions of expected body weights in the treatment of restrictive EDs and (2) develop an outline of a preliminary therapeutic session for discussions of expected body weights. We will enroll a total of 40 participants, consisting of 20 multidisciplinary providers and 20 patients. Provider participants, comprising therapists, dietitians, and physicians, will have a minimum of one year of experience treating patients with EDs, be currently treating patients with EDs in an outpatient setting, and be English-speaking. Patient participants, aged 14-26, will meet clinical criteria for a restrictive ED, have recent outpatient ED treatment experience (within the past 6 months), and be English-speaking. Interviews will be analyzed using inductive thematic analysis with a realist lens, and results will inform the development of a personalizable EBW therapeutic session outline. If successful, a personalizable therapeutic session for providers to discuss EBWs with patients has the potential to align treatment goals, demystify EBW identification, and address core ED symptoms, ultimately improving outcomes for individuals with EDs.