Dr Daniel Wilson’s research on eating disorders

Tell us about your research area, Dan. 

Eating disorders can be incredibly debilitating conditions for young people and families affected. We have some good evidence-based treatments for eating disorders, but even these treatments don’t work for everyone all the time. 

We do know that some treatments will be effective for young people, whereas other treatments have not been able to achieve recovery, but we have very little evidence to guide treatment recommendations and allocation. With this research we hope to be able to identify the factors that influence outcomes between treatments so we can be able to assess young people at the start of treatment and predict which therapy is most likely to be effective for them. 

This could mean that young people can access the treatment that is most effective for them as early as possible and make progress towards recovery as early as possible. Additionally, it will help us understand what factors are a barrier to recovery and what treatment modifications/enhancements we might need to make to improve outcomes.

Dan Wilson

Clinical Psychologist and Research Fellow focusing on young people with eating disorders and their families

Researcher profile

How do you conduct your research? 

The research is being conducted with young people and their families who are engaged with one of the treatments at the Children’s Health Queensland Child and Youth Mental Health Service Eating Disorders Team. If families consent to research, we assess their scores on a range of measures of eating disorder psychopathology and comorbid conditions at the start of treatment and the end to understand if they have improved or not, and what might be predictive of better or worse outcomes. 

What are the outcomes of your research?

The research is still a work in progress, but we have some preliminary findings on some service changes in response to clinical problems. Long waitlists were a problem that we had as this meant a delay to treatment, which predicts treatment dropout and poorer overall outcome. We implemented a pre-treatment intervention, which reduced wait-times, improved young people’s weight and eating disorder psychopathology, and improved parents’ self-efficacy and depression. This was important as it meant that families could start the journey to recovery even before they started frontline treatment. 

We also had a problem of whilst our frontline treatment of Family Based Treatment (FBT) achieves recovery for a lot of families, it does not work for everyone (as even the best treatments don’t). We implemented and assessed both an intensive day program treatment, as well as a referral pathway to an alternative treatment (enhanced Cognitive Behaviour Therapy) for young people who had failed to progress in FBT. There is little existing research to guide these changes, but our research found that these options were both effective and achieved recovery among those who had not responded to FBT. 

This is important as it gives hope to young people and families who have not response to FBT. It is also important from a systems perspective, in that offering these types of follow up treatments may be a promising way of improving recovery rates. 

Do you have any notable statistics to share?

Among those who had discontinued FBT but went on to finish CBT-E treatment (which takes a lot of dedication, mind you!), around two-thirds achieved complete recovery. When you bear in mind that a lot of young people respond positively to initial FBT and need no further follow-up, then this indicates that one or a combination of these treatments are achieving a positive outcome. This is important, as historically, eating disorders have been a mental health issue that has been one of the more difficult to achieve positive outcomes.

Were there any unexpected findings?

In our pre-treatment program, young people showed small but significant improvements in eating disorder psychopathology. I was surprised at this due to the brevity of the treatment and that the invention is largely parent-focused and doesn’t directly target eating, weight and shape concerns at this point. We will have to dig deeper to better understand the mechanisms at play here!

What does your research mean for the people of Queensland? 

We are understanding more about what treatment/s work for young Queenslanders with an eating disorder. This research is the starting point that we hope to continue to improve treatments so that no one has to live with what can be an incredibly impairing and horrible disorder. 

Does this open the door to any further research topics?

Absolutely, it poses more questions than answers, really! We’ve learnt a few things about what to offer those who have not responded fully to FBT, but then so many questions come from this!

How do we know who might not respond to initial treatments in the first place? If we can identify them and allocate them to a different treatment, will they respond to that as their first treatment instead of having to go through an elongated journey? What are the mechanisms that differ between those with and without positive outcomes? How can we change our treatments to address these mechanisms? What are the experiences of people undertaking our treatment – what can they tell us?

There’s a lifetime of questions to answer!

Do you have any advice for aspiring mental health researchers?

Collaborations are key. I’ve been very lucky to fall backwards into teams, places and people who have been wonderfully supportive and enabling of research.

Additionally, advice that I’m frequently reminded of when I’m trying to solve the world’s problems in a single study is ‘dream big, but start small’. 

Is there anything else you’d like to share? 

I’d like to thank all the young people and families who have engaged with our service, as well as anyone affected by an eating disorder. This research is for you.