Virtual Care Could Reduce Hospital Admissions in Severe Eating Disorders, Study Finds

Key Takeaways:

• A fully virtual, multidisciplinary treatment programme demonstrated strong engagement and positive clinical outcomes for adults living with severe eating disorders
  
• Structured online support during high-risk transition periods may help reduce hospital admissions and sustain recovery following discharge
  
• The model highlights the potential for digitally delivered, evidence-based care to bridge gaps between inpatient and community services
  
  
  

Evaluating a new approach to severe eating disorder care

An evaluation conducted by Oxford Health NHS Foundation Trust has examined whether intensive, fully virtual treatment can effectively support people living with severe eating disorders. The study, published in the Journal of Eating Disorders, focused on a service known as Step Care, developed through the HOPE Provider Collaborative.

Researchers describe this as the first prospective study to investigate a completely virtual, intensive treatment model using multidisciplinary enhanced cognitive behavioural therapy (CBT-E). The programme is designed to support individuals as they transition between inpatient treatment and community-based care.

This period of transition is widely recognised as a critical phase in recovery. People living with severe eating disorders face a particularly high risk of relapse shortly after discharge from hospital, especially within the first two months. The study therefore explored whether structured virtual support during this vulnerable period could help maintain recovery and reduce the likelihood of readmission.

Addressing gaps in existing services

Step Care was developed in response to well-documented challenges within eating disorder services. These include fragmented transitions between inpatient and community care, repeated hospital admissions, and limited access to intensive day treatment.

The service is delivered entirely online and brings together a multidisciplinary team, including professionals from psychology, nursing, dietetics, and art therapy. This integrated approach aims to provide consistent and coordinated care across different stages of recovery.

Step Care operates through three distinct pathways:

• Starting Well – for individuals at risk of requiring hospital admission, with a focus on prevention
  
• Staying Well – for those recently discharged from inpatient care, supporting early recovery
  
• Working towards Recovery – for individuals who have begun restoring weight and are focusing on longer-term recovery
  

Lucy Gardner, professional lead dietitian within the Step Care service, highlighted the importance of integrating nutritional support within a broader therapeutic framework:

“Nutrition plays a crucial role in mental health, yet access to the right level of dietetic support is often inconsistent,” she said. “Our model offers a clear, evidence-informed way to tailor dietetic input to individual need, delivering CBT-E virtually as part of a multidisciplinary team.”

Positive outcomes across key measures

The evaluation reported high levels of engagement and programme completion, including among individuals who had been living with eating disorders for an extended period.

Participants within the Starting Well pathway experienced significant improvements across several clinical and psychological measures, including:

• Body mass index (BMI)
  
• Eating disorder symptoms
  
• Psychosocial impairment
  
• Mood
  

Importantly, most individuals in this group were able to avoid hospital admission during the course of the programme.

For those in the Staying Well pathway, outcomes were also encouraging. Participants maintained their weight and experienced a reduction in the overall impact of their illness during a period typically associated with high relapse risk. Unplanned hospital admissions were reported to be rare, and many individuals were successfully supported in transitioning to community-based care.

Sharon Ryan, nurse lead within the Step Care service, emphasised the importance of this post-discharge phase:

“The weeks after leaving hospital are often the most fragile,” she said. “Step Care provides consistent multi-disciplinary support at that point, helping people maintain their recovery with support to feel safe and confident out of hospital.”

Implications for future care models

The findings suggest that intensive, evidence-based treatment for severe eating disorders can be delivered effectively in a virtual format. This approach may offer a valuable additional option for supporting individuals at home, particularly during critical transition periods.

Agnes Ayton, clinical lead for the HOPE Provider Collaborative, explained the underlying aim of the service:

“Step Care was designed to bridge the gap between inpatient and community services,” she said. “The findings show that intensive, evidence-based treatment can be delivered safely online, providing continuity of care at a time when people are most vulnerable.”

She also noted that both engagement and clinical outcomes were encouraging, including among individuals who had experienced long-term illness.

A complement to existing services

The authors conclude that virtual programmes such as Step Care may serve as an important complement to traditional inpatient and community services. By providing structured, multidisciplinary support during high-risk periods, these models have the potential to enhance continuity of care and support sustained recovery for people living with severe eating disorders.

As healthcare systems continue to explore digital and hybrid models of care, this study adds to a growing body of evidence suggesting that virtual interventions can play a meaningful role in complex, long-term conditions.