Stephanie was told she would never get better. Now she's at the forefront of treating her illness

The Age

5 days ago

For years, Stephanie Boulet was told she would never recover from anorexia nervosa. Enduring hospital admissions and residential care through her adolescence and 20s, the treatment – which assumed she was motivated by a desire to be thin – didn't work.
'It is not fair that I was in that state for as long as I was, repeatedly reaching out for care and being called 'treatment resistant' and [my condition] 'severe and enduring',' Boulet said.
Evidence-based treatments for adults with eating disorders do not work for roughly half of patients, and there is no standalone evidence-based treatment for anorexia or other specific disorders, meaning clinicians rely on guesswork to find ways to help.
But a promising new US trial has found a personalised treatment approach targeting unique combinations of symptoms for each patient led to a greater decline in symptoms compared to the current gold-standard treatment, enhanced cognitive behavioural therapy (CBT-E).
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The results of the small randomised controlled trial, the first trial of personalised treatment for any mental illness, were presented at the Australian Eating Disorders Research and Translation Centre's (AEDRTC) conference in Sydney last week. The findings are yet to be peer-reviewed.
Lead researcher Professor Cheri Levinson, director of the Eating Anxiety Treatment (EAT) Laboratory at the University of Louisville, said current treatments were based on averages that don't account for the huge variations in the symptoms, behaviours, thought processes and characteristics of people with eating disorders.
'Patients with the same diagnosis can present with extremely different symptoms,' she said.
'Growing data shows that about 50 per cent of patients have weight and shape concerns as their central or most important symptoms, meaning 50 per cent do not,' she said, floating the concept of an 'eating spectrum disorder' approach to diagnosis.