Eating Disorders and the Use of Restrictive Practices
Principle Investigator
Professor Joy Duxbury
Brief Description
This research project aims to understand and reduce the use of restrictive practices in the care of children and young people with eating disorders across healthcare settings in England.
The study brings together researchers, clinicians, young people, parents, and carers to examine how restrictive practices are used, how they are experienced, and what can be done to make care safer, more compassionate and less distressing.
Restrictive practices
‘Restrictive practices’ is a collective term for different types of restraint – acts carried out with the purpose of restricting an individual’s movement, liberty and/or freedom to act independently.
These can range from not having access to outdoor space or bedrooms during the daytime, to feeding or medicating against a patient’s will (i.e. via nasogastric tube). Service wide restrictive practices, described as ‘blanket restrictions’, can include not allowing home leave until a weight target or stage in treatment is achieved.
Restrictions may be in place across eating disorder treatment pathways to facilitate physical safety or to promote compliance with treatment programmes. But paradoxically these practices can cause conflict and can be the direct cause of harm and trauma.
Despite rising admissions of young people with eating disorders, there is limited research into the emotional and practical impact of these interventions, or how their use might be reduced.
Patient and public involvement
Young people with lived experience of eating disorders, their families and frontline clinicians have played a leading role in shaping the study. One of the project’s co-applicants with lived experience is Adele. She said: “This research is so important as there are so many restrictive practises alongside physical restraint that are not discussed enough, despite having a high emotional impact on individuals and their loved ones. I am proud to be part of this project and share some insight into what measures are being taken for those in inpatient settings hearing the perspective from those that have experienced it.
To ensure these perspectives continue to guide the work, two dedicated advisory groups - one for carers and parents and one for the young people - will work alongside the research team throughout the project. Wellbeing support will be provided by leading national eating disorder charity BEAT. Young people involved in the study will receive training and support to contribute to drive the project, data analysis, writing, and presenting findings.
The research project
The research will consider a range of NHS settings, including inpatient units, community teams, and paediatric services. The research includes:
- Reviewing existing evidence and national data to map current patterns of restrictive practice
- Observation within participating NHS services to better understand decision-making processes
- Interviews with young people, families, and staff to explore lived experiences
- Co‑produced workshops to develop solutions and recommend good practice
- A final implementation phase to support meaningful, lasting change
The research A sequential mixed method study to investigate, understand and find co-produced solutions to the use of restrictive practices in health settings when caring for children and young people with eating disorders is a collaboration between the University of Cumbria, Edge Hill University, King’s College London, the University of West London and the UK’s eating disorder charity BEAT. The project is funded by the National Institute for Health Research and runs until February 2029.
Press appearances
Contact
To find out more: contact Professor Joy Duxbury (joy.duxbury@cumbria.ac.uk) or Marieke Torensma (marieke.torensma@cumbria.ac.uk)