Evaluating the Effectiveness and Feasibility of the RENew-ED Group
Research type
Research Study
Full title
A Quasi-Experimental Mixed-Methods Study: Investigating the effectiveness and feasibility of the Recovery in Exercise and Nutrition for Eating Disorders (RENew-ED) group
IRAS ID
353578
Contact name
Kerry Hill
Contact email
Sponsor organisation
Cornwall Partnership NHS Foundation Trust
Duration of Study in the UK
0 years, 8 months, 1 days
Research summary
Eating disorders are a group of mental health conditions whereby the individual will alter their food intake and engage in inappropriate behaviours due to weight and/or shape concerns. Compulsive and maladaptive exercise is a feature of eating disorders, and can be defined as movement which is: rigid or rule-based and/or undertaken to regulate emotions and/or completed to prevent any perceived negative outcomes (such as weight gain). It has been shown in the research that people with eating disorders who engage in compulsive or maladaptive exercise may have negative treatment outcomes.
This study will investigate the effectiveness and feasibility of a pilot five-session intervention called the Recovery in Exercise and Nutrition for Eating Disorders group (RENew-ED group). The group will be an adjunct therapy to usual eating disorder treatment for healthy weight participants with eating disorders. The group will aim to reduce compulsive and maladaptive exercise behaviours, improve nutritional intake to support exercise, and increase appropriate use of rest and recovery, to overall encourage healthy exercise. It will do this through use of education, reflection, therapeutic techniques and group discussion.
The group’s aims, effectiveness, and feasibility will be assessed through use of questionnaires and other measures such as weights, body mass index (which can indicate if someone is a healthy weight), as well as demographics. These measures will be taken before, immediately after, and three months after the RENew-ED group. The study will also gather information on number of people recruited and drop-outs. Given this is a pilot study, it will only investigate pre and post test values for one group and the study will not include a control group.
Lay summary of study results: Individuals with eating disorders often struggle with exercise which is excessive, compulsive, and/or rigid. It may also not be supported by adequate nutrition. We developed a five-session group programme to address this called the Recovery in Exercise and Nutrition for Eating Disorders (RENew-ED group). We tested whether it could be delivered safely, whether people would attend and stay engaged, and whether it was helpful.
We invited healthy weight individuals already receiving eating disorder treatment at Cornwall Foundation NHS Trust Adult Eating Disorder Service to take part. The intervention was five weekly sessions which each focused on a different topic around healthy exercise or nutrition. Out of 185 individuals open to the local eating disorder service, seven individuals started the group intervention and five people completed it. Participants completed weighing and questionnaires before the intervention, after, and again three months later.
Body mass stayed stable throughout the intervention and at follow up. There were no adverse effects. Scores measuring unhelpful exercise thoughts and behaviours fell to below the level of concern at follow-up after the group, but the study was too small to confirm whether this is significant or reliable. Most reported eating patterns to support exercise improved after the intervention, but some were not sustained at follow-up. At follow-up, individuals were spending significantly more time lying or sitting down compared to before the intervention. This may reflect a healthy decrease in over-exercising, or changes in life circumstances which limits exercise. Most participants found the group intervention helpful, safe and supportive, though a minority would have preferred individual sessions.
There were some challenges in the study design. The questionnaires were answered anonymously, so we could not match each individuals answers from before and after the group. This meant that we could only look at how the group as a whole changed at each time point, which may have affected results.
This study shows the programme can be delivered safely and was valued by most who completed it. Not everyone who started it, finished it, and it was hard to get people to sign up to the study. The findings will be used to refine the group intervention, including offering more flexible delivery, before testing it in a larger study with a comparison group.
REC name
South East Scotland REC 01
REC reference
25/SS/0018
Date of REC Opinion
7 Mar 2025
REC opinion
Further Information Favourable Opinion