InsideOut in collaboration with QIMR Berghofer and researchers in the USA, Sweden and Denmark are conducting world-first genome-wide association studies to identify the genes associated with Anorexia Nervosa (the ANGI study) and other eating disorders (the EDGI study). Identifying genetic and neurochemical pathways will allow us to better understand the interaction between the biological, psychological and social influences on eating disorders and revolutionise our approach to treatment and early intervention in high-risk groups.

As part of the Million Minds MRFF Mainstream Research Program we are partnering with clinical and research leads in states across Australia to locate research capacity within frontline service settings. This will establish the infrastructure for the growth of the research workforce nationally and help close the translation gap by co-locating clinical and research expertise. Our first hubs go live in Melbourne and Brisbane in early 2021.

These studies seek to examine the role of the microbiome, gut-brain axis and polygenic risk profile in the establishment of the vicious cycle in anorexia nervosa. Comprised of three studies the program will examine biological and psychological processes in dieting, full syndrome anorexia nervosa and an animal model for anorexia nervosa

This study is looking at the genetic foundations of the full clinical spectrum of anorexia nervosa - both atypical and full syndrome to elucidate any differences in the genetic contributions and potential differences in the contribution of polygenic risk scores

InsideOut recently designed and validated a new high risk screening tool for early identification of disordered eating behaviour in all ages and genders. Early screening may be key to improving early intervention rates (currently, only 1 in 4 people with an eating disorder is receiving treatment), ultimately driving reduced morbidity and mortality. The screener is currently being trialled in primary care and Headspace clinics across Australia.

InsideOut is working with epidemiologists and national data linkage specialists to evaluate 15 years of national health system data to establish the first national comprehensive and population-based surveillance system of people with EDs. This is based on administrative health data from the State, Commonwealth and youth mental health platforms, headspace and newly developed Innowell (ProjectSynergy) platform that span the various access points to the health system in the screening, diagnosis and treatment of individuals with EDs.

InsideOut is establishing a National Eating Disorder Lived Experience Lifetime Survey, similar in scope to longitudinal feedback studies in other major illness groups such as Multiple Sclerosis. This project reflects a growing body of literature which privileges the sharing of consumer knowledge and experience in informing clinical research and practice, so we can better understand illness, carer and financial burden, treatment and research gaps and quality of life over the illness journey.

InsideOut in collaboration with the Lambert Initiative and national clinical partners is conducting an open label-pilot trial exploring the safety and efficacy of cannabidiol (CBD) to treat anxiety in young people with anorexia nervosa (AN) as they undergo Maudsley family-based therapy (FBT). It is hypothesised that if anxiety can be reduced while treatment is administered outcomes will improve.

InsideOut with national partners is conducting a pilot study of psilocybin in combination with psychotherapy for treatment-refractory anorexia nervosa.

InsideOut in collaboration with University of California San Francisco are conducting a pilot researching telemedicine delivery of Maudsley Family Based Therapy for Anorexia Nervosa into the home of rural and regional families in NSW.

InsideOut in collaboration with Sydney Children's Hospital Network, Sydney Local Health District, South East Sydney Local Health District and Northern Sydney Local Health District have been funded by the Medical Research Futures Fund (MRFF) through Sydney Partners to examine the translation of evidence based treatment for children and adolescents with Anorexia Nervosa within NSW districts. The trial will determine barriers and enablers for the embedding of evidence based care in hospital and community settings and develop mechanisms to support it.

Currently there is no validated instrument to assess eating disorders in Aboriginal and Torres Strait Islander Communities. Best available evidence would suggest that eating disorders have a higher prevalence in these communities however without a culturally appropriate valid instrument this cannot be definitively determined. This project, funded by NSW Health, was codesigned and will be led by Aboriginal researchers. We will use a Yarning and Delphi methodology to validate the gold standard diagnostic instrument for eating disorders within this context.

COVID-19 and its attendant restrictions have had a unique impact on individuals suffering from mental illness. InsideOut conducted a national survey evaluating the impact of COVID-19 on Australians with eating disorders and body image concerns, including behaviour and mental health symptom change, impact of social isolation and other circumstances associated with the pandemic, and access to treatment/changes in treatment modality

As part of the Mainstream initiative, InsideOut in collaboration with Sydney Economics is developing health system and economic models to inform decision making about effective, cost-effective and equitable access to healthcare for this population. This involves evaluating costs, outcomes and cost-effectiveness of evidence based versus non-evidence-based pathways to care; assessing the effects of health policy changes at state and national levels on individuals with EDs accessing care (including recent Medicare changes); and evaluating the pattern of and factors driving changing inequalities in care access over time.

Microlearning is a branch of e-learning delivered in short modules (or units) and incorporating videos, games and puzzles to achieve specific learning outcomes in very short periods of time – flexible and has proven very effective for time-poor General Practitioners. This is the first trial of microlearning for GPs in eating disorders. Funded by the Psyche Foundation.

A significant gap in knowledge in understanding the process and outcomes of dieting in a population who report very high levels of it – young people. Dieting is the single strongest predictor of the onset of an eating disorder. The natural physiology of dieting will be followed during this longitudinal study, assessing psychological, physiological and behavioural responses, in those who frequently engage in dieting (16-25 years). Our aim is to identify underlying biological and psychological changes in response to dieting, how these impact dieting adherence, dieting outcomes and to determine if any markers of risk (i.e., through neuro, endocrine, gut microbes, physiology) can be determined for unhealthy dieting and the onset of an eating disorder.

InsideOut in collaboration with our partners at the Kings College London, and Birmigham Eating Disorder Service are conducting a research trial developing a child and adolescent version of the CASIAN instrument used to stage Anorexia Nervosa in Adults. The instrument once validated will be used to identify kids early in the illness progression so as to help them gain access to services early and maximise remission rates.

InsideOut in collaboration with headspace, Community Mental Health teams and Peter Beaumont eating disorder service is examining the effectiveness of a online 10 session CBT guided self-help program for individuals aged 16 and over with Bulimia Nervosa, as part of routine clinical pathways in these settings in a randomised controlled trial.

InsideOut, in collaboration with Project Air, the University of Wollongong and the University of Western Sydney, are researching suicidality in Anorexia Nervosa.

InsideOut in collaboration with Deakin University Melbourne is examining the effectiveness of a online 10 session CBT guided self-help program for individuals aged 16 and over with Binge Eating Disorder.

InsideOut in collaboration with the University of Melbourne is studying compulsive exercise in people with eating disorders and muscle dysmorphia. This is a mixed methods approach in an under-researched area designed to explore the experiences of compulsive exercise in people with muscle dysmorphia, This research will be used to inform the development of an adapted psychological treatment to reduce compulsive exercise cognitions.