Envisioning a new way to approach Disordered Eating in Community Health

Helping people establish and nurture a healthy relationship with eating on their terms

How might we best support those experiencing Disordered Eating?

An individual experiences Disordered Eating when they develop problematic eating behaviours that don’t quite fit a clinical diagnosis. It’s a huge, largely invisible issue in the community, with an estimated 12% of the population challenged by food and body image (Eating Disorders Victoria, no date). While disordered eating may not present immediate physical health concerns, it’s one of the major risk factors for developing a more serious, clinically-diagnosed eating disorder (National Eating Disorder Collaboration, 2021).

Our client, a Victorian community healthcare provider, saw an increase in disordered eating presentations as the state came out of Covid lockdowns. To address this need, they piloted a six-step program focused on early intervention. While they had some initial success, the team found that many participants were not sufficiently motivated to complete the program, resulting in a high rate of drop-outs.

Wave was brought on to review and redesign our client’s approach to supporting people across the disordered eating/ eating disorder spectrum through a ‘fresh look’ at the problem space from the end user’s perspective.

Our mission was to:

• Reduce barriers to engaging with early interventions around disordered eating
• Create a blueprint for a service that allows people to establish and nurture a healthy relationship with eating on their terms.
• Build confidence and tangible next steps towards creating such a service for our clients.

Identifying keys to success

At the start of every project, Wave’s designers look for a core tension that will help them reframe a challenge in a new and interesting way. As we worked with stakeholders to gain an internal view of the Disordered Eating pilot, we noticed something interesting. While the pilot objective was to create opportunities for ‘early intervention’ in Disordered Eating, the current approach relied on finding participants who were highly motivated to address their mental health. We wondered: how easy is it to be highly motivated if you’re only in the early stages of presenting symptoms?

Clarifying what ‘early intervention’ and ‘motivation’ looked like from a participant perspective was quickly identified as key to success.

Understanding from a place of safety

To understand the experience of disordered eating, and what support looks like for people challenged by it, we conducted in-depth, semi-structured interviews with people at various points in their healing journey.

Because our research would potentially touch on difficult emotional experiences for our participants, our planning placed strong emphasis on participant safety. This involved enabling the participant to be active in shaping the discussion and setting boundaries throughout the course of the interview. Approaches included?using images as prompts to let them voluntarily explore their experiences and responses safely and encouraging participants to pause or shift the conversation at any point.

Making sure it meets the needs – Desirability

Our research gave us seven key insights about what it feels like to grapple with disordered eating. These covered three areas:

• What’s in my head: the internal experience of disordered eating
• What’s happening around me: the external factors influencing how someone responds to these feelings
• The Journey: how both these elements play out over time as people move towards healing.

Our next step was to collaborate with our client to respond to these opportunities in order to envision the future of care they could provide for people with Disordered Eating.

Starting with a design workshop, we created a range of high level North Star concepts. A North Star creates a vision of an ideal future state from which to backcast – or reverse engineer – steps to achieving this value for the end user in short, medium and long-term scenarios.

Our concepts were focused on:

• creating space for the individual from the day-to-day stress of disordered eating in order to gain a new perspective on it
• involving non-clinical aspects of support, to build trust in, and complement clinical approaches
• activating strong support networks based on existing relationships and others with lived experience
• allowing for fluid entry points into support whatever the stage of the journey an individual finds themselves in.

Making sure it would work – Feasibility & Viability

North Star concepts can feel like a giant leap for some organisational stakeholders, because they represent future thinking that is led by customer desirability rather than by today’s implementation and costing assumptions. To address this concern we provided a feasibility and viability analysis to our clients that showed how key elements of the concepts could be developed to have immediate impact for the organisation, while meeting existing constraints and providing valuable learnings.

Embedding ownership of the outcomes in our client’s hands

When we hand designs over to clients to lead the next steps internally, we need to set them up with a compelling narrative that speaks to the impact of a new approach. In this project, we did this using a Service Blueprint, which follows a fictitious character as they engage with different aspects of the solution across their journey.

This not only gave detail around how our concepts came together, but also surfaced the emotional quality that will help our client sell the vision and secure buy-in for further development. The blueprint, along with an implementation roadmap, will be used to inform upcoming funding applications to move into delivery.

WAVE Reflections

Will Farrier Senior Service Designer | WAVE

"Often healthcare design starts with best practice clinical interventions and fits these around capability and cost assumptions. Patient experience is a by-product of these decisions, and isn’t necessarily given the attention it deserves. It falls to clinicians delivering services to take the initiative to incrementally improve things, but this generally falls flat when so much of an experience is embedded at a system level.

Our approach starts by gathering clear insight into the desired patient experience by examining what meaningful care and support looks and feels like for them. This provides a strong foundation on which to layer clinical interventions that can meet the broader needs of individuals, while delivering safe and effective healthcare."

Client-side Reflections

Manager for Innovation & Design | Community Health Provider

“Working alongside Wave to better understand how we could design a service to support people experiencing disordered eating was really valuable because they brought an 'outside-in' perspective to our model of care.?

They demonstrated great ability to listen to people's stories and were able to bring the learnings and insights to life, ensuring the client's voice was always present and top of mind. This evidence-based thinking helped us to move forward with greater clarity and confidence that the service we were designing was aligned with our clients' needs.”

This case study was developed by Will Farrier, Senior Service Designer at WAVE. Will Farrier has designed for healthcare, aged care, financial services, insurance and start-ups, including helping to build the global ethical fashion platform Good On You. At WAVE, Will uses his skills as a facilitator, researcher and designer to help clients tackle big challenges by thinking differently.