A revolutionary Monash University-led eating disorder research program will target biological causes and possible new treatments including novel drugs, brain stimulation and hormones.
The world class Li Transformative Hub for Research in Eating Disorders (THRED) will be coordinated through Monash University's HER Centre Australia, which was launched in 2022 to consolidate and expand research into and treatment of women's mental illness.
Researchers from the HER Centre and the Department of Neuroscience in Monash's Central Clinical School will work collaboratively on the disorders.
An estimated one million Australians, or four per cent, live with an eating disorder such as anorexia nervosa, bulimia nervosa, and binge eating disorder. The THRED program will have three key pillars: delivering new, effective treatments, enhancing current treatments and uncovering biological causes.
It was made possible by a generous donation by THRED's Founding Patrons, Melbourne Symphony Orchestra chair and former professional violinist David Li AM and his pianist wife, Angela Li. They provided seed funding and HER Centre Australia and the Central Clinical School will align its philanthropic vision and goals with generating additional funding to achieve THRED's full potential.
HER Centre Australia Director Professor Jayashri Kulkarni AM said as the incidence of eating disorders (EDs) continued to rise in the wake of Covid-19, a new approach was needed. She said most treatments focussed on talking therapies, with varying success, and effective biological treatments had not been developed.
"Over the past 60 years there has not been any real change in how treatments for eating disorders, which cover a spectrum ranging from various disordered patterns of eating to anorexia nervosa, have been delivered," Professor Kulkarni said.
"We need a new approach. We want to provide a better understanding of why EDs occur and how to treat them from a biological perspective. We will do this by conducting clinical trials that will investigate possible treatments. These trials will be informed by investigation into the biological abnormalities that underpin eating disorders"
THRED will conduct clinical trials of new treatment approaches for serious eating disorders, and hopefully deliver more effective treatment options.
Expected to start in the second half of 2023, its clinical trials will assess brain stimulation, hormonal manipulation and novel drug therapies as well as developing new treatments as they are generated based on their own and other research findings from Australia and around the world.
To this end, discovery science uncovering the role of genes and proteins in a personalised medicine approach will be undertaken and linking all this will be novel artificial intelligence driven smartphone technologies to deliver personalised care to people experiencing an eating disorder.
Professor Kulkarni said eating disorders could develop due to biological changesrelated to genes, RNA, and proteins, yet not much had been invested in developing treatments that targeted brain biology and/or biological factors. She said a holistic approach was needed.
"For too long, eating disorders have been surrounded by ignorance about their cause and stigma that often assigns blame to the person with the ED 'if only she would eat … the problem would go away'," Professor Kulkarni said.
"It's not that simple. These are complex conditions that require multi-faceted solutions. Psychotherapy is important but does not encompass the big picture, or the possibility of biological causes.
"The impact of eating disorders also worsened during Covid, with some people eating too much and others developing anorexia. We have a condition that has a high mortality and a very high morbidity but the only treatments available are 'talking therapies' that haven't provided patients with the treatment they deserve."
Eventually, THRED hopes to move into a second phase of research investigating biomarkers that could help define ED subtypes and pave the way for new treatments.
"This program won't be a 'silver bullet' for eating disorders, which are notoriously difficult to treat," Professor Kulkarni said. "But we hope our focus on the biology will result in improved treatments that will make a real difference.
"There have been very few biological eating disorder treatment trials, and what has been done has been very patchy. We believe this program is unique in Australia and possibly a world-first in terms of its combination of neurological trials in a clinical setting, with a focus on brain stimulation, hormones and new medications, coupled with discovery sciences approaches to discover root causes."
The Dean of Monash University's Sub-Faculty of Translational Medicine and Public Health, Professor Stephen Jane, emphasised the importance of the initiative.
"A new lens for examining the causes of eating disorders and for the development of new treatment paradigms is desperately needed – the combination of discovery science coupled with clinical trials represents a unique approach that we believe will positively re-sculpt the landscape for patients with eating disorders," he said.
