Who this is for
Adults with diagnosed or suspected eating disorder. Medical instability (HR <50, low K, BMI <17.5, severe dehydration) requires medical clearance / inpatient or partial-hospitalization stabilization BEFORE pathway start. This pathway SUPPLEMENTS - never replaces - the member's outside ED treatment team.
What brings people here
EAT-26 >=20; SCOFF >=2; clinician referral; member self-disclosure of restriction, binge-purge, or orthorexia patterns.
Clinical framework
OneVillage-developed (AED clinical guidelines).
How the 8 weeks run
Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.
Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.
Re-score, refresh the care plan, and check in 1:1 on what is and is not working.
The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.
Final re-score, relapse prevention, and the plan for what happens next.
When your sessions fall
The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.
| Module | Weeks | Sessions | Cadence |
|---|---|---|---|
| Module 1 | Weeks 1 to 4 | 2 | every other week |
| Module 2 | Weeks 5 to 8 | 2 | every other week |
Week by week
- Before you beginBefore you begin
This is the reading before your first visit, and it matters more than any other week here. Everything this pathway does depends on you being connected to an eating disorder treatment team, and on your medical safety being established first. Week 0 is where both of those happen.
- Week 1What treatment actually is
This week explains what evidence-based treatment for an eating disorder looks like, so that you can tell whether you are receiving it, and so that you have language for asking. None of it is delivered by this program.
- Week 2Perfectionism, control and identity
This week you meet Kimberly Macon, the Mindset Coach, for 45 minutes. The session is not about eating and it is not therapy.
- Week 3The medical side
Eating disorders are psychiatric illnesses with physical consequences, and the physical part is why medical monitoring is not optional. This week explains what your clinicians are watching and why, so that appointments feel less like surveillance and more like what they are.
- Week 4Mid-program: is the coordination working
Week 4 is your second 45-minute visit with Cindy. In most pathways this is where the mid-program measures are reviewed. Here it is also where we ask a harder question: is the care around you actually the right care, and is it actually happening.
- Week 5The people around you
Eating disorders happen inside households, and the people around you are affected whether or not anyone has acknowledged it.
- Week 6Sleep
This week you meet Kelly Day O'Brien, NBC-HWC, the Sleep Coach, for 45 minutes. Sleep is disrupted in most people with an active eating disorder, it makes everything else harder, and it is one of the few areas in this pathway where a coach can work directly rather than routing you elsewhere.
- Week 7Movement, handled carefully
Every other pathway OneVillage runs has a movement week that encourages you to move more. This one does not, and the difference is deliberate. In eating disorder recovery, exercise is a clinical decision made by your treatment team, and for many people at many points the correct answer is not yet.
- Week 8Making it hold
Week 8 is your third 45-minute visit with Cindy and the last of the structured program. This pathway runs for at least twelve months, so this is a checkpoint rather than an ending, and the point of it is to leave you with something written down that survives a bad month.
Who you will work with
Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.
Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.
Meet Kimberly Macon, Professional Certified Coach (PCC), wife, mother, and a cancer survivor specialized in helping OneVillage members build mental resilience in the face of difficult situations and life changing events. Kimberly spent more than 15 years working in various roles across the Consumer Packaged Goods Industry within Marketing, Brand Management, Sales and Business Development.
Kelly is a sleep behavior expert who connects to clients with genuine curiosity and compassion to unlock their potential for positive change. Sleep is a universal need AND is completely unique to the individual. No two sleep profiles are the same and Kelly uses multi-faceted and science-based approaches to support an understanding of the client’s desired outcome.
What we work on
| Domain | What this pathway does |
|---|---|
| Nutrition & Metabolism | RDN-led meal plan. Weight stabilization (not loss) goal in restrictive cases. NEVER use weight goals. |
| Movement & Mobility | Exercise reintroduced ONLY when medically cleared. Compulsive-exercise screen. |
| Sleep & Recovery | Disrupted in active ED. ISI tracked. Address gradually. |
| Stress & Resilience | Control, perfectionism, anxiety as core themes. |
| Mind & Mood | PHQ-9 + GAD-7 monthly. Co-occurrence very common. |
| Relationships & Purpose | Meal social isolation; family meal repair; identity beyond ED. |
How progress is measured
These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.
| Tool | Cadence | Owned by |
|---|---|---|
| EAT-26 + SCOFF | Onboard | WHC + LCSW |
| EDE-Q | Onboard, monthly | LCSW |
| Weight + vitals (HR, BP, K+) | Weekly during Stabilize | RN Nav (with outside team) |
| PHQ-9 + GAD-7 + C-SSRS | Onboard, monthly; PRN any concern | LCSW |
| Compulsive Exercise Test | Onboard, q4 weeks | Exercise Coach + LCSW |
| ISI | Onboard, q4 weeks | Sleep Coach |
The research behind this pathway
Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.
Guidelines this pathway follows
- Academy for Eating Disorders clinical guidance · Academy for Eating Disorders
Medical risk is assessed first and treated as urgent.
- Enhanced cognitive behavioral therapy (CBT-E) · Fairburn and colleagues
The transdiagnostic model behind the pathway's structure. PMID 12711261
- SCOFF and EAT-26 · Morgan and colleagues; Garner and colleagues
The two screens administered here. PMID 10582927
Key studies
- Garner DM et al. (1982). Psychol MedThe eating attitudes test: psychometric features and clinical correlates
The paper that produced the EAT-26, the eating attitudes screen this pathway administers. PMID 6961471
- Morgan JF et al. (1999). BMJThe SCOFF questionnaire: assessment of a new screening tool for eating disorders
Introduced the short SCOFF screen for eating disorders, which is the quick screen used before anything longer. PMID 10582927
- Arcelus J et al. (2011). Arch Gen PsychiatryMortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies
Pooled 36 studies. Death rates were roughly six times expected in anorexia nervosa and about twice expected in bulimia, and one in five of those who died from anorexia died by suicide. PMID 21727255
- Fairburn CG et al. (2003). Behav Res TherCognitive behaviour therapy for eating disorders: a "transdiagnostic" theory and treatment
Set out the transdiagnostic theory behind enhanced cognitive behavioral therapy: what keeps eating disorders going is shared across diagnoses, so one treatment can address them. PMID 12711261
- Hilbert A et al. (2020). Int J Eat DisordMeta-analysis on the long-term effectiveness of psychological and medical treatments for binge-eating disorder
Pooled long-term outcomes for binge-eating disorder treatments. Psychotherapy and structured self-help held up over follow-up; results for body weight were inconsistent. PMID 32583527
- Melisse B et al. (2023). J Med Internet ResEfficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy-Enhanced for Binge Eating Disorder: Randomized Controlled Trial
Randomized 180 people with binge eating disorder to guided self-help enhanced cognitive behavioral therapy over the web, or to a waiting list. Binges fell from about 19 to 3, and 40 percent were in full remission. PMID 37126386