Care approaches for people with longstanding eating disorders: a lived experience perspective on the need for recovery-fostering care

People with longstanding eating disorders (EDs) are often conceptualised as 'treatment-resistant' when they are not currently benefitting from established recovery-focused treatments. This may encourage a shift from recovery-focused treatments to care approaches that for many individuals do not foster recovery. As a result, the present article offers an explicitly hope-holding and recovery-fostering care (RFC) approach that neither demands recovery nor abandons the possibility of recovery, whatever recovery may mean to the individual being cared for. RFC is guided by the following principles, which were developed in response to limitations identified in current care approaches for people with longstanding EDs: [1] Holding hope for meaningful recovery and enabling opportunities for it; [2] Building therapeutic alliances; [3] Formulation-based and epistemically just care; [4] Unconditional safeguarding; and [5] Supporting caregivers. RFC is not a scientific model with the level of specification often demanded by academic frameworks. Rather, it is a creative, flexible, and person-led approach to care that prioritises people with lived experience over strict adherence to manuals, and values humanity-based care alongside evidence-based care.