Journal article
Iatrogenic harm and premature treatment discontinuation in eating disorders: a lived experience response to Wade and Schmidt (2026)
Journal of Eating Disorders, Vol.14, pp.1-9
2026
PMCID: PMC13425919
PMID: 42533359
Abstract
Premature discontinuation from eating disorder (ED) treatment is commonly interpreted through adherence, motivation, ambivalence, treatment fit, or symptom change. Wade and Schmidt make an important contribution by identifying seven strategies intended to improve retention and by moving beyond explanations located solely within the patient. They explicitly frame retention as a route through which people may obtain greater therapeutic benefit. This commentary argues that continued participation does not, by itself, establish benefit, safety, acceptability, treatment quality, or recovery. Some discontinuation may reflect treatment non-response or circumstances unrelated to care. In other cases, it may communicate poor treatment fit, coercion, relational rupture, cultural or identity-related misattunement, or iatrogenic harm. These possibilities cannot be distinguished reliably when adverse effects are poorly defined, inconsistently monitored, and inadequately reported, or when patient accounts of iatrogenic harm are discounted. We propose an expanded framework in which retention is evaluated alongside collaboratively defined benefit, treatment safety, reasons for staying and leaving, and patient-reported experiences during treatment and follow-up. Mixed-methods research, informed consent about potential negative effects, repeated confidential feedback, repair-oriented responses to reported harm, and lived experience-led co-production are required to determine whether care is safe and worth continuing. Retention records participation. Its clinical value depends on the care in which people are retained.
Details
- Title
- Iatrogenic harm and premature treatment discontinuation in eating disorders: a lived experience response to Wade and Schmidt (2026)
- Authors
- Laurence Cobbaert (Corresponding Author) - UNSW SydneyRosiel Elwyn (Author) - University of the Sunshine Coast
- Publication details
- Journal of Eating Disorders, Vol.14, pp.1-9
- Publisher
- BioMed Central Ltd.
- Date published
- 2026
- DOI
- 10.1186/s40337-026-01719-2
- ISSN
- 2050-2974
- PMID
- 42533359; PMC13425919
- Copyright note
- This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
- Data Availability
- No datasets were generated or analysed during the current study.
- Organisation Unit
- Thompson Institute
- Language
- English
- Record Identifier
- 991246898902621
- Output Type
- Journal article
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