Photo from left: Grace Shaw, Social Worker, MSW, AEDS and Alexandria Houston, Manager, Adult Outpatient Mental Health & Addictions in an office discussing diagnoses
February 3, 2026
In August 2024, the number of patients on the wait list for the Adult Eating Disorders Service (AEDS) at London Health Sciences Centre (LHSC) was 317. As of November 2025, that number is down to 31 and wait times continue to improve.
Updates in the AEDS
In January 2025, the staff and physicians of the AEDS began training for their service’s new model of care: moving from both a residential and outpatient program, to one that offers outpatient-only services.
“We wanted to be able to meet the needs of patients with an eating disorder in a positive and impactful way,” shares Dr. Hiba Rahman, Psychiatrist. “The residential program was not providing the significant outcomes we were working towards, with many patients returning to the program shortly after discharge. This new model of care, focusing on outpatient support, is better able to meet the needs of our patients.”
The funding that was used to support the residential service was repurposed for the transformation and program redesign.
“We were able to hire four more social workers and a nurse practitioner to our team,” says Tammy Fisher, Director, Adult Mental Health and Addictions at LHSC. “This means we have been able to see more patients in a timely manner and are able to get to those on the wait list sooner.”
AEDS outpatient model
This program supports those seeking treatment for their eating disorder from across the province – with some coming from as far as Ottawa.
Patients are referred to the program from their primary care provider and go through a formal intake process to receive an assessment before engaging with a therapist.
The therapy typically used is CBT-E: Cognitive Behavioural Therapy that helps with a variety of mental health conditions, including eating disorders such as binge eating, anorexia nervosa, bulimia nervosa and other specified feeding or eating disorders (OSFEDs). This is a practice standard that the AEDS maintains through their transformation as well as a standard followed by other eating disorder programs across the country.
Another therapy, called CBT-AR, specifically treats avoidant/restrictive food intake disorder (ARFID) and is available to patients with this specific condition.
There are a variety of members of the healthcare team for patients of the AEDS:
- Social workers support therapy.
- Dietitians support diet and nutrition for patients in the program.
- A nurse practitioner (NP) and a registered nurse (RN) are available for medical support and consultation. The NP or RN will also follow-up with patients during the refeeding stage.
- A psychologist provides additional therapy for patients, as well as mentorship for the social workers on staff.
- A psychiatrist (Dr. Rahman) consults with patients who have more acute mental health needs.
- A psychometrist collects and shares crucial data and information with the team and develops and evaluates the pre- and post-service questionnaires. The psychometrist also supports the child and adolescent program.
Now, with a new streamlined process, the service is better able to see people sooner and provide a higher level of care faster.
This model also better aligns with LHSC’s standard of care and allows the team to meet the needs of patients. If a patient requires more support than the program can provide, just like before the transformation, the team continues to refer the patient to other services that may better meet their needs.
Dr. Rahman shares that, “While there are many reasons why a person may prefer outpatient services, there is a significant reason to consider with residential services – and that is essentially putting one’s life on hold. Life responsibilities continue and many patients often find the transition easier between beginning and ending treatment when they are already in an outpatient service.”
Fisher elaborates on this noting that this service, like a lot of mental health services, is not like a day surgery where you can come to the hospital and then go back home. “This service is designed to empower patients by teaching strategies they can use to manage life challenges and stressors. Our focus is on supporting individuals as they learn these strategies and apply them in ways that improve their daily lives and overall well-being.”
Patient satisfaction with the care
While the AEDS no longer provides the option for residential support, the data collected from patients is noting improved satisfaction with the service.
Fisher notes that “We found that the pandemic changed a lot of patient’s expectations for support. To enter the residential service the criteria was quite stringent. And, when the pandemic response loosened, we started hearing from many patients that were on the wait list for residential services that they wanted to stay in their home and do virtual appointments or other outpatient programs instead.”
Continued evolution of care
During the transformation, the working group incorporated thoughts, ideas and opinions of staff and patient partners before formalizing the processes.
While the AEDS team is already seeing improvements in patient satisfaction and wait times, the service continues to evolve through this transformation.
As of January 2025, the AEDS team began to offer five psychoeducational groups for coping skills, nutrition, Cognitive Behavioural Therapy (CBT), handling emotions and tolerating uncertainty. There are also three meal supports (breakfast, lunch and an afternoon snack) Monday through Thursday.
“The emotions group provides education to patients to learn what emotions are and how to use them to their advantage,” explains Grace Shaw, Social Worker MSW in the Adult Eating Disorders Service. “And meal supports are virtual, so patients learn to eat regularly in their own environment. We don’t have meal supports on Fridays to give patients the opportunity to practice eating regularly outside of the virtual support environment.”
“There is always more work to be done to ensure patients are receiving the level of care they expect and deserve when they come to the AEDS. We will continue to evaluate the effectiveness of our processes and procedures and include feedback from patients and staff as we keep evolving the program,” says Fisher.