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Behavioral and mental health are paramount to well-being, but finding appropriate care can be difficult, particularly for patients who live far from in-person care options or experience challenges around transportation, mobility, or their daily schedule or responsibilities.
This can be especially troubling when it comes to eating disorders—dangerous mental health conditions that can have a devastating impact on mental, emotional, and physical health. That’s why Within Health co-founders Dr. Wendy Oliver-Pyatt and Abhilash Patel felt compelled to create a better way.
Within Health is a pioneering service that offers personal eating disorder care through virtual methods, including an app, website, and video chat technology. Treatment is personalized for each patient and, unlike most virtual treatment programs for behavioral health, available for higher levels of care, including a virtual equivalent of partial hospitalization programs.
In the aftermath of the pandemic, many industries, including mental health care, started experimenting with online models. But Oliver-Pyatt had started working with virtual methods for mental health treatment even before then, giving her a head-start in understanding how to reach and treat patients through an online medium.
With more than 25 years of clinical experience and work on developing four unique mental health treatment programs, it seemed like a natural transition for Oliver-Pyatt to develop a virtual-focused program for eating disorders – conditions she also has struggled with personally.
When she met Patel in 2020, the two quickly realized that there wasn’t only a great need for this type of service but that their backgrounds dovetailed perfectly to build such a model and scale it for a national outreach.
Like Oliver-Pyatt, Patel had personal experience battling disordered eating, which gave him an intimate understanding of how difficult the conditions can be and how pivotal the need for appropriate care is. While Oliver-Pyatt understood what needed to be brought to the table clinically, Patel’s experience in the tech world gave him insight into how to virtually create that experience and scale the program to reach people all over the country.
“Wendy’s passion was to take care of people where they are, and I love building something from the ground up and building something really impactful,” Patel says. “The more we got to speak, the more it became almost inevitable, the idea of bringing this type of relief, care, and freedom to people. Even those first few patients we worked with, it was like, ‘Wow, this is going to be pretty extraordinary.’”
There is so much about Within Health that is unique, including some of the technology being used to facilitate care.
“We couldn’t use anything off the shelf because the eating disorder community is so specific,” Patel says. “So we basically had to go to the whiteboard and enable a treatment team to collaborate on a system that could not just deliver nuanced care to a patient in a way they could easily use, but in a way that’s clinically appropriate and in a way that can help facilitate group care.”
They wound up with a platform that was not only easy to use but helped keep patients engaged, even with the possible distractions of an at-home environment. According to Oliver-Pyatt, the program has an immensely high retention rate, with nearly all patients who complete higher levels of care also completing lower-intensity programs at Within.
“The app was created in a delicate and thoughtful way with the human connection in mind,” she says. “Every detail has been considered by our team, from the point of view of ‘How is this going to feel for the person on the receiving end?’”
But it’s not just the app that’s uniquely impressive. Within has also collaborated with tech companies to pioneer tools for remote monitoring, allowing physicians to track things like a patient’s body temperature or sleep patterns. This allows Within’s team to remotely treat more severe cases and has led to even further developments in eating disorder research, with the company’s physicians being published in clinical journals thanks to the insights provided by these new technologies.
Recreating group care remotely
Another goal for Oliver-Pyatt and Patel was to recreate a group care scenario in a virtual environment.
Oliver-Pyatt said this was a paramount concern, as group treatment can help people identify with others, reducing feelings of shame and increasing feelings of hope. She noted the platform could also open the program up to family treatment.
For Patel, the importance of offering group care also came from a personal place. As a male who struggled with an eating disorder, he had a hard time finding other people like him to relate to. However, a remote program could open up that pool of participants, eliminating the need for geographic proximity.
“Groups like men with eating disorders, BIPOC or LGBTQ people with eating disorders – those groups don’t always co-exist in the same physical buildings,” he says. “But if I’m in a group of people who give me permission to let me feel not okay, I’m going to be in a vulnerable position and feel more ready to heal. This creates a way to do that that’s regulatorily compliant and clinically appropriate.”
Connecting people to help them heal together was only one reason Patel and Oliver-Pyatt felt so strongly about creating a virtual eating disorder care program. Their experiences and professional backgrounds also gave them empathy and insight into the issue.
Approximately 30 million people have eating disorders, with 5 million more diagnosed every year and one person dying from eating disorder-related complications every minute, Oliver-Pyatt pointed out.
“Every system, from your brain to your toes, and your heart, mind, soul, and quality of life is affected,” she says. “And the vast majority of people who struggle don’t have access to care, so it’s a gigantic opportunity to reduce suffering.”
That’s especially true for a condition that is traditionally difficult and expensive to treat and often requires lengthy stays in treatment facilities. A remote program expands access to this type of care and allows people to more easily tailor their treatment to their schedule, letting them keep their jobs and, subsequently, their health care.
Patel added that the need to raise awareness was equally important, especially as only a small percentage of people who struggle with eating disorders have the “underweight” body type commonly associated with these conditions.
“Eating disorders are awfully stigmatized; there’s so much shame and reticence to speak about it and not enough physicians providing care,” he says. “The need to speak about it is really important; that’s how you destigmatize anything.”
The pair hopes to do just that by starting initiatives like the Within Health Summit.
“Being vulnerable and authentic and sharing vulnerability is a very powerful and brave move,” Oliver-Pyatt says. “The more we tell our stories, the more vulnerable we are, the deeper our connections will be, and we want to be the first one to take that leap and continue to spread the foundation of love.”