'Stepping outside the red line': An exploration of two co-design methodologies exploring lived experiences of remote support for eating disorders throughout COVID-19 and beyond

The COVID-19 pandemic necessitated the rapid transition to online support for eating disorders (e.g., Lewis et al. 2021). Beyond the pandemic, remote support continues to be widely adopted and requested. The benefits of online support include its role as a virtual lifeline during the pandemic, its subsequent ability to provide a wider range of support methods, convenience for recipients’ ability to access support at home and, for service providers, cost-eBectiveness and flexibility (Murphy-Morgan and Branley-Bell 2022). Remote support challenges include accessibility, digital self-eBicacy and problematic a Bordances of platforms. Examples include the potential anxiety of the recipient seeing their self-image on camera during a video call, or a therapist's concern regarding individuals' ability to hide behind the camera to mask the severity of their symptoms (e.g., Waller et al. 2020). However, online services can provide accessible support, including for individuals without diagnosis and with no access to clinical services (Yim et al. 2021).

Through interactive workshops and semi-structured interviews our research has gathered perspectives of challenges and opportunities presented by online support for eating disorders. There is little research exploring the diverse narratives of lived experiences of such support, what future interventions could be considered in improving provision, and how these decisions can be made. Co-design (Simonsen and Robertson 2013; Durant et al. 2017) methodologies are tools for social change with democratisation and agency at their core (Collingham et al, 2022; Sanders and Stappers 2008). They allow for phenomenological approaches to question, and redress, potential power imbalances through allowing lived experience narratives to shape interpretation and dissemination of research findings (Çarçani et al. 2023; Cooper and Cornish 2023). In this paper, we explore, and reflect upon, two creative co-design approaches we have used: an animation portraying online support experiences, and a good practice toolkit for online support.