Successful early intervention approach to eating disorders rolled out across England

How we're changing clinical practice

Eating disorders are highly prevalent in the UK, with approximately 1.25 million people estimated to currently be suffering from an eating disorder, such as anorexia nervosa, bulimia nervosa, binge eating disorder or another eating disorder.

Eating disorders typically start in adolescence, but they can become chronic lifelong conditions. Eating disorders also increase the risk of severe medical complications, depression, anxiety, suicidality and other mental health problems.

Eating disorders in young people

Adolescence and early adulthood are critical periods, as young people have to navigate finishing their education, finding employment, forming social relationships and developing an identity. Having an eating disorder during this critical period can wreak havoc by damaging a young person’s development across so many areas of their life.

Eating disorders can harm brain development, neurotransmitter levels, metabolism and alter an individual’s relationship with food for life. Anorexia nervosa carries the highest risk of death compared with other psychiatric disorders.

FREED

A programme called First Episode Rapid Early Intervention for Eating Disorders (FREED) developed by NIHR Maudsley BRC researchers demonstrated the positive impact of early intervention. Teenagers and young adults (aged 16-25) who came forward for treatment were contacted within 48 hours and commenced treatment as soon as two weeks later.

The FREED model provided rapid, specialised treatment for young people who had recently started experiencing eating disorder symptoms. The model is considered the 'gold-standard' of care, because it helps young people cope better with their transition to adulthood, with a personalised treatment approach for each young person.

By rapidly accessing treatment tailored to their needs, young people were able to benefit from treatment before changes to brain, body and behaviour inflicted by eating disorders became deeply engrained and potentially harder to reverse. They were less likely to miss out on educational, social and employment opportunities, which prevented their likelihood of future relapses.

Early intervention in eating disorders, as demonstrated by the FREED model, significantly improved treatment outcomes. Young people treated early on were more likely to engage with treatment, which improved their clinical outcomes, quality of life, and reduced the need for in-patient care.

Furthermore, by removing barriers to diagnosis and treatment of eating disorders, the FREED model hopes to use proactive community outreach to improve access to treatment and outcomes for young people from Black and Minority Ethnic backgrounds.

Roll-out in England

The success of the FREED model has led to it being adopted by the Network of Academic Health Sciences Network (AHSNs) onto their national programme and NHS-England has provided funding to roll out this new service to 18 specialist eating disorder teams across England . Already, over 1,200 teenagers and adolescents with eating disorders have been supported by the FREED programme, to date.

Given the additional pressures experienced by young people during the COVID-19 pandemic, early intervention and support through the innovative FREED model is more important than ever

The investment in the early intervention – First Episode Rapid Early Intervention for Eating Disorders (FREED) – service is part of the NHS Long Term Plan commitment to provide an additional £1 billion a year by 2023/24 to expand and improve community mental health care so adults, including those with an eating disorder, can get earlier access to care, as close to home as possible.

Find out more about FREED in the video below: