Early intervention for eating disorders
Approximately 1.25 million people in the UK are thought to currently have an eating disorder, such as anorexia nervosa, bulimia nervosa or binge eating disorder. Eating disorders typically start in adolescence but can become lifelong conditions with physical and mental health complications.
Emerging data suggest that brain changes associated with eating disorder symptoms become more entrenched over time and potentially harder to reverse. Despite this rationale for early intervention, time to first treatment of eating disorders in the UK is on average 2.5-5.5 years. We work to understand firstly the biological underpinnings of eating disorder development in young people and secondly how early intervention can help.
We used brain imaging techniques and long-term follow-up data to demonstrate that there are differences in brain structure and function in areas relating to self-regulation and habit formation, in young people who later develop eating disorders.
Genetic markers related to obesity, attention-deficit hyperactivity disorder and personality traits distinguish the development of different eating disorder behaviours and so are early predictors of vulnerability for different eating disorders.
First Episode Rapid Early Intervention for Eating Disorders (FREED)
With patients and carers, we co-developed a treatment programme called First Episode Rapid Early Intervention for Eating Disorders (FREED). FREED provides rapid, specialised treatment for young people (16-25 years) who recently started experiencing eating disorder symptoms.
By quickly accessing treatment tailored to their needs, young people can recover before eating disorder-related changes to brain, body and behaviour become deeply engrained and they are less likely to miss out on education and social and employment opportunities.
National rollout of FREED
We found that young people treated under FREED had much better recovery rates than those given usual treatment. FREED also reduced the need for in-patient care and led to substantial cost-savings and patients were highly satisfied with the treatment.
FREED’s success led to it being adopted by the Network of Academic Health Sciences Network (AHSNs) onto their national programme and NHS England providing funding to roll out FREED nationally (between 2020 and 2023).
FREED now has a footprint in all eligible NHS trusts in England and to date, over 5,000 young people with eating disorders have been supported by the programme.
Young people and carers are involved in the national roll-out. This work includes proactive community outreach to develop resources for, and improve access to, treatment and outcomes for young people from minoritised backgrounds.
Service providers in other parts of the UK and internationally are also beginning to set up FREED services.
We have also received funding from UKRI (UK Research and Innovation) to do further in-depth work on who develops eating disorders and why, and to develop more personalised prevention programmes for young people at risk of eating disorders (www.edifyresearch.co.uk).
Read more about our research into Obesity, Lifestyle and Learning from Extreme Phenotypes.
IMPACT AREAS:
National and International Collaboration | Improving Access and Uptake | Personalising Treatment to Patients
