Eating disorders are a serious mental illness that involve extreme concern about eating, weight or shape, plus disordered eating. They include anorexia nervosa, bulimia nervosa, binge eating disorder, and “other specified feeding or eating disorders”.
Eating disorders affect 600,000-725,000 people in the UK every year with an associated £3.9-4.6 billion in NHS treatment costs, £6.8-8 billion in lost income and £2.6-3.1 billion in carer-related costs each year. They carry one of the highest levels of mortality amongst mental health disorders. Peak onset for eating disorders is during adolescence and early adulthood, a sensitive time when the brain is still developing.
Evidence from research studies suggests that treatment outcomes are best if the condition is identified and treated at the earliest opportunity, within the first three years of illness. 30% of young people referred for eating disorders treatment wait over 18 weeks and another 34% wait over six months. Most of these people see their condition worsen whilst waiting. Resources to treat eating disorders are particularly stretched for adults (age 18 and over) and access to evidence-based treatment and care is often delayed until patients show considerable deterioration, causing distress to individuals and families and greater costs to the NHS.
This national programme aims to:
• Ensure earlier intervention and treatment of eating disorders in young people
• Reduce the duration of untreated eating disorders in young people
• Reduce waiting times and day/inpatient admissions
• Improve clinical outcomes
• Reduce use of healthcare services, in particular reduce the need for inpatient or day-patient admissions.
The outcomes above will be achieved by supporting eating disorder services to implement evidence-based models. One approach is the FREED (First episode Rapid Early intervention for Eating Disorders) model, developed by South London and Maudsley NHS Foundation Trust and King’s College London. FREED is an innovative, evidence-based, specialist care package for 16 to 25-year-olds with a first episode eating disorder of less than 3 years duration.
The FREED model:
• Overcomes barriers to early treatment and recovery, and has a target waiting time from referral to treatment of 4 weeks
• Provides highly coordinated early care, with a central focus on reducing the duration of an untreated eating disorder, overseen and led by a FREED champion
• Consists of a service model and a care package of evidenced based treatments. This includes a greater emphasis on early engagement and change, family involvement, attention to social media use as a potential illness maintaining factor, and attention to transitions (such as transitions out of child/adolescent services and those to university, employment and other adult roles).
A 5 minute film introducing FREED including information on evidence, patient experience and scaling up of the programme can be found here https://www.youtube.com/watch?v=jKYGdPA-MJ4