Assessing the impact of First Episode Rapid Early Intervention for Eating Disorders on duration of untreated eating disorder: A multi‐centre quasi‐experimental study
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Background: Duration of untreated eating disorder (DUED), that is, the time between illness onset and start of first evidence‐based treatment, is a key outcome for early intervention. Internationally, reported DUED ranges from 2.5 to 6 years for different eating disorders (EDs). To shorten DUED, we developed FREED (First Episode Rapid Early Intervention for EDs), a service model and care pathway for emerging adults with EDs. Here, we assess the impact of FREED on DUED in a multi‐centre study using a quasi‐experimental design. Methods: Two hundred and seventy‐eight patients aged 16–25, with first episode illness of less than 3 years duration, were recruited from specialist ED services and offered treatment via FREED. These were compared to 224 patients, of similar age and illness duration, seen previously in participating services (treatment as usual [TAU]) on DUED, waiting times and treatment uptake. Results: FREED patients had significantly shorter DUED and waiting times than TAU patients. On average, DUED was reduced by ∼4 months when systemic delays were minimal. Furthermore, 97.8% of FREED patients took up treatment, versus 75.4% of TAU. Discussion: Findings indicate that FREED significantly improves access to treatment for emerging adults with first episode ED. FREED may reduce distress, prevent deterioration and facilitate recovery.
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Early intervention in EDs is associated with better outcomes.
“Early intervention in EDs is associated with better outcomes [23–28].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [26]
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Melisse, B., de Jonge, M., van den Berg, E. M., Dekker, J., & de Beurs, E. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24562 · Cited by 3 · see citing works
Predictors of Treatment Outcome in an Early Intervention Eating Disorder Sample
Allen, K. L., Austin, A., Flynn, M., Glennon, D., Mountford, V. A., Brown, A., Franklin‐Smith, M., Jones, W. R., Brady, G., Nunes, N., et al. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24593 · Cited by 3 · see citing works
Self-citationVirtually Accompanied Eating in the Outpatient Therapy of Anorexia Nervosa
Vogel, M., Gil, A., Galaz, C., Pascuala Urrejola, N., Lacalle, L., Jara, R., Verónica Irribarra, P., Vuskovic, M. L., Costa, D. S. A., & Espinoza, G. (2023) · Nutrients · doi:10.3390/nu15173783 · Cited by 3 · see citing works
Potterton, R., Brown, G. L., & Schmidt, U. H. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01260-8 · Cited by 5 · see citing works
Self-citationService models in eating disorders: a scoping review
Knight, R., Stagnitti, K. E., & Pépin, G. (2025) · Journal of Eating Disorders · doi:10.1186/s40337-025-01252-8 · Cited by 3 · see citing works
Cammaert, J. (2022) · Social Work in Mental Health · doi:10.1080/15332985.2022.2048335 · Cited by 3 · see citing works
Alsaud, J. S., Aljuaylan, N., Alsaloom, D. S., Alsakaker, A. A., Alfayez, J. S., & Alshehi, R. (2024) · Cureus · doi:10.7759/cureus.71039 · Cited by 3 · see citing works
Reuter, L., Kästner, D., Schmidt, J., Weigel, A., Voderholzer, U., Seidel, M., Schwennen, B., Fehrs, H., Löwe, B., & Gumz, A. (2021) · Journal of Eating Disorders · doi:10.1186/s40337-021-00490-w · Cited by 3 · see citing works
Hyam, L., Gallagher, L., Clemente, G. D., Killackey, E. J., Glennon, D., Griffiths, J., Mills, R., Wilkins, J., Ahmed, M. W., Allen, K. L., et al. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70132 · Cited by 2 · see citing works
Self-citationObeid, N., Porter, J., LaMarre, A., Silva‐Roy, P., Coelho, J. S., Dimitropoulos, G., Maharaj, A., Feder, S., Norris, M. L., Spettigue, W. J., et al. (2026) · Translational Behavioral Medicine · doi:10.1093/tbm/ibaf092 · Cited by 2 · see citing works
Grave, R. D., & Calugi, S. (2022) · IJEDO · doi:10.32044/ijedo.2022.01 · Cited by 2 · see citing works
Davey, E., Bryant‐Waugh, R., Bennett, S. D., Micali, N., Baudinet, J., Konstantellou, A., Clark-Stone, S., Green, A., & Shafran, R. (2025) · European Eating Disorders Review · doi:10.1002/erv.3171 · Cited by 2 · see citing works
Grycuk, L., Monssen, D., Davies, M. R., Sharpe, H., Allen, K. L., Prasad, V., Potterton, R., Popat, P., Mountford, V. A., McNeil, S., et al. (2025) · Pilot and Feasibility Studies · doi:10.1186/s40814-024-01585-2 · Cited by 3 · see citing works
Self-citationAustin, A., Flynn, M., Richards, K. L., Allen, K. L., Mountford, V. A., Glennon, D., Brown, A., Grant, N., Franklin‐Smith, M., Schelhase, M., et al. (2025) · Psychiatry Research Communications · doi:10.1016/j.psycom.2025.100217 · Cited by 2 · see citing works
Self-citationThe Role of Parents and Other Caregivers in the Early Detection of Eating Disorders
Ciao, A. C., Pascual, S., & Hodges, G. (2023) · Springer eBooks · doi:10.1007/978-3-031-16691-4_19 · Cited by 2 · see citing works
Primary Care in Eating Disorders
Tan, J. O. A., & Gray, F. (2023) · Springer eBooks · doi:10.1007/978-3-030-97416-9_53-1 · Cited by 2 · see citing works
Bone Fracture History in Women With First Episode or With Persistent Anorexia Nervosa
Lopes, M. P., Ahmed, S., Beaman, L., Stubbs, B., Campbell, I. C., Schmidt, U. H., & Robinson, L. (2024) · European Eating Disorders Review · doi:10.1002/erv.3153 · Cited by 2 · see citing works
Self-citationThe Role of Parents and Other Caregivers in the Early Detection of Eating Disorders
Ciao, A. C., Pascual, S., & Hodges, G. (2022) · Springer eBooks · doi:10.1007/978-3-030-67929-3_19-1 · Cited by 1 · see citing works
Early Intervention for Eating Disorders
Schmidt, U. H., & Jackson, I. (2023) · Springer eBooks · doi:10.1007/978-3-030-97416-9_54-1 · Cited by 1 · see citing works
Self-citationParental engagement in an early intervention program for anorexia nervosa: a qualitative study
Diot, T., Loisel, A., Moro, M. R., & Blanchet, C. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02827-1 · Cited by 2 · see citing works
Recent Advances and Future Directions in Eating Disorder Treatments for Emerging Adults
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Self-citationMcClelland, J., Austin, A., Flynn, M., Mountford, V. A., Simic, M., & Schmidt, U. (2026) · Early Intervention in Psychiatry · doi:10.1111/eip.70164 · Cited by 1 · see citing works
Self-citationStonawski, V., Stehbach, C., Bauer, M., Wangler, S., Moll, G. H., Horndasch, S., & Kratz, O. (2024) · European Eating Disorders Review · doi:10.1002/erv.3128
Baudinet, J., & Eisler, I. (2024) · Springer eBooks · doi:10.1007/978-3-030-97416-9_99-1 · Cited by 1 · see citing works
Kennett, J., & Stelfox, H. T. (2024) · Mental Health Science · doi:10.1002/mhs2.94 · Cited by 1 · see citing works
Value of treatment for eating disorders
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Reuter, L., Kästner, D., Schmidt, J., Weigel, A., Voderholzer, U., Seidel, M., Schwennen, B., Fehrs, H., Löwe, B., & Gumz, A. (2021) · Research Square · doi:10.21203/rs.3.rs-467666/v1
Essstörungen – State of the Art und neuere Entwicklungen
Bauman, T., & Voderholzer, U. (2022) · PiD - Psychotherapie im Dialog · doi:10.1055/a-1477-1044
Clemente, G. D. (2021) · Clinical Psychology Forum · doi:10.53841/bpscpf.2021.1.343.63
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Ward, S., Daughtrey, N., Constable, C., & Bell, J. M. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12757
Baudinet, J., & Eisler, I. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_99
Primary Care in Eating Disorders
Tan, J. O. A., & Gray, F. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_53
Early Intervention for Eating Disorders
Schmidt, U. H., & Jackson, I. (2024) · Springer eBooks · doi:10.1007/978-3-031-46096-8_54
Self-citationPaceley, M. S., McGeough, B. L., Ananda, J., Pearson, J., Harrop, E. N., Evans, S., Gleason, T., Hamor, L., & Riquino, M. R. (2025) · Sexual and Gender Diversity in Social Services · doi:10.1080/29933021.2025.2580648
Reuter, L., Kästner, D., Schmidt, J., Weigel, A., Voderholzer, U., Seidel, M., Schwennen, B., Fehrs, H., Löwe, B., & Gumz, A. (2021) · Figshare · doi:10.6084/m9.figshare.16928588
Richards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.25556600
Self-citationRichards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702770
Self-citationRichards, K. L., Woolrych, I., Allen, K. L., & Schmidt, U. (2022) · Figshare · doi:10.6084/m9.figshare.20098376
Self-citationRichards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702764
Self-citationVuillier, L., Greville-Harris, M., Talbot, C. V., May, L., & Moseley, R. L. (2024) · Figshare · doi:10.6084/m9.figshare.26669805
Richards, K. L., Woolrych, I., Allen, K. L., & Schmidt, U. (2022) · Figshare · doi:10.6084/m9.figshare.20098379
Self-citationRichards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.25556666
Self-citationRichards, K. L., Phillips, M. D., Grycuk, L., Hyam, L., Allen, K., & Schmidt, U. (2024) · Figshare · doi:10.6084/m9.figshare.26702767
Self-citationRecent Innovations in Eating Disorder Prevention and Early Intervention
Burton, K., Finkelstein, J. R. J., & Brown, T. A. (2025) · Current Psychiatry Reports · doi:10.1007/s11920-025-01657-x · Cited by 2 · see citing works
Turner, A., Hickie, I. B., Maguire, S., Tonini, E., LaMonica, H. M., Varidel, M., Nichles, A., Zmicerevska, N., Scott, J. L., Pantelis, C., et al. (2026) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-026-02978-9
Design, Implement, Sustain: Advancing Program‐Led Interventions for Binge Eating, a Narrative Review
Melisse, B., van Doornik, S. F. W., & Elburg, A. A. V. (2026) · European Eating Disorders Review · doi:10.1002/erv.70118
Erwachsenwerden mit Essstörung – Stand der Forschung und Empfehlungen für eine gelingende Transition
Gradl-Dietsch, G., Schneider, M., Skoda, E. M., Teufel, M., Seitz, J., Mayordomo-Aranda, A., Schulla, E., Naab, S., & Voderholzer, U. (2026) · Der Nervenarzt · doi:10.1007/s00115-026-01965-4
Duration of untreated eating disorders and its impact on outcomes: An updated systematic review
Menescal, L. L., Lassen, R. H., Peres, M. A. D. A., de Moraes, C. E. F., & Appolinário, J. C. (2026) · Psychiatry Research Communications · doi:10.1016/j.psycom.2026.100275
de Geus, G., Trott, M., Monteleone, A. M., Firth, J., Siskind, D., Teasdale, S., Arnautovska, U., Iyer, R., Stubbs, B., Demidenko, N., et al. (2026) · Journal of Eating Disorders · doi:10.1186/s40337-026-01731-6
Self-citation
- Authors
- Flynn, M., Austin, A., Lang, K., Allen, K., Bassi, R., Brady, G., Brown, A., Connan, F., Franklin‐Smith, M., Glennon, D., Grant, N., Jones, W. R., Kali, K., Koskina, A., Mahony, K., Mountford, V., Nunes, N., Schelhase, M., Serpell, L., & Schmidt, U.
- Affiliations
- King's College London (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- Central and North West London NHS Foundation Trust (GB)
- Leeds and York Partnership NHS Foundation Trust (GB)
- North East London NHS Foundation Trust (GB)
- Corresponding author
- Schmidt, Ulrike
- ORCID
- Venue
- European Eating Disorders Review
- Publisher
- Wiley
- Published
- 2020-10-28
- Volume
- 29
- Issue
- 3
- Pages
- 458-471
- ISSN
- 1072-4133 (ISSN-L)
- 1099-0968
- OpenAlex
- W3096792315
- Cited by
- 97
- References
- 44
- Citations by year
- 2026: 9 · 2025: 17 · 2024: 26 · 2023: 14 · 2022: 15 · 2021: 16
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Eating Disorders Review (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Health Foundation (Scaling Up Improvement Award)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- eating disorders, emerging adults, care pathways, treatment wait times, treatment uptake, access to treatment
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Humans, Young Adult
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