The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics

Abstract Background The COVID-19 pandemic increased the incidence and burden of eating disorders (EDs) globally. First Episode Rapid Early Intervention for EDs (FREED) is a nationally implemented early intervention service model for young people (16–25 years) with EDs in England. This study evalua...

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Main Authors: Lucy Gallagher, Lucy Hyam, Karina Allen, Ulrike Schmidt
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933825100382/type/journal_article
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author Lucy Gallagher
Lucy Hyam
Karina Allen
Ulrike Schmidt
author_facet Lucy Gallagher
Lucy Hyam
Karina Allen
Ulrike Schmidt
author_sort Lucy Gallagher
collection DOAJ
description Abstract Background The COVID-19 pandemic increased the incidence and burden of eating disorders (EDs) globally. First Episode Rapid Early Intervention for EDs (FREED) is a nationally implemented early intervention service model for young people (16–25 years) with EDs in England. This study evaluates the longer-term impact of the pandemic on presentations and service provision in FREED. Methods Data from January 2019 to September 2024 were analyzed, including three services with pre-, pandemic, and post-pandemic data (Sample 1), and 62 services with post-pandemic data (Sample 2), 32 of which also contributed data during the pandemic. Linear mixed models examined referral numbers, duration of untreated ED, diagnostic mix, average body mass index for anorexia nervosa, and wait times. Results In the three services with pre-, pandemic, and post-pandemic data, referrals remained significantly higher post-pandemic compared to the pre-pandemic period. Across all services, post-pandemic referrals declined compared to the pandemic period. Consistently, anorexia nervosa diagnoses decreased, and the duration of untreated ED at presentation increased post-pandemic. Conclusions The COVID-19 pandemic has had lasting impacts on ED service provision in England. Sustained investment and national support are essential to ensure FREED services continue to meet the needs of young people with recent-onset EDs and to reduce the duration of untreated ED.
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spelling doaj-art-4c930b3aa71a44ccbf90a01385f7e7ef2025-08-20T03:47:02ZengCambridge University PressEuropean Psychiatry0924-93381778-35852025-01-016810.1192/j.eurpsy.2025.10038The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristicsLucy Gallagher0https://orcid.org/0009-0004-4821-2691Lucy Hyam1https://orcid.org/0000-0003-1857-2106Karina Allen2https://orcid.org/0000-0003-2896-6459Ulrike Schmidt3https://orcid.org/0000-0003-1335-1937Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, https://ror.org/0220mzb33 King’s College London, London, UKCentre for Research in Eating and Weight Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, https://ror.org/0220mzb33 King’s College London, London, UKCentre for Research in Eating and Weight Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, https://ror.org/0220mzb33 King’s College London, London, UK Eating Disorders Outpatient Service, https://ror.org/015803449 South London and Maudsley NHS Foundation Trust, London, UKCentre for Research in Eating and Weight Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, https://ror.org/0220mzb33 King’s College London, London, UK Eating Disorders Outpatient Service, https://ror.org/015803449 South London and Maudsley NHS Foundation Trust, London, UK Abstract Background The COVID-19 pandemic increased the incidence and burden of eating disorders (EDs) globally. First Episode Rapid Early Intervention for EDs (FREED) is a nationally implemented early intervention service model for young people (16–25 years) with EDs in England. This study evaluates the longer-term impact of the pandemic on presentations and service provision in FREED. Methods Data from January 2019 to September 2024 were analyzed, including three services with pre-, pandemic, and post-pandemic data (Sample 1), and 62 services with post-pandemic data (Sample 2), 32 of which also contributed data during the pandemic. Linear mixed models examined referral numbers, duration of untreated ED, diagnostic mix, average body mass index for anorexia nervosa, and wait times. Results In the three services with pre-, pandemic, and post-pandemic data, referrals remained significantly higher post-pandemic compared to the pre-pandemic period. Across all services, post-pandemic referrals declined compared to the pandemic period. Consistently, anorexia nervosa diagnoses decreased, and the duration of untreated ED at presentation increased post-pandemic. Conclusions The COVID-19 pandemic has had lasting impacts on ED service provision in England. Sustained investment and national support are essential to ensure FREED services continue to meet the needs of young people with recent-onset EDs and to reduce the duration of untreated ED. https://www.cambridge.org/core/product/identifier/S0924933825100382/type/journal_articleCOVID-19eating disorder servicesearly interventionfeeding and eating disordersnational health services
spellingShingle Lucy Gallagher
Lucy Hyam
Karina Allen
Ulrike Schmidt
The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
European Psychiatry
COVID-19
eating disorder services
early intervention
feeding and eating disorders
national health services
title The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
title_full The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
title_fullStr The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
title_full_unstemmed The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
title_short The continuing impact of COVID-19 on eating disorder early intervention services in England: An investigation of referral numbers and presentation characteristics
title_sort continuing impact of covid 19 on eating disorder early intervention services in england an investigation of referral numbers and presentation characteristics
topic COVID-19
eating disorder services
early intervention
feeding and eating disorders
national health services
url https://www.cambridge.org/core/product/identifier/S0924933825100382/type/journal_article
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