Early intervention for eating disorders

Currently, one in five people with an eating disorder may develop a longstanding illness and there are delays of up to a decade in people accessing evidence-based eating disorder informed treatment. Such delays contribute to the high personal and community burden of eating disorders. The present paper reports known actions that are likely to overcome barriers to and enable early prevention in eating disorders across four themes within public health and primary care interventions. These are as follows: (1) public health programs to increase health literacy and reduce stigma, for example, Mental Health First Aid; (2) increased screening and early identification in primary care, for example, upskilling family doctors; (3) wide dissemination of accessible online and similar treatments, for example guided self-help cognitive behavioural therapy; and (4) whole of health service and similar developments to facilitate early eating disorder informed care, for example, the First Episode and Rapid Early intervention for Eating Disorders (FREED) program. Whilst there is robust evidence for many interventions, in particular guided self-help (including family therapy) and virtual forms of cognitive behavioural therapy, as well as general practitioner education, major gaps in knowledge are identified. These include the research base for healthcare first responder training in eating disorders, more recently defined disorders, particularly avoidant/restrictive food intake disorder, and the translation of effective screening instruments into regular and more widespread use. The conclusion is, however, optimistic, given the growing evidence base, widening recognition and use of effective interventions and contemporary contributions of people with lived experience.