FREED is First Episode Rapid Early Intervention for Eating Disorders.
FREED is designed to give young people rapid access to specialised evidence-based treatment and support tailored to their needs.
Eating disorders aren’t just about food
It is a service for 16 to 25-year-olds who have had an eating disorder for three years or less.
Young people getting help for their eating disorder through FREED are given rapid access to specialised treatment which gives special attention to challenges we know young people face during these years of their life, and in the early stages of an eating disorder.
FREED is a flexible evidence-based treatment approach focused on early intervention; making it much more effective than traditional treatments at reversing the changes to brain, body and behaviour caused by eating disorders.
The FREED service was developed and tested by the South London and Maudsley NHS Trust Foundation’s Eating Disorders Unit and King’s College London. When FREED was compared with “business as usual”, FREED reduced the amount of time an eating disorder was left untreated. FREED patients waited less time for assessment and treatment and had better treatment outcomes. Most made a full recovery from their eating disorder within one year. Using the FREED service was a positive experience for patients, carers and staff.
FREED confirmed that treating people as early as possible leads to better results for eating disorder treatment.
People sometimes ask why FREED is only for those aged 16 to 25 with an eating disorder of up to three years. If someone has only been unwell for a short time treatment seems to work better. This is most true during adolescence and young adulthood. People with eating disorders also experience changes to their brain, body and behaviour. In the first three years of illness these changes are more easily reversed.
Eventually, we hope that everyone with an eating disorder will be able to access tailored, specialist treatment quickly. FREED is one step towards this goal.
Research on early intervention in eating disorders
Clinical, biological and neurobiological studies have shown that the first three years of illness provide a critical window for early effective intervention in eating disorders.
There are three main reasons for this:
- For anorexia nervosa in particular, illness duration is a key predictor of treatment outcomes. Outcomes are best with duration of illness < 3 years.
- Growing evidence suggests that eating disorders are associated with significant structural and functional brain changes. Eating disorder behaviours are initially rewarding, then habitual, and then neurocognitively engrained.
- Because eating disorders typically develop in adolescence and young adulthood, when the brain is still developing, these brain changes have potential to disrupt brain maturation.
Eating disorders tend to persist over time. The longer a young person is unwell, the more likely it is that brain changes will occur and persist. In addition, they are more likely to experience disruptions to social, educational and emotional development.
Early intervention is consistent with a stage of model illness, for which there is considerable support for anorexia nervosa in particular and all eating disorders to some degree.