Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;29(3):329-345.
doi: 10.1002/erv.2745. Epub 2020 Jun 23.

Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature

Amelia Austin  1 , Michaela Flynn  1 , Katie Richards  1 , John Hodsoll  2 , Tiago Antunes Duarte  3 , Paul Robinson  4 , Jonathan Kelly  5 , Ulrike Schmidt  1   6
Affiliations

Duration of untreated eating disorder and relationship to outcomes: A systematic review of the literature

Amelia Austin et al. Eur Eat Disord Rev. 2021 May.

Abstract

Objective: This systematic review assesses the average duration of untreated eating disorder (DUED) in help-seeking populations at the time of first eating disorder (ED) treatment and investigates the relationship between DUED and symptom severity/clinical outcomes.

Method: PRISMA guidelines were followed throughout. Selected studies provided information on either: (i) length of DUED, (ii) components of DUED, (iii) cross-sectional associations between DUED and symptom severity, (iv) associations between DUED and clinical outcomes, or (v) experimental manipulation of DUED. Study quality was assessed.

Results: Fourteen studies from seven countries were included. Across studies, average DUED weighted by sample size was 29.9 months for anorexia nervosa, 53.0 months for bulimia nervosa and 67.4 months for binge eating disorder. A younger age at time of first treatment was indicative of shorter DUED. Retrospective studies suggest that a shorter DUED may be related to a greater likelihood of remission. Manipulation of DUED by shortening service-related delays may improve clinical outcomes.

Conclusions: Data on length of DUED provide a benchmark for early intervention in EDs. Preliminary evidence suggests DUED may be a modifiable factor influencing outcomes in EDs. To accurately determine the role of DUED, definition and measurement must be uniformly operationalised. Highlights This systematic review is the first to examine duration of untreated eating disorder (DUED) across different eating disorders. Definitions and measurement of DUED and its components vary considerably between studies. Across different eating disorders average DUED weighted by sample size ranges from approximately two and a half years (for anorexia nervosa) to nearly 6 years (for binge eating disorder). DUED appears to be related to age such that younger patients have shorter DUED.

Keywords: anorexia nervosa; bulimia nervosa; duration of untreated illness; early intervention; eating disorder.

PubMed Disclaimer

References

REFERENCES

    1. Agras, W. S., Lock, J., Brandt, H., Bryson, S. W., Dodge, E., Halmi, K. A., … Woodside, B. (2014). Comparison of 2 family therapies for adolescent anorexia nervosa: A randomized parallel trial. JAMA Psychiatry, 71(11), 1279-1286. https://doi.org/10.1001/jamapsychiatry.2014.1025
    1. Allen, K. L., Mountford, V., Brown, A., Richards, K., Grant, N., Austin, A., … Schmidt, U. (2020). First episode rapid early intervention for eating disorders (FREED): From research to routine clinical practice. Early Intervention in Psychiatry. Advanced Online Publication. DOI. https://doi.org/10.1111/eip.12941
    1. Ambwani, S., Cardi, V., Albano, G., Cao, L., Crosby, R., MacDonald, P., … Treasure, J. (2020). A multicenter audit of outpatient care for adult anorexia nervosa: Symptom trajectory, service use, and evidence in support of “early stage” versus “severe and enduring” classification. International Journal of Eating Disorders. https://doi.org/10.1002/eat.23246
    1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th, Text Revision). Washington, DC: American Psychiatric Association.
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.

Publication types

MeSH terms