Introduction: a troubling landscape for adult eating disorder care
Adults in England living with eating disorders are facing alarming delays in accessing essential treatment. The National Audit of Eating Disorders (NAED) has surfaced stark figures showing that some patients wait as long as 700 days for vital care. This finding, highlighted in the first NAED report, raises urgent questions about how the health system supports people with eating disorders and how regional disparities affect access to services across the country.
The scale of the problem
While waiting times vary by region and service, the NAED data confirms a systemic problem: many adults seeking help for eating disorders encounter protracted delays before they can begin evidence-based therapies. The impact is not merely administrative; it translates into prolonged suffering, the risk of physical and psychological deterioration, and increased use of emergency services in some cases. The report emphasizes that timely, integrated care is critical for recovery and long-term health outcomes.
Why these waits matter for adults
Eating disorders are complex illnesses with medical and nutritional components that require multidisciplinary treatment. For adults, delays can worsen malnutrition, bone health, heart rate and rhythm changes, and co-occurring conditions such as anxiety or depression. Early intervention often correlates with better prognosis, making the NAED findings especially troubling. The report also notes that access to specialist services—typically housed within NHS pathways—has not kept pace with growing demand, leading to bottlenecks that disproportionately affect adults who may be balancing work, family, and other responsibilities.
What the NAED report reveals about access to care
The NAED’s inaugural audit sheds light on how patients navigate pathways to treatment, including referral processes, assessment times, and the availability of appropriate therapies. Across England, there are pockets where services meet or come close to national guidelines, but significant gaps persist elsewhere. The report calls for a more consistent standard of care, better data collection, and increased transparency about regional performance so patients and clinicians can advocate for timely help.
Regional disparities and system-wide implications
Access to eating disorder treatment is not uniform. Some regions report shorter waits and more robust teams, while others struggle with staffing shortages and limited bed or outpatient capacity. These disparities can compound health inequities and lead to a domino effect: delayed treatment can strain other parts of the system, including primary care, crisis services, and inpatient facilities when conditions escalate. The NAED recommends targeted investment, workforce planning, and streamlined referral routes to bridge these gaps and reduce wait times where possible.
What needs to change: policy and practice recommendations
Experts say that addressing these long waits requires a multi-pronged approach. Key recommendations include expanding the number of trained clinicians in eating disorder care, improving early recognition in general practice, and developing clearer national guidelines for prioritizing cases with the greatest risk. Additional priorities include expanding outpatient and community-based services to reduce hospital-based bottlenecks, investing in digital tools for faster assessments, and ensuring patients have consistent access to family, social, and peer-support resources during treatment journeys.
What patients and families can do now
While systemic changes take time, patients and caregivers can advocate effectively by documenting symptoms, seeking second opinions when appropriate, and engaging with local health boards to understand local wait times and service options. Support groups and patient organizations can provide practical guidance for navigating referrals and accessing interim supports while waiting for formal treatment. Clinicians, too, can work toward early intervention strategies that mitigate deterioration and improve engagement with care plans during the waiting period.
Looking ahead
NAED’s findings are a call to action for policymakers, clinicians, and commissioners to reimagine how England delivers eating disorder care to adults. The goal is timely, evidence-based treatment that can improve outcomes and quality of life. As the health system responds, ongoing monitoring and public reporting will be essential to ensure progress toward shorter, more equitable wait times and a stronger care pathway for every adult affected by eating disorders.
