FREED is designed to give young people rapid access to specialised evidence-based treatment for eating disorders and support tailored to their needs.
An introduction to FREED
Eating disorders are serious mental illnesses that involve extreme concern about eating, weight or shape plus disordered eating. They are not a lifestyle choice or “phase”.
Eating disorders have the highest mortality rate of any mental health disorder. One in seven women will experience an eating disorder over their lifetime. Peak onset is in adolescence and young adulthood, but eating disorders can develop before and after this too. They affect boys and girls, men and women, young and old, rich and poor, and people of all cultures.
There are four main categories of eating disorder: anorexia nervosa, bulimia nervosa, binge eating disorder, and “other specified feeding or eating disorder” (OSFED). OSFED is no less serious than the other categories and just means that symptoms don’t exactly match those for anorexia nervosa, bulimia nervosa or binge eating disorder.
Eating disorders aren’t all about food. People with eating disorders often feel a lot of pain, sadness and worry. The eating disorder can be a way to cope.
‘Disordered eating’ can include limiting food intake, binge eating (eating a very large amount of food at once and feeling out of control of eating) and/or purging (making yourself sick or misusing laxatives). People may also exercise a lot, or exercise in rigid ways.
Some of the symptoms associated with eating disorders include:
Usually at least a few of these symptoms are present in someone with an eating disorder.
“An eating disorder is never the solution to a person’s distress or difficulties. It is always the problem.”
Ulrike Schmidt, Psychiatrist and Professor of Eating Disorders
Early intervention means providing treatment as soon as possible when someone needs it. Research tells us that we should try and reach someone with an eating disorder within the first three years of the illness. People with eating disorders experience changes to their brain, body and behaviour. In early stages these changes are more easily reversed.
After three years, eating disorder symptoms tend to become “hard wired” in the brain. Symptoms can still be changed, but it gets harder to make changes and there may be long-lasting consequences.
There are two key things that stop early intervention for eating disorders: difficulties spotting the illness early, and difficulties getting help. FREED aims to address both sets of difficulties.
Phoebe received treatment through FREED in London. She shares her experiences of her eating disorder, treatment and recovery.
Services using FREED aim to provide rapid, specialised, evidence-based treatment for young people with a recent onset eating disorder (anorexia nervosa, bulimia nervosa, binge eating disorder or another eating disorder). This means that treatment is more likely to be effective and young people are less likely to miss out on study, relationships and other opportunities because of their illness.
FREED was developed for 16 to 25-year-olds with an eating disorder of up to 3 years duration. 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.
“FREED has really saved my life. Early intervention is crucial and without this I probably would not be where I am now - I am sustaining a job, have moved out to a new home, and able to love myself. I still have eating issues and anxieties but I have come so far in my wellbeing and quality of life.”
FREED service user
FREED is First Episode Rapid Early Intervention for Eating Disorders. It is a service model and care package for 16 to 25-year-olds who have had an eating disorder for three years or less (anorexia nervosa, bulimia nervosa, binge eating disorder, or another eating disorder).
FREED helps young people to access specialised evidence-based treatment quickly. The goal is for treatment to start within 4 weeks of referral to an eating disorder service.
FREED also attends to the specific needs of young people in the early stages of an eating disorder. It emphasises early, pro-active engagement; early symptom change; family involvement; attention to the effects of eating disorders on the brain; attention to social media use; and attention to transitions (out of school, to university, into work) and ‘emerging adulthood’.
FREED operates as a ‘service within a service’. It complements, rather than replaces, existing eating disorder services and treatments.
“Without FREED I am not sure I would be here today, getting early intervention was such a positive thing to happen to me when I was in a really dark place, and it gave me lots of hope for the future.”
FREED service user
The FREED service was developed and tested by the South London and Maudsley NHS Foundation Trust’s Eating Disorders Unit and King’s College London. The initial trial took place across 2014-2015. Compared to treatment-as-usual, FREED reduced the amount of time an eating disorder was left untreated and improved treatment outcomes.
Key benefits included:
Introducing FREED did not result in non-FREED patients waiting longer for treatment.
FREED confirmed that treating people as early as possible leads to better results for eating disorder treatment.
In 2016, FREED was introduced to three new eating disorder services in the UK. In 2018, FREED was introduced to eight new services. By 2020, we hope that at least 20 services will be using FREED. Work is also being done to establish FREED in Australia. Services that use FREED form part of the FREED Network. FREED is also being used in South Australia under the term EmergED.
We have an online training package and implementation toolkit for services interested in adopting FREED. This covers the why, what and how of delivering FREED and working effectively with young people and their families. There is currently no charge for this material but we ask that you register to access this part of the site.
We also have guides for healthcare professionals to use and guides and tools you can share with patients and carers. You don’t need to register to use these.
Professor of Eating Disorders (King's College London), Consultant Psychiatrist & FREED Executive Director (Maudsley)
FREED National Head & Consultant Psychotherapist (Maudsley)
FREED Consultant Clinical Psychologist (Maudsley) & Visiting Senior Lecturer (King's College London)
FREED National Co-lead & Senior Counselling Psychologist (Maudsley)
FREED National Co-lead, EDSA Deputy Curriculum Lead & Eating Disorders Therapist (Maudsley)
FREED PhD Student (King's College London)
FREED PhD Student (King's College London) & Counselling Psychologist
FREED National Assistant Psychologist (Maudsley)
Psychological Therapies Team Lead (St Ann's)
Senior CBT Therapist & FREED Champion (St. Ann's)
Trainee Counselling Psychologist & FREED Champion (St Ann's)
Occupational Therapist & FREED Champion (CNWL)
Clinical Nurse Specialist & FREED Champion (CNWL)
Counselling Psychologist & FREED Champion (ELFT)
Counselling Psychologist & FREED Champion (ELFT)
Counsellor & FREED Champion (SET CAMHS EDS, Essex)
Senior Specialist Nurse & FREED Champion (Kent & Medway)
CBT Therapist & FREED Champion (SLaM)
Counselling Psychologist & FREED Champion (South-West London & St George's)
Clinical Psychologist & FREED Champion (West London)
Principal Clinical Psychologist / Clinical Lead (West London)
Advanced Practitioner & FREED Champion (Cambridge)
Senior Eating Disorders Nurse & FREED Champion (Great Yarmouth & Waveney)
FREED Champion & Occupational Therapist (North East & West Essex)
Senior Eating Disorders Practitioner & FREED Coordinator (South Essex)
Trainee CB Therapist/FREED Coordinator (Birmingham & Solihull)
Clinical Psychologist & FREED Champion (Birmingham)
FREED Champion (Black Country)
Team Manager/Nurse Therapist & FREED Champion (Derbyshire)
Eating Disorders Therapist & FREED Champion (Leicestershire)
Trainee Clinical Associate Psychologist & FREED Champion (Leicestershire)
Senior Eating Disorders Practitioner & FREED Co-ordinator (Lincolnshire)
Nurse Specialist & FREED Co-ordinator (Lincolnshire CAMHS)
FREED Champion (North East Lincolnshire)
Senior Counselling Psychologist & FREED Champion (Northamptonshire)
FREED Champion (Northamptonshire)
Specialist Mental Health Practitioner & FREED Pathway Lead (Nottinghamshire)
Advanced Practitioner & FREED Champion (North Staffordshire)
Nurse Therapist & FREED Champion (Midlands)
Specialist Eating Disorder Nurse & FREED Champion (Northumberland)
Senior Eating Disorders Practitioner & FREED Champion (North Cumbria)
Specialist Eating Disorder Nurse & FREED Champion (Leeds & York)
Clinical Specialist Practitioner & FREED Champion (Leeds & York)
Senior Eating Disorders Practitioner & FREED Champion (Tees, Esk & Wear Valleys)
Clinical Lead (Hull)
Eating Disorder Family Practitioner & FREED Champion (Hull)
Senior Eating Disorder Practitioner & FREED Coordinator (Cheshire & Wirral)
Nurse Practitioner & FREED Practitioner (Chester)
FREED Practitioner (Macclesfield)
Eating Disorders Practitioner & FREED Practitioner (Warrington & Halton)
FREED Practitioner (Trafford)
FREED Eating Disorder Practitioner (Bolton)
Clinical Psychologist/FREED Champion (Greater Manchester/Salford)
Psychological Therapist & FREED Champion (Manchester)
CBT Therapist & FREED Lead (Stockport)
FREED Champion & Clinical Psychologist (Liverpool & Sefton)
FREED Champion & Specialist Nurse (Liverpool)
Clinical Psychologist & FREED Champion (Liverpool & Sefton)
Senior Nurse Practitioner (Knowsley & St Helens)
Mental Health Social Worker/Psychological Therapist & FREED Champion (Berkshire)
Occupational Therapist & FREED Champion (Buckinghamshire)
Clinical Lead Nurse & FREED Champion (Oxford)
Clinical Nurse Specialist & FREED Champion (Oxfordshire)
Consultant Nurse Practitioner & FREED Champion (Wiltshire)
Principal Clinical Psychologist & FREED Champion (Southern Health)
Clinical Psychologist & FREED Champion (Hampshire)
CBT Therapist & FREED Champion (Surrey)
Mental Health Practitioner & FREED Champion (Surrey & Borders)
Clinical Psychologist & FREED Champion (Sussex)
Occupational Therapist & FREED Champion (Avon And Wiltshire)
Clinical Psychologist & FREED Clinical Lead (Devon)
Senior Eating Disorder Practitioner & FREED Champion (Gloucestershire)
Clinical Lead & FREED Champion (Plymouth)
FREED Champion & Occupational Therapist (Cornwall)
Psychological Therapist & FREED Champion (Somerset)
FREED is much more effective than traditional treatments at reversing the changes to brain, body and behaviour caused by eating disorders.
The FREED Network consists of all services using FREED, with access to evidence-based protocols and patient resources to support early intervention in eating disorders.
Access helpful guides for GPs and other health professionals (no registration required) or register for our online training platform if you are interested in using FREED in your service.
Help & Support
The sooner you seek support, the sooner things can start to get better. We can help you find the right option for you.
Don’t want to use the tool? Download our guide to seeking help and support for more general information and advice.
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