Evidence map›Paper›PMID 42897606›Full record

ReviewJournal of eating disorders2026

Duration of untreated illness in eating disorders: a comprehensive systematic review and meta-regression.

Gyselle de Geus, Mike Trott, Alessio Maria Monteleone, Joseph Firth, Dan Siskind, Scott Teasdale, Urska Arnautovska, Ravi Iyer, Brendon Stubbs, Natasha Demidenko and 18 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of eating disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Gyselle de Geus *Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Mike Trott *Queensland Centre for Mental Health Research, Brisbane, QLD, Australia.
Alessio Maria Monteleone *Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy.
Joseph FirthDivision of Psychology and Mental Health, University of Manchester, Manchester, UK.
Dan SiskindQueensland Centre for Mental Health Research, Brisbane, QLD, Australia.
Scott TeasdaleSchool of Clinical Medicine, Nutrition, Exercise and Social Equity Research Group, University of New South Wales, Sydney, NSW, Australia.
Urska ArnautovskaQueensland Centre for Mental Health Research, Brisbane, QLD, Australia.
Ravi IyerSwinburne University of Technology, Centre for Mental Health and Brain Sciences, Melbourne, VIC, Australia.
Brendon StubbsDepartment of Psychological Medicine, King's College London, London, UK.
Natasha DemidenkoOttawa Hospital Research Institute, Ottawa, ON, Canada.
David MartinOttawa Hospital Research Institute, Ottawa, ON, Canada.
Ruxandra AntochiRoyal Ottawa Mental Health Centre, Ottawa, ON, Canada.
Jess G FiedorowiczOttawa Hospital Research Institute, Ottawa, ON, Canada.
Amelia AustinDepartment of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Ulrike SchmidtCentre for Research in Eating and Weight Disorders (CREW), King's College London, London, UK.
Tracey WadeBlackbird Initiative, Flinders University, Adelaide, SA, Australia.
Fernando Fernandez-ArandaCiber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.
Beate Herpertz-DahlmannDepartment of Child and Adolescent Psychiatry, RWTH Aachen University, Aachen, Germany.
Hans W HoekParnassia Psychiatric Institute, The Hague, The Netherlands.
Ulrich VoderholzerSchoen Clinic Roseneck, Prien am Chiemsee, Germany.
David KolarDepartment of Psychology, University of Regensburg, Regensburg, Germany.
Stephan ZipfelDepartment of Psychosomatic Medicine and Psychotherapy, University of Tuebingen, Tübingen, Germany.
Kathleen M PikeDepartments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA.
Andreas KarwautzDepartment of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.
Stephen WonderlichDepartment of Psychiatry and Behavioral Science, University of North Dakota, Fargo, ND, USA.
Lee SmithCentre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.
Marco CarfagnoDepartment of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy.
Marco SolmiOttawa Hospital Research Institute, Ottawa, ON, Canada. msolmi@toh.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEating disorders (EDs) substantially impair physical health, psychological well-being, and social functioning. Shorter untreated illness duration has been proposed to be associated with better outcomes, though evidence for this relationship remains mixed. Nonetheless, delays in accessing treatment remain common and contribute to prolonged suffering and risk of lasting harm. This study aimed to estimate the duration of untreated eating disorder (DUED) and examine potential moderators.

methodsA PRISMA 2020-compliant systematic review and meta-analysis was conducted. Searches were performed from inception to March 2026 in PubMed, Embase, PsycINFO, and CINAHL. Random-effects models were used to estimate pooled DUED of available studies, with subgroup and meta-regression analyses to explore moderators. Study quality and risk of bias were assessed using National Institutes of Health (NIH) tools.

resultsOf 2,776 records identified, 29 studies (n = 17,433) were included. The pooled DUED of available studies was 21.9 months (95% CI 18.0-25.8), with substantial heterogeneity (I² = 99.7%). In subgroup analyses, DUED was longer in bulimia nervosa than anorexia nervosa (41.5 vs. 19.9 months). Meta-regression identified mean age as a significant moderator (β = 1.91, 95% CI 1.1 to 2.7, p < 0.001), indicating longer delays in older individuals. DUED also differed across country, continent, age group, and study design, while decade subgroup estimates were lower in studies from the 2020s than the 2010s.

conclusionIndividuals with EDs experience substantial delays before accessing treatment, with untreated illness exceeding 20 months on average. Older age was associated with longer DUED, suggesting potential gaps in detection and help-seeking among adults. DUED varies across demographic, geographic and methodological factors. While decreasing DUED over time is encouraging, these findings highlight the need for earlier identification and streamlined care pathways to reduce delays and improve outcomes in people with ED.

Indexed as

Duration of untreated eating disordersEarly interventionEating disordersMeta-analysisTreatment delay

Identifiers

PMID42897606
PMCPMC13679174

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.