{
  "abstract": "Introduction\n\nEating 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.Methods\n\nA 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.Results\n\nOf 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.Conclusion\n\nIndividuals 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.",
  "abstract_shown": true,
  "affiliations": [
    "Ottawa Hospital Research Institute, Ottawa, ON, Canada.",
    "SCIENCES Lab, Department of Psychiatry, University of Ottawa, 501 Smyth Road, Ottawa, ON, Canada.",
    "Queensland Centre for Mental Health Research, Brisbane, QLD, Australia.",
    "Faculty of Health, Medicine and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia.",
    "Addiction and Mental Health Service, Metro South Health, Brisbane, QLD, Australia.",
    "Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy.",
    "Division of Psychology and Mental Health, University of Manchester, Manchester, UK.",
    "School of Clinical Medicine, Nutrition, Exercise and Social Equity Research Group, University of New South Wales, Sydney, NSW, Australia.",
    "Swinburne University of Technology, Centre for Mental Health and Brain Sciences, Melbourne, VIC, Australia.",
    "Department of Psychological Medicine, King's College London, London, UK.",
    "Center for Sport Science and University Sports, University of Vienna, Vienna, Austria.",
    "The Ottawa Hospital, Mental Health Department, Ottawa, ON, Canada.",
    "Royal Ottawa Mental Health Centre, Ottawa, ON, Canada.",
    "Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.",
    "Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.",
    "Centre for Research in Eating and Weight Disorders (CREW), King's College London, London, UK.",
    "South London and Maudsley NHS Foundation Trust, London, UK.",
    "Blackbird Initiative, Flinders University, Adelaide, SA, Australia.",
    "Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain.",
    "Psychoneurobiology of Eating and Addictive Behaviors Group, IDIBELL, Barcelona, Spain.",
    "Department of Clinical Psychology, Bellvitge University Hospital, IDIBELL, Barcelona, Spain.",
    "Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.",
    "Department of Child and Adolescent Psychiatry, RWTH Aachen University, Aachen, Germany.",
    "West German Center for Child and Adolescent Health, University Hospital Cologne, Cologne, Germany.",
    "Parnassia Psychiatric Institute, The Hague, The Netherlands.",
    "Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.",
    "Department of Epidemiology, Columbia University, New York, NY, USA.",
    "Schoen Clinic Roseneck, Prien am Chiemsee, Germany.",
    "Department of Psychiatry and Psychotherapy, LMU Munich, Munich, Germany.",
    "Department of Psychology, University of Regensburg, Regensburg, Germany.",
    "Department of Psychosomatic Medicine and Psychotherapy, University of Tuebingen, Tübingen, Germany.",
    "German Centre for Mental Health (DZPG), Tübingen, Germany.",
    "Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, NY, USA.",
    "Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria.",
    "Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, ND, USA.",
    "Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK.",
    "Department of Public Health, Faculty of Medicine, Biruni University, Istanbul, Turkey.",
    "Ottawa Hospital Research Institute, Ottawa, ON, Canada. msolmi@toh.ca.",
    "SCIENCES Lab, Department of Psychiatry, University of Ottawa, 501 Smyth Road, Ottawa, ON, Canada. msolmi@toh.ca.",
    "The Ottawa Hospital, Mental Health Department, Ottawa, ON, Canada. msolmi@toh.ca."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 28,
  "authors": [
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      "name": "Gyselle de Geus"
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  "cited_by": 0,
  "doi": "10.1186/s40337-026-01731-6",
  "fulltext_url": "https://europepmc.org/articles/PMC13679174",
  "id": "945k8bbkkeqzn",
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    "2050-2974"
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  "landing_url": "https://europepmc.org/article/MED/42897606",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
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  "pdf_url": "https://europepmc.org/articles/PMC13679174?pdf=render",
  "pmcid": "PMC13679174",
  "pmid": "42897606",
  "published": "2026-08-01",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/945k8bbkkeqzn.ris",
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      "first_seen": "2026-10-30T12:19:41Z",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:3203|Eating Disorders and Behaviors",
      "subfield": "psychiatry"
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  "title": "Duration of untreated illness in eating disorders: a comprehensive systematic review and meta-regression.",
  "title_text": "Duration of untreated illness in eating disorders: a comprehensive systematic review and meta-regression.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:45:36Z",
  "url": "https://research.draconitic.com/paper/945k8bbkkeqzn",
  "venue": "Journal of eating disorders",
  "versions": []
}