Eating Disorders and Adults

There are three providers of adult community eating disorder services in Greater Manchester:

  • Greater Manchester Mental Health NHS Foundation Trust (Salford, Bury, Oldham, Tameside and Glossop, Heywood, Middleton and Rochdale, Wigan, and Manchester)
  • Cheshire and Wirral NHS Partnership (Bolton, Trafford)
  • Oakwood Psychology (Stockport)

Our Aims

  • To provide a responsive, effective and safe service to adults with eating disorders in Greater Manchester.
  • To improve and standardise the service offered across the 10 localities of Greater Manchester.

Why This Matters

  • Eating disorders are a range of complex conditions which can have adverse effects physically, psychologically and socially on adults. Eating disorders have the highest mortality rate of all psychiatric conditions.
  • Eating disorders are characterised by a preoccupation with food, weight, body shape and harmful eating patterns. They can have a high cost to individuals and their families/carers in terms of emotional impact, disruption to education and employment and in their access to physical and emotional wellbeing and mental health services through their life span.
  • The onset of eating disorders is typically in mid-late teens but eating disorders can also start or resurface at a later age.
  • Eating disorders can affect anyone regardless of gender, sexuality, age, ethnic or cultural background. They can affect adults of different weights.
  • Effective psychological treatments for adults with eating disorders exist and a significant proportion of adults accessing these can fully recover from an eating disorder. Adults who do not fully recover can still achieve improvements that improve quality of life and reduce the effects of an eating disorder.
  • FREED  ( is an early intervention pathway that has been developed for adults aged between 18-25 years of age who have an eating disorder of three years or less. Research has shown that access to a FREED pathway improves outcomes for adults by a further 20% to 70% in total.

What We’ve Achieved So Far

  • A range of high quality, NICE and evidence-based psychological treatments continue to be available to adults accessing the three services.
  • As part of the treatment that is provided, specialist dietetics is also available.
  • The services have been successful in accessing funding from Community Mental Health Transformation Funding to improve the service provided. Specifically, this funding will be used to develop FREED pathways, establish protocols for medical monitoring and management and increase access to the service for those with a mild to moderate eating disorder.
  • FREED Early Intervention Pathway has launched and has run successfully in 3 of the 10 Greater Manchester localities over the past 18 months (Salford, Manchester and Heywood, Middleton and Rochdale). FREED has also launched recently in Stockport.
  • The three providers of adult community eating disorder services have formed a new network with key stakeholders including commissioners and those with lived experience, aimed at improving the service offered to adults who require an eating disorder service in Greater Manchester and to allow sharing of good practice.
  • The three services are also part of a wider network of eating disorder providers/stakeholders, the Provider Collaborative, Empowered, which launched in October 2021 and which is responsible for inpatient eating disorder admissions in the North West of England. The aim of this group is to improve eating disorder services across the pathway from community to inpatient specialist eating disorder units, which will be required by a small number of adults across our localities.
  • Work is underway to increase awareness of and access to the services from communities that experience racial inequalities and other underrepresented groups including older adults.
  • Awareness and training to support implementation of the new MEED guidelines (college-report-cr233-medical-emergencies-in-eating-disorders-(meed)-guidance.pdf ( is underway and protocols are being developed with colleagues in the acute hospital Trusts to improve recognition and care provided for adults who need acute medical care.

What’s Next

  • FREED Early Intervention pathway will be launched over 2022/23 in the further six localities of Greater Manchester.
  • Supporting awareness of and implementation of MEED Guidelines across acute hospitals and primary care to ensure that adults with eating disorders receive effective, safe and compassionate care.
  • Continuing to identify new ways of working and delivering effective treatments to meet the significant increase in demand from COVID-19 and reduce waiting times for treatment.
  • Continuing to increase access to the most effective psychological treatments for adults with eating disorders by training staff in the services.
  • Establishing clear protocols for medical monitoring and support.
  • Working together to identify resources for adults and their families/partners/carers to access support/evidence-based self-help materials while waiting for treatment.
  • The adult community eating disorder steering group will also meet regularly with the Children and Young People’s Eating Disorder Steering group to focus on improving aspects of care that span all ages including transitions.