For many young people living with an eating disorder, reaching the age where they must leave child and adolescent services and move into adult care can feel like stepping off a cliff. The service structures and mental health professionals they know suddenly change, and the new systems can feel confusing and overwhelming. Families often describe this time as one of uncertainty, fear, and frustration. In eating disorders, where stability and support are vital for recovery, poor transitions can make the difference between moving forward and relapse - and sadly, relapse can be life-threatening.
Compiled for Beat by: Dr Maria Livanou & Dr Julian Baudinet
Eating disorders are among the most serious mental health conditions, with high relapse rates and, tragically, some of the highest mortality rates of any psychiatric illness. Young people with eating disorders are also more likely to live with neurodevelopmental conditions such as autism or ADHD, which can make navigating health systems even more challenging.
When transition support between services is inadequate, the impact is far-reaching. For young people, it can mean losing trust in services, experiencing a deterioration in mental and physical health, or disengaging from care altogether. For families, it often leads to heightened stress, feelings of helplessness, and financial strain. For the NHS, it can result in more hospital admissions, longer treatment episodes, and increased costs.
The move from child & adolescent to adult eating disorder services represents a major turning point for young people and their families. Research consistently shows that this is a particularly vulnerable time: many young people feel unprepared, anxious, or “lost in the gap” between services. Some experience relapses or drop out of treatment entirely.
These difficulties often arise because child and adult services operate very differently. Child & adolescent services typically involve families closely in care, while adult services expect young people to take greater responsibility for managing their health. This sudden shift in expectations—combined with disrupted relationships, inconsistent communication, and rigid age-based cut-offs—can leave young people feeling isolated and unsupported.
In recent transition studies, many young people described feeling “cut off” when their therapy ended abruptly, losing contact with professionals they trusted. Families also said they often felt left out or unsure how to help because of strict confidentiality rules in adult care. Long waiting times, poor communication between services, and age-based cut-offs made things worse.
Some NHS eating disorders services have recognised these concerns and developed “all age” or “lifespan” services where there is no transition from adolescent to adult, but these services are few and far between.
Research, including findings from our study, highlights several strategies that can make transitions smoother and safer.
Early and open conversations about what will change and when help young people and families feel more prepared. Transitions should be based on individual readiness, not just age. Developmental and emotional readiness should be assessed when service providers prepare a transition plan.
Clear, step-by-step plans shared between child and adult teams improve continuity of care and reduce the risk of people “falling through the cracks.” This approach reduces uncertainty and makes young people and their families feel valued and respected.
Keeping parents and/or carers involved (with the young person’s consent) supports emotional stability and ensures practical support continues.
Hearing from others who have already made the transition helps young people build confidence and trust. Peers can offer hope and practical advice, reduce isolation and increase sense of belonging. Peer involvement can strengthen therapeutic relationships and reduce power imbalances by drawing on shared lived experience.
Learning how to manage stress, use healthy coping strategies, and understand their condition empowers young people and reduces relapse risk.
Transitions are a known risk point. But despite this, services across the UK - and internationally - often lack structured processes for supporting young people as they move from Child and Adolescent Mental Health Services (CAMHS) into adult services.The TEDYI project (Transitions for Eating Disorders Youth intervention) is working to change this narrative. By bringing together young people with lived experience, their families, and healthcare professionals, TEDYi is co-designing a new model of care to make transitions safer, more supportive, more empowering and more relevant.
FREED Transitions modules are a set of five free online learning resources created by FREED (First Episode Rapid Early Intervention for Eating Disorders). They aim to help clinicians support young people moving from child and adolescent eating-disorder services (CAEDS) to adult eating-disorder services (AEDS).
The series comprises five modules that cover key aspects of service transitions.
This module explains why transitions are important, maps out service differences, and explores developmental considerations and service models.
This module provides practical guidance on planning and tailoring transitions, starting conversations, and fostering effective inter-service collaboration.
This module focuses on how to have meaningful, person-centred transition conversations, manage transition planning, and conclude the process safely and effectively.
This module helps professionals navigate family involvement and confidentiality complexities during transitions.
This module considers age-related life changes beyond services, such as moving to higher education, and how these intersect with care transitions.
TEDYi is being developed directly in response to the problems young people, families, and professionals described. It is a co-produced intervention – meaning it is being designed with young people, carers, and clinicians, not just for them. TEDYi brings everyone together to build a toolkit that makes the move from child to adult services smoother, safer, and more supportive.What makes TEDYI unique is that it is not being designed by researchers or clinicians alone. Instead, it is being co-produced with young people, carers, and healthcare professionals working side by side. This approach is called Experience-Based Co-Design (EBCD).
The project unfolded in two main phases:
Interviews and listening – Young people and families shared their experiences of transition. They spoke about what was missing, what was frightening, and what would have made the process easier. Some common themes emerged:
EBCD workshops and co-design – Over more than a year, our lived experience team worked alongside professionals to design a new model of care. This collaborative process ensured that TEDYi was not only clinically informed but also rooted in the realities of those who live through transitions.
One of the most powerful impacts of TEDYI so far has been on the people involved in creating it. Young people and carers have described feeling empowered, valued, and heard in ways they hadn’t before. For many, participation transformed their relationship with their eating disorder — reframing it not as a source of shame, but as a form of expertise that could help others.
This process has:
The TEDYI model is now ready for piloting. Over the next two years, the focus will be on testing it within NHS settings to see how it works in practice. The hope is that it will:
If successful, TEDYi could be embedded across NHS eating disorder services nationally. In the longer term, its principles might even inform transitions in other areas of mental health and chronic illness.
The potential benefits are wide-reaching:
The TEDYi project illustrates something crucial: when services are co-designed with those who use them, the results are richer, more relevant, and more sustainable. Too often, health systems are built top-down, with good intentions but limited understanding of the lived realities of patients and families. TEDYi flips this dynamic.
By embedding lived experience from the start, TEDYi has already delivered impact: empowerment, community, and de-stigmatisation. And it promises more: structural change that could transform how services support young people through one of the most vulnerable points in their recovery journey.