Still waiting: referral patterns, delays, and key factors in accessing specialized eating disorder treatment in an Italian cohort

Background: Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral. Methods: This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral. Results: On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral. Conclusion: Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.