Barriers to access treatment for eating disorders: Literature review

Background: Eating disorders (EDs) are disabling, potentially fatal, and costly mental disorders. According to recent data, Chile has the highest prevalence of both anorexia nervosa (AN) and bulimia nervosa (BN) in Latin America. However, there is no published data regarding the barriers experienced by patients with EDs in Chile until they start treatment. Aim: To review and synthesize the literature regarding barriers to access to treatment for patients with EDs. Methods: A search was conducted through PubMed/Medline, PsychInfo, Web of Science, Scopus, Embase, Scielo, and Google Scholar. Seventy-two studies were selected for full-text reading. Results: 53 studies were included, all conducted in developed countries. A wide range of barriers was found, which can be classified according to their role. These barriers were predominantly at the level of the patient with an ED, the family and social environment, the health professionals, the sociocultural context, and the healthcare system. The barriers most commonly found in studies were the patient's ego-syntonic behaviors and the social stigma associated with EDs. Discussion: The national context calls for discussing access problems in patients with EDs in Chile. The barriers found in this study should be considered when designing public policies, although the role of the cost of treatment should be more emphasized in Chile.