On hold: the psychological impact of prolonged waitlists for eating disorder treatment

Prolonged waitlists for eating disorder (ED) treatment are a growing concern in Australia, with limited access to specialised services contributing to delays in care. Despite increasing awareness of these systemic barriers, little is known about the lived experience of adults awaiting psychological treatment for EDs. This study explored the psychological and emotional impacts of being on a waitlist and the coping strategies individuals employ during this time. Fourteen females (M = 27.1 years) who were currently, or had recently been, on a waitlist for ED treatment in Australia participated in semi-structured interviews. Data were analysed using reflexive thematic analysis within a critical-realist framework. Participants described feeling deprioritised, not "sick enough", and that the waitlist itself contributed to symptom escalation. Four key themes were generated: living in limbo, reflecting uncertainty and disempowerment; incubation period, describing exacerbation of ED symptoms and psychological distress; reliance on other support, illustrating variable use of formal and informal networks; and alternative coping mechanisms, highlighting the use of previously learned strategies. Findings suggest that prolonged waiting can intensify distress, entrench ED behaviours, and undermine recovery motivation. Enhancing communication, interim support, and structured self-help may help mitigate these harms and improve service responses during the waitlist period.