# The Australia and New Zealand clinical quality registry for the treatment of eating disorders (TrEAT Registry): protocol and preliminary data

## TL;DR

The TrEAT Registry is a new data collection system in Australia and New Zealand to improve eating disorder treatment by tracking outcomes across different care settings.

## Contribution

The TrEAT Registry is the first clinical quality registry for eating disorders in the region, enabling systematic evaluation of treatment outcomes in both public and private sectors.

## Key findings

- 88.1% of invited clients consented to contribute data, with 93.7% completing the pre-treatment survey.
- Most participants were young, female, and received care in outpatient settings, showing clinically significant symptomatology at baseline.
- The registry supports real-world research and evaluations of residential and virtual day programs, as well as Medicare and credentialing systems.

## Abstract

Eating disorders are a major public health concern in Australia and Aotearoa New Zealand, with significant morbidity, mortality, and economic burden. Despite substantial government investment in eating disorder care, there is limited infrastructure to evaluate treatment outcomes, particularly in community settings. Clinical Quality Registries (CQRs) offer a mechanism for systematic data collection, benchmarking, and feedback to improve care quality. The Australia and New Zealand Clinical Quality Registry for the Treatment of Eating Disorders (TrEAT Registry) was developed to address this gap.

The TrEAT Registry is a multi-centre, longitudinal CQR that collects clinician- and client-reported data across outpatient, day patient, residential, and inpatient settings. Data are collected at treatment commencement, during treatment, and at discharge or follow-up. Clients aged 13 years and older provide informed consent to contribute de-identified data to a research databank. Core measures include the Eating Disorder Examination Questionnaire (EDE-Q), Clinical Impairment Assessment (CIA), and Depression Anxiety and Stress Scale (DASS-21).

Between September 2021 and June 2025, 754 clients were invited to contribute their clinical data to the registry databank, with 88.1% consenting and 93.7% of consenting participants completing the pre-treatment survey. The sample was predominantly female (91.8%), young (mean age = 26.0 years), and urban-dwelling (> 85%). Most clients in the registry were treated in privately operated outpatient settings. Mean scores on the EDE-Q (Global = 3.80), CIA (Total = 30.92), and DASS-21 subscales (Depression = 10.29, Anxiety = 7.00, and Stress = 10.67) indicated clinically significant symptomatology.

The TrEAT Registry is a pioneering initiative in eating disorder care, providing infrastructure for health surveillance, quality improvement, and research. The registry has supported real-world research and clinical trials, including ongoing evaluations of residential and virtual day programs, and planned evaluation of Medicare and credentialing systems. Its unique inclusion of private sector clinics and client consent enhances ethical standards and data richness. Planned expansion and digital enhancements aim to improve coverage, data accessibility, and follow-up rates, supporting a learning health system across Australia and New Zealand.

Trial registration Registered on the Australian Register of Clinical Registries (#ACSQHC-ARCR-279).

This paper describes the TrEAT Registry, an initiative in Australia and New Zealand that collects information about people receiving treatment for eating disorders. The goal is to improve care by understanding what treatments work best, for whom, and in which settings. The registry includes people from both public and private clinics, and covers different types of care, such as outpatient, day programs, and residential services.

People who join the registry give permission for their treatment information to be used for research and quality improvement. This helps clinicians and researchers learn more about eating disorders and how to support recovery. The registry also gives feedback to clinics to help them improve their services.

So far, hundreds of people have joined the registry, most of whom are young and receiving care in outpatient settings. The registry is helping to identify gaps in access to care and will support future research and policy decisions. Over the next few years, the registry will expand to include more clinics, including more coverage of inpatient care, and improve how data is collected and shared.