Eating Disorders in Young People

Diagnosing Eating Disorders in CYP

Penrose Health Action Plan

Treatment Goals

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Our aim is to work in partnership with our patients to achieve lifelong mental health and wellbeing for them. The goals of treatment and how we accomplish them are:

The key tasks in primary care are diagnosis, risk assessment and initial management, as well as monitoring patients after discharge in collaboration with secondary care/Eating Disorder Services (EDs), as part of a Shared Care agreement.

For a patient who may have an eating disorder, rapidly exclude other causes and look for weight concern, reluctance to eat and purging.

⚠️ Safety netting

For any interaction with a patient with suspected/confirmed eating disorder:

• Perform risk assessment. If patient is high risk or in crisis → discuss with another professional (e.g. GP, PCMHT team) as appropriate and consider the need for emergency medical or psychiatric admission for CYP at risk of serious physical complications, suicide or serious self-harm.
• If eating disorder suspected in CYP → refer immediately to an age appropriate eating disorder service for specialist assessment and management.
• Normal blood tests and relatively preserved energy levels can be falsely reassuring. Any patient with a severe eating disorder can deteriorate rapidly, and should be referred without delay.
• Ensure there is a clear agreement between primary and secondary or tertiary care about the responsibility for monitoring a CYP with an eating disorder.

Where to refer

Information required for referral

Physical risk assessment in primary settings should include nutritional status (including current intake), disordered eating behaviours, physical examination, blood tests and electrocardiography.

What to do while awaiting specialist assessment

The time between an accepted referral and first appointment can be up to one month.

While awaiting a referral response or first appointment, keep in mind:

• to regularly monitor the patient for changes in situation.
• actions and review timelines are dependent on good clinical judgement in assessing the patient's physical and mental health risk status.
• urgent admission and/or consultation with specialist is advisable if health status deteriorates.
• consider signposting to other eating disorder services (🎊Beat Eating Disorders , 🎊RecoveryRecord App, 👧The Mulberry Hub).
• consider simultaneous paediatric referral for children and young people with eating disorders.
• consider consultation/referral to other specialist services if complications arise.

Shared Care

Eating disorders are covered, in England, by the term severe mental illness (SMI) and physical checks in primary care should be performed, even if under specialist outpatient care. Patients with eating disorders not presenting in an emergency may nevertheless require urgent referral.

When the patient is deemed well enough to return home, contact between the secondary provider and primary care must be made with:

1. a clear management plan,
2. requirements for monitoring,
3. contingency plans if the above do not go well.

The patient must participate in this process and have a chance to pose questions.