NEDA TOOLKIT for Parents
Eating disorders: Core interventions in the treatment and
management of anorexia nervosa, bulimia nervosa, and
related eating disorders.
U.K. National Collaborating Centre for
Mental Health: Brief Summary
Bibliographic Source
National Collaborating Centre for Mental Health.
Eating disorders. Core interventions in the treatment
and management of anorexia nervosa, bulimia
nervosa and related eating disorders. Leicester (UK):
British Psychological Society; 2004. 260 p. [408
references] Major Recommendations
Evidence categories (I-IV) and recommendation
grades (A-C) are defined at the end of the Major
Recommendations field.
shared with the patient and, where appropriate,
his/her family and caregivers.
Providing Good Information and Support
C — Patients and, where appropriate, caregivers
should be provided with education and information on
the nature, course, and treatment of eating disorders.
C — In addition to the provision of information, family
and caregivers may be informed of self-help groups
and support groups, and offered the opportunity to
participate in such groups where they exist.
Care Across All Conditions
C — Healthcare professionals should acknowledge
that many people with eating disorders are
ambivalent about treatment. Healthcare professionals
should also recognize the consequent demands and
challenges this presents.
Assessment and Coordination of Care
Getting Help Early
C — Assessment of people with eating disorders
should be comprehensive and include physical,
psychological, and social needs and a comprehensive
assessment of risk to self.
There can be serious long-term consequences to a
delay in obtaining treatment.
C — The level of risk to the patient’s mental and
physical health should be monitored as treatment
progresses because it may change--for example,
following weight gain or at times of transition
between services in cases of anorexia nervosa.
C — For people with eating disorders presenting in
primary care, general practitioners (GPs) should take
responsibility for the initial assessment and the initial
coordination of care. This includes the determination
of the need for emergency medical or psychiatric
assessment. C — Where management is shared between primary
and secondary care, there should be clear agreement
among individual healthcare professionals on the
responsibility for monitoring patients with eating
disorders. This agreement should be in writing (where
appropriate using the Care Program Approach) and
C — People with eating disorders seeking help should
be assessed and receive treatment at the earliest
opportunity. C — Whenever possible patients should be engaged
and treated before reaching severe emaciation. This
requires both early identification and intervention.
Effective monitoring and engagement of patients at
severely low weight or with falling weight should be a
priority. Management of Physical Aspects
C — Where laxative abuse is present, patients should
be advised to gradually reduce laxative use and
informed that laxative use does not significantly
reduce calorie absorption.
C — Treatment of both subthreshold and clinical
cases of an eating disorder in people with diabetes is
essential because of the greatly increased physical
risk in this group.
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