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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. Page | 35