NEDA TOOLKIT for Parents
C — People with type 1 diabetes and an eating
disorder should have intensive regular physical
monitoring, because they are at high risk of
retinopathy and other complications.
C — Pregnant women with eating disorders require
careful monitoring throughout the pregnancy and in
the postpartum period.
C — Patients with an eating disorder who are vomiting
should have regular dental reviews.
C — Patients who are vomiting should be given
appropriate advice on dental hygiene, which should
include avoiding brushing after vomiting; rinsing with
a nonacid mouthwash after vomiting; and reducing an
acid oral environment (for example, limiting acidic
foods). C — Healthcare professionals should advise people
with eating disorders and osteoporosis or related bone
disorders to refrain from physical activities that
significantly increase the likelihood of falls.
Additional Considerations for Children and
Adolescents C — Family members, including siblings, should
normally be included in the treatment of children and
adolescents with eating disorders. Interventions may
include sharing of information, advice on behavioral
management, and facilitating communication.
C — In children and adolescents with eating disorders,
growth and development should be closely monitored.
Where development is delayed or growth is stunted
despite adequate nutrition, pediatric advice should be
sought. C — Healthcare professionals assessing children and
adolescents with eating disorders should be alert to
indicators of abuse (emotional, physical and sexual)
and should remain so throughout treatment.
C — The right to confidentiality of children and
adolescents with eating disorders should be respected.
C — Health care professionals working with children
and adolescents with eating disorders should
familiarize themselves with national guidelines and
their employers’ policies in the area of confidentiality.
Identification and Screening of Eating Disorders in
Primary Care and Non-Mental Health Settings
C — Target groups for screening should include young
women with low body mass index (BMI) compared
with age norms, patients consulting with weight
concerns who are not overweight, women with
menstrual disturbances or amenorrhea, patients with
gastrointestinal symptoms, patients with physical signs
of starvation or repeated vomiting, and children with
poor growth.
C — When screening for eating disorders one or two
simple questions should be considered for use with
specific target groups (for example, “Do you think you
have an eating problem?” and “Do you worry
excessively about your weight?”).
C — Young people with type 1 diabetes and poor
treatment adherence should be screened and
assessed for the presence of an eating disorder.
Management of Anorexia Nervosa in Primary
Care C —In anorexia nervosa, although weight and BMI are
important indicators of physical risk they should not
be considered the sole indicators (as they are
unreliable in adults and especially in children).
C — In assessing whether a person has anorexia
nervosa, attention should be paid to the overall
clinical assessment (repeated over time), including
rate of weight loss, growth rates in children, objective
physical signs, and appropriate laboratory tests.
C — Patients with enduring anorexia nervosa not
under the care of a secondary care service should be
offered an annual physical and mental health review
by their GP.
Psychological Interventions for Anorexia
Nervosa The delivery of psychological interventions should be
accompanied by regular monitoring of a patient’s
physical state including weight and specific indicators
of increased physical risk.
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