The Royal College of Psychiatrists (RCP) has published new guidance, emergencies in eating disorders (MEED): guidance on recognition and management. This new guidance is intended for healthcare practitioners to help them identify serious harms associated with eating disorders, so that appropriate care and treatment can be provided as early as possible.
Included in the new guidance are recommendations on:
- Risk assessment
- Location of care and transfer between services
- Safe refeeding of malnourished patients with restrictive eating disorders
- Nasogastric and other routes of feeding
- Management of behavioural manifestations of eating disorders on medical or paediatric wards
- Providing help to parents, relatives, and carers
- Compulsory admission and treatment
- Eating disorders and type 1 diabetes
- Policies and protocols
- Challenges for commissioners and managers.
83% increase in hospital admissions for eating disorders in the last few years
Moreover, the same guidelines have been published at a time when hospital admissions, related to eating disorders, have increased. Recent NHS statistics show that admissions have increased by 83% from 2015/2016 to 2020/2021, from 13,219 to 24,268 in England alone.
Children and young people worst affected
According to RCP analysis, children and young people with eating disorders are the worst affected. There has been a rise of 90% in a 5-year period (from 3541 to 6713 episodes) and a 35.4% increase in 2021. Morevover, a stark rise of 128% is seen in boys and young men, from 280 hospital admissions to 637 over the past few years.
Children and young people account for a significant proportion of hospitalisations, increasing from 3,541 to 6,713 over the past few years, with a 35 per cent rise in 2021 alone.
It is thought that the pandemic closed departments and led to a reluctance to attend appointments. However, the demand still remained. Isolation, loneliness and fear from the pandemic also increased the incidence of mental health disorders. It is thought that the combined factors led to the surge.
Anorexia nervosa has the highest mortality rate of any psychiatric disorder
Eating disorders are known to be devastating mental illnesses. Anorexia nervosa has the highest mortality rate of any psychiatric disorder. Bulimia is associated with severe medical complications as well, and people with binge eating disorder often experience the medical complications associated with obesity.
One in five deaths of people with anorexia nervosa are from suicide. In addition, there are high rates of self-harm and depression across all eating disorder diagnoses.
Dr Dasha Nicholls
Dr Dasha Nicholls, who chaired this new guideline’s development group, said: ‘Eating disorders such as anorexia, bulimia, and binge eating don’t discriminate, and can affect people of any age and gender. They are mental health disorders, not a “lifestyle choice”, and we shouldn’t underestimate how serious they are.”
‘Even though anorexia nervosa is often referred to as the deadliest mental health condition, most deaths are preventable with early treatment and support. Full recovery is possible, if spotted and treated early.’
‘We need to raise awareness of common eating disorders symptoms. Our guidance encourages healthcare professionals to spot when someone is dangerously ill and dispel the myths surrounding them. They remain poorly understood, with devastating consequences for thousands of patients and their families.’
SIGN has also published a new guideline on eating disorders in January this year, which covers anorexia nervosa, bulimia nervosa, binge eating disorder, and eating-disordered psychopathology occurring in the context of type 1 diabetes.
This issue is not unique to the UK, as recent statistics show that hospitalisations for eating disorders in Canada have risen by nearly 60% for young women aged 10–17 years.
In addition to the guidelines, the Department of Health and Social Care in England announced a £53 million investment in children and young people’s eating disorder services with the aim to increase capacity in 70 community support teams across the UK. On top of that, a further £79 million is to be invested in children’s mental health services in the hopes that at least 2,000 more children and young people will have access to eating disorder services.