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General management and advice to patient and family

(ref 262)

Eating disorders are serious conditions with a high lifetime mortality, mainly from suicide.

The GP can undertake early simple steps to treat eating disorder with the help of the practice nurse, counsellor and/or dietician.

Anorexia nervosa

  • Family involvement is essential for any intervention with children and adolescents (ref 263)
  • The patient, parents and other family members need information and education about the disorder.
  • Expect denial from the patient. Encourage and empower parents to be in charge concerning the child's health, eating and safety. Emphasis should be placed on empowering parents as controllers of the patient's food intake.
  • Weigh the patient weekly and chart their weight. Set manageable goals in agreement with the patient and their family; for example, aim for a 0.5 kg weight increase per week. For patients who are denying the illness, setting the task of gaining weight can often be usefully presented as ‘diagnostic’- someone who is not suffering from an eating disorder should be able to gain weight relatively easily.
  • Older adolescents might benefit from individual support.

Bulimia nervosa

  • Family involvement and providing information and education are equally important as they are in anorexia nervosa (ref 263).
  • Older adolescents might benefit from individual support and the use of appropriate self-help literature.

References

262 Robin A, Gilroy M, Dennis AB. Treatment of eating disorders in children and adolescents. Clin Psychol 1998, 18(4): 421-446. (CIV)

263 Eisler I, Le Grange D, Asen E. Family interventions. In: Treasure J, Schmidt U, van Furth E (eds.) Handbook of Eating Disorders. Chichester: John Wiley and Sons, 2003.

Last edited: 20/1/2004


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