Children and young people with suspected eating disorders: Guidelines for primary care professionals

An Introduction to the Community Eating disorder Service for Children and Young People in Greater Manchester

Dr Meenaka Williams, CAMHS Consultant Psychiatrist, talks about how the service is organised, how to make referrals, waiting times, supporting diagnosis using MEED guidance, and when to consider a hospital admission.

Community Eating disorder Service for Children and Young People in Greater Manchester case study

Lois suffered from an eating disorder for several years. She is now fully recovered following treatment by the Manchester University Foundation Trust Community Eating Disorder Service. Lois is currently studying medicine in Edinburgh.

Download these guidelines: Children and Young People with Suspected Eating Disorders Guidelines for Primary Care Professionals June 2023

These guidelines aim to share information about spotting the signs of eating disorders to inform when and how to refer children and young people  to the community eating disorders service (CEDS) for specialist outpatient support.

Key signs and symptoms

  • History of weight loss or failure to gain weight. Have clothes size changed?
  • Have parents or carers noticed any weight loss or other physical changes?
  • How long have they been trying to lose weight & what have they tried?
  • How much are they currently eating & drinking?
  • Are they over-exercising, vomiting, or using any other methods lose weight or to limit calorie intake? How often?
  • If they report they are binging, what do they mean by this? How often?
  • Any physical health concerns: fainting, dehydration, constipation, chest pain, shortness of breath? If appropriate, when did they last have a menstrual cycle?
  • Any mental health changes: confusion, distress? Any risk of self-harm, suicide or harm from or to others?

How to refer

  • Refer by letter or email: see contact details below
  • Refer as soon as a young person presents to you with any combination of the symptoms outlined.
  • Consent is needed for a referral. Ensure the child or young person and parents/carers are aware of the referral.

The physical exam

DO NOT DELAY REFERRAL WAITING FOR RESULTS!

Red flags

  • Weight loss > 1kg a week for a minimum of 2 consecutive weeks AND not eating and/or fluid refusal for more than 24 hours
  • Cardiovascular compromise and fainting
  • Percentage Median BMI <70%
  • BP <0.4th centile sitting and a postural drop
  • Pulse <40 bpm
  • Temperature <35 ˚C

 IF YOU COME ACROSS THESE SYMPTOMS PLEASE PHONE YOUR LOCAL CYP-CEDS FOR ADVICE

Other considerations

  • Low weight’ is now defined as a loss of 10% of a young person’s expected body weight.
  • Make a referral based on signs and symptoms irrespective of weight.
  • Consider impact of other external life events and stressors.

THINK: STATE NOT WEIGHT – WHAT IS THEIR FUNCTIONING LIKE?

Timescales

  • All referrals will be screened within 24 hours of receipt except on weekends or Bank Holidays.
  • All accepted referrals will be screened for urgency and will be offered either an emergency appointment within 24 hours, an urgent within one week appointment or a routine appointment within 28 days.

DO NOT WATCH & WAIT. REFER ALL CHILDREN AND YOUNG PEOPLE  SUSPECTED OF HAVING AN EATING DISORDER TO YOUR LOCAL COMMUNITY EATING DISORDER SERVICE

How to contact your local Eating Disorder Service

Wigan and Bolton Community Eating Disorder Service

  • Areas the service covers: Wigan and Bolton
  • Service provided by: Greater Manchester Mental Health NHS Foundation Trust
  • Telephone number: Monday to Friday 9am to 5pm t: 01942 775400
  • Email: WiganBoltonCEDS@gmmh.nhs.uk

Pennine Care NHS Foundation Trust Community Eating Disorder Service (North)

  • Areas the service covers: Bury; Oldham Heywood Middleton and Rochdale
  • Service provided by: Pennine Care NHS Foundation Trust
  • Telephone number: Monday to Friday 9am to 5pm  t: 0161 716 1560
  • Email: Pcn-ceds@nhs.net

Pennine Care NHS Foundation Trust Community Eating Disorder Service (South)

  • Areas the service covers: Tameside & Glossop and Stockport
  • Service provided by: Pennine Care NHS Foundation Trust
  • Telephone number: Monday to Friday 9am to 5pm  t: 0161 716 4060
  • Email: Pcn-ceds@nhs.net

 Manchester University NHS Foundation Trust Community Eating Disorder Service

  • Areas the service covers: Manchester, Salford and Trafford
  • Service provided by: Manchester University NHS Foundation Trust
  • Telephone number: Monday to Friday 9am to 5pm t: 0161 701 0447
  • Email: mftceds@mft.nhs.uk

 

With thanks to the Healthy London Partnership for allowing us to re-use their content to make it relevant for colleagues in Greater Manchester

Beat are the UK’s eating disorder charity. Visit www.beateatingdisorders.org.uk/ for more information about eating disorders, to access online support groups and one to one chat.