Tips for feeding or eating disorders in adults

Tip Sheet 4 - What to do

Who is this for?

These tips have been developed for professionals working across health care; from primary care to hospital general services through to mental health teams and specialist adult eating disorder services.



This is the fourth of four tip sheets to provide you with condensed learning on feeding or eating disorders (FEDs) in adults aged 18 years and over. Tips for working with FEDs in children and young people up to age 18 are available separately here.

Treatment of FEDs is a collaborative process; with the person and their family/carers/supporters, not treatment of them. In this, the fourth of our tip sheets, we provide top tips on what to do with and for adults (18 years and over) with different FEDs. This is not a therapy manual or therapy guide, it’s brief tips and help to guide you on the journey.

Collaboration is key: with the patient, the family/supporters, and any other health care teams involved. In the early phase of treatment this may be especially challenging. It is common for people with FEDs to have distortions in their thinking regarding their weight or shape, be very wary of seeking help, or doubt their own capacity to make changes.

Early intervention is key, and earlier access to eating disorder multidisciplinary expertise leads to better outcomes.

Good quality psychoeducation and self-help resources can be helpful for all FEDs.


Treatment and care

Onset of feeding or eating disorders (FEDs) can be linked to coping with uncertainty: the person can feel as if they are gaining an element of control

Normal emotional responses to eating can get reversed in some of the disorders but not all

The illness may be masked by apparent clear thinking outside of the eating disorder issue

Resumption of adequate food intake is a key first step in treatment of anorexia nervosa

Establishing regular eating is key for successful outcome of bulimia nervosa treatment

Avoidant/restrictive food intake disorder (ARFID): understand what is driving and maintaining the eating disturbance to inform future treatment

What do people with FEDs want in their treatment?

What do carers, relatives and friends of people with FEDs say they want from professionals?

NICE guidance recommends

Treatment of anorexia nervosa (AN) in adults

Treatment of bulimia nervosa (BN) in adults

Treatment of binge eating disorder (BED) in adults

Treatment of avoidant restrictive food intake disorder (ARFID) in adults

Treatment of other specified feeding or eating disorders (OSFED) in adults

Consider self-help resources in primary care or non-specialist settings

Anxiety, depression and other mental health disorders often occur with eating disorders and may need additional treatment

Trauma symptoms may co-occur with FEDs and impact on treatment

Make reasonable and appropriate adaptations for autistic people and people with learning disability

What helps to engage someone in treatment?

Be aware, people also have a range of thoughts, feelings or behaviours that may be experienced as obstacles to recovery

Shared elements in the early phase of feeding or eating disorders treatments

Key psychological factors to be addressed in treatments

Medical emergencies can arise in eating disorders. Use the national guidance on Medical Emergencies in Eating Disorders (MEED)

Managed transitions are critical for good care

Use treatment outcome measurement tools

Medication in eating disorders and vitamin supplements

Service Delivery and Models of Care

Wider system levers, drivers and policy

Further Information




Further elearning from NHS HEE & MindEd

All ages - NHS HEE TEL Resources


These tips have been curated, drawn and adapted from a range of existing learning, including MindEd, NHS England, NICE, MEEDs guidance, NHS HEE elfh/BEAT/RCPsych resources. Extracts from the MEEDs are included with permission courtesy of the MEEDs team.  

The content has been edited by Dr Karina Allen (MindEd adult eating disorder Editor) and Dr Raphael Kelvin ( NHS England MindEd Consortium Clinical Educator Lead) with close support of the inner expert group of Dr Nikola Kern, Dr Paul Robinson, Dr William Rhys Jones, and Prof Ulrike Schmidt.

We also acknowledge the support and input of our wider expert stakeholder group including BEAT, the MindEd Consortium, and NHS England/Health Education England.


This document provides general information and discussions about health and related subjects. The information and other content provided in this document, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.

If you or any other person has a medical concern, you should consult with your healthcare provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that you have read in this document or in any linked materials. If you think you may have an emergency, call an appropriate source of help and support such as your doctor or emergency services immediately.

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