Tips for CYP feeding or eating disorders

Tip Sheet 1 - What to be aware of

Who is this for?

These bite-size tips have been developed for professionals working across health care; from primary and universal care to hospital general paediatric services through to specialist Child and Young People Mental Health Services (CYPMHS).

 

Introduction

This is the first of four tip sheets to provide you with quick access, bite-size learning on feeding or eating disorders in children and young people. Infants 0-2 years are covered in a fifth, separate tip sheet.

Feeding or eating disorders (FEDS) are complex, and potentially life-threatening mental illnesses that can affect anyone regardless of age, gender, ethnicity, sex, socioeconomic group or background.  There are many myths and misconceptions surrounding eating disorders combined with a lack of knowledge. This can produce many negative outcomes such as preventing someone from reaching out for help.

This first set of tips is divided into four sections (A-D), and aims to support you in raising your awareness and earlier recognition.

Section A - Be aware

Section B - Know the diagnostic categories

Section C - Be aware of what works in treatment

Section D - Understanding the origins of feeding and eating disorders

 

Section A - Be aware

Stigma and blame are impediments to early detection and good care

Feeding or eating disorders are easily missed: so be alert because early intervention leads to better outcomes

Remember that feeding or eating disorders are mind-body conditions, care must be holistic to be effective

Feeding or eating disorders affect all ages, sex, gender, race and ethnic groups

Earlier intervention matters: detect and refer early

Aim to work with the family

Early psychoeducation is important for the young person, their family and carers

Positive outcomes are expected for the majority of young people with feeding or eating disorders

Be aware young people with feeding or eating disorders may lack insight into their condition or being unwilling to talk about it

There are many effects of starvation

Section B - Know the diagnostic categories

There are seven specified types of feeding or eating disorders (ICD11): be familiar with them so you don’t miss them

One important distinction between different FEDs is whether body image distortion/dissatisfaction is directly linked to the eating disturbance

Section C - Be aware of what works in treatment

Tip sheet 4 'What to do' provides much more detail on interventions

 

The best treatment for ARFID will depend on the specific issues underlying the eating disturbance in the individual

Bulimia also has severe physical consequences: regular eating breaks the cycle of bingeing and starving 

BED, ARFID, RD and pica can also have severe physical consequences. Just different ones

Weight matters for health but is a poor measure of health on its own and differs between people

The illness drives the thinking, it’s not a simple choice for the person

What do young people say they want from professionals?

Section D - Understand the origins of feeding & eating disorders

Key factors

Risk factors

Further Information

Resources

BEAT-HEE-RCPsych

References

Further elearning from NHS HEE & MindEd

Children and Young People - MindEd resources

All ages - NHS HEE TEL Resources

Acknowledgements

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

The content has been edited by Dr Mima Simic (MindEd CYP Eating Disorder Editor  and Dr Raphael Kelvin MindEd Consortium Clinical Lead) with close support of the inner expert group of Prof Ivan Eisler, Dr Dasha Nicholls, Dr Rachel Bryant Waugh and Dr Simon Chapman.

A wider expert reference groups include BEAT (Kathrina Dixon-Ward, Martha Williams, Brooke Sharp), Dr Elaine Lockhart (RCPsych Child and Adolescent Faculty Executive chair), Gemma Trainor MindEd Consortium RCN lead rep), Prof Ulrike Schmidt (Professor SLAM/KCL and MindEd Editor) Dr Lisa Shostack MindEd Consortium BPS Lead Rep.

Further support is available from NHS England.

Disclaimer

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.

MindEd is created by a group of organisations and is funded by Health Education England, the Department of Health and Social Care and the Department for Education.

elfh is a Health Education England Programme in partnership with the NHS and Professional Bodies.

© 2021 MindEd / Royal College of Psychiatrists and Health Education England 

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