Tips for CYP feeding or eating disorders

Tip Sheet 4 - What to do

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

Treatment of feeding or eating disorders is a collaborative process; with the child or young person and their family/carers, not treatment of the family and carers. In this, the fourth of our five tip sheets, we provide top tips on what to do for children and young people with feeding or eating disorders. This is not a therapy manual or therapy guide, it’s bite size tips and help to guide you on the journey.

Collaboration is key. In the early phase of treatment this may be especially challenging. The child or young person may have distortions in their thinking regarding their weight or shape, may be very wary of seeking help, or may doubt their own capacity to make changes.

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

 

Treatment and care

Onset of eating disorders can be linked to coping with uncertainty: the young 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 the bulimia nervosa treatment

Avoidant/Restrictive Food Intake Disorder-ARFID- understand what is driving, maintaining the eating disturbance to inform future treatment

What do young people want in their treatment?

Family therapy focused on anorexia nervosa (FT-AN) is the best evidenced treatment for anorexia nervosa

Family therapy focused on bulimia nervosa (FT-BN) and/or FT-BN cognitive behavioural therapy (CBT) is best evidenced-based treatment for bulimia nervosa

NICE guidance recommends

Family therapy for children and young people with anorexia nervosa (AN)

Bulimia nervosa-focused family therapy (FT-BN) for children and young people with bulimia nervosa (BN)

If FT-BN is unacceptable or ineffective, consider individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

ARFID Treatment

Binge eating disorder (BED) treatment

Anxiety and depression often occur with eating disorders and may need additional treatment

Make reasonable and appropriate adaptations for autistic children and young people, and those with learning disability

What helps to engage a young person in treatment?

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

Shared elements of treatments in early phase feeding or eating disorders

Key psychological factors to be addressed in treatments

Managed transitions are critical for good care

Use treatment outcome measurement tools

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

Medication in eating disorders and vitamin supplements

Service Delivery and Models of Care

Wider system levers, drivers and policy

Further Information

BEAT, HEE, RCPsych

References

Children and Young People - MindEd resources

All ages - NHS HEE TEL Resources

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.

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