Guideline for the Assessment and Management of Patients with Suspected or Confirmed Eating Disorders in the Emergency Department [v1.0]
McCabe, Aileen; Raji, Omotayo; Boyle, Pauline; Feehan, Sinead; Deery, Sarah; McGarvey, Aine; Naddy, Breda; McKay, Paula; Clifford, Michelle
Eating disorders are a group of mental disorders that are characterised by serious
disturbance in eating behaviour and weight regulation as a result of core psychopathology
around eating and body image.
They are associated with cardiac arrhythmias, refeeding syndrome and suicidal ideation, and
affect a wide demographic irrespective of gender, age, social class and ethnicity. It is not
uncommon for eating disorders to remain undetected, and patients may engage in masking
behaviour to avoid detection.
Emergency care clinicians have an important role in the recognition, assessment, and
management of patients with eating disorders. Data from the UK has shown that people with
eating disorders are 1.6 times more likely to attend ED. Furthermore, up to 16% of 14-20
year old patients attending the ED have an eating disorder and 43% of frequent attenders
had an eating disorder on screening.
Given the challenges in recognition and complexity of management, this guideline collates
expert opinion to offer a standardized evidence-based approach to patients who present to
the ED with suspected eating disorders.
The guideline builds on work done by the HSE National Clinical Programme for Eating
Disorders and references the Royal College of Psychiatrists standard document “Medical
Emergencies in Eating Disorders: Guidance on Recognition and Management”.
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