The new medical guidelines for Eating Disorder care are important – and I’d like to talk about it!
Now, I am aware that the majority of those reading the blogs here are Counsellors, Talking Therapists and similarly interested individuals – NOT medical professionals. However, there is a little more to this topic than first meets the eye, so please stick around and have a read.
Just in case you are not already aware, around a month ago the Royal College of Psychiatrists (RCPsych) released new guidelines regarding the medical risk management of those with Eating Disorders. The extensive guidelines (totalling 185 pages) are called ‘Medical Emergencies in Eating Disorders’, or ‘MEED’ for short, and are designed for frontline medical staff who find themselves caring for patients with Eating Disorders. The guidelines cover everything from the different roles that different professionals and different settings have in the care of those with Eating Disorders, information about Refeeding Syndrome, and details about different tests and their relevance to this patient group, plus much more.
These guidelines replace prior ones (circa 2014) titled ‘MARSIPAN: ‘Management of Really Sick Patients with Anorexia Nervosa’. And, this is where the importance of the new guidelines starts. You might already be noticing that those older guidelines state that they are specifically in relation to patients with Anorexia Nervosa, whereas the new MEED guidelines are inclusive of all types of Eating Disorders.
This is important because it is often implied that those with other Eating Disorders (Bulimia Nervosa, Binge Eating Disorder, Avoidant and Restrictive Food Intake Disorder etc) are at less medical risk, and in less need of medical monitoring. This is an absolutely false assumption to make because there are unfortunately many people with any of those other Eating Disorder presentations who face serious and potentially life threatening consequences from their disorder. While we can say that Anorexia Nervosa has the highest mortality rate, that doesn’t mean that other Eating Disorders have zero risk or zero mortality!
So, we have win number 1 – a greater equalisation in the recognition of medical needs across all Eating Disorders.
The next win – number 2 – can be found in the opening forward by Dr Adrian James (President of RCPsych), in the executive summary AND in the very first paragraph of the introduction. Here it is directly recognised that Eating Disorder-related deaths have happened that should not have done, that may have been preventable had the professionals had sufficient education and understanding on the topic. Although such ownership of the problem cannot undo what has been done, hopefully it can save future lives. Furthermore, each person who opens the guidelines will be met by this reality, and I would hope will feel obligated to keep reading as a result.
The third win is to be read in the scope information, where it is clearly stated that mortality data is lacking when it comes to certain Eating Disorder presentations. Surely, this is opening up space for their future research to focus on this – and potentially signifying a shift in the field, where currently much of the discourse, research and funding is still focused on restrictive eating disorders.
So, all in all, in addition to much needed up dated guidelines, it seems we are really starting to see things shift in – what I at least would consider – the right direction.
Now, although chances are you are a Counsellor / Therapist, I would really encourage you to make time to read the guidelines. Although you might not understand all the medical language, it IS important that you understand the risks faced by those with Eating Disorders.