Eating disorders are on the rise and can now be considered common among adolescent girls.
A Dutch study has found a lifetime prevalence among 19-year-old women of 5.7%, compared with 1.2% in men.
But anorexia, bulimia and binge eating disorder are dangerously misunderstood, say the authors. Population studies consistently find that people who meet the diagnostic criteria are falling through the cracks.
“While eating disorders are associated with high mortality and morbidity, international evidence shows that many patients either do not access or do not receive treatment,” they write in the BMJ.
“Indications for urgent referral to specialist mental health services for children and young people include rapid weight loss, body mass index <75% of expected body weight and binge eating and purging several times a day.”
The authors emphasise the importance of intervening early, adding that outcomes in anorexia are especially poor if the patient is not treated within the first three years.
Effective treatment includes building a therapeutic relationship with the family — not just with the patient.
What can be effective, they write, is “conceptualising eating problems as separate from the young person, so that parent and child can team up against the disorder.”
The paper includes some useful tips for GPs, including a perspective by Caitlin, a 17-year-old recovered patient:
- Advise patients that, even if they look and feel well and are of normal weight, they can still be very unwell.
- Female patients might find it easier to talk to a female doctor about body image problems, so offering patients a choice of whom to see is helpful.
- It’s important to speak to the patient on their own, without their parents.
- Children should be given the same respect as adults, and have their problems taken seriously.
- Social media can often be an important contributor to illness.
- Even though patients may find it distressing, hard facts about the physical risks are essential. The patient might respect the information given by a doctor more than that from their parents or families.
This article was originally published by 6 Minutes.