Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Eating disorders - Management
How should I manage someone with a confirmed eating disorder in primary care?

  • Ensure there is a clear agreement between primary and secondary or tertiary care about the responsibility for monitoring someone with an eating disorder. Monitoring of general medical problems usually occurs in primary care.
    • Advise people who are vomiting on the importance of regular dental review and dental hygiene, including avoiding brushing after vomiting, rinsing with a non-acidic mouthwash after vomiting, and reducing the acidity of the oral environment (for example by limiting acidic foods).
    • Place an alert in the prescribing record of people with anorexia nervosa concerning the risk of adverse effects. Harmful effects of drugs, such as prolonged QT interval and cardiac dysrhythmias, are more likely in people who are malnourished with electrolyte abnormalities. Each drug prescribed to people with an eating disorder should be reviewed with this in mind.
    • Monitor the level of risk to the person's mental and physical health as treatment progresses, because it may change – for example following weight change or at times of transition between services.
  • If the person has enduring anorexia nervosa and is not under secondary care, review their physical and mental health at least annually in primary care.
  • Manage complications depending on their type and severity. Some people will need admission to hospital, whereas others can be managed in primary care.
    • For more information on managing the osteoporosis risk associated with amenorrhoea in primary care, see the CKS topic on Amenorrhoea.
  • For information on what treatments may be offered in secondary care, see:

© NHS Institute for Innovation and Improvement