The National Institute for Health and Clinical Excellence recommends that GPs should take the responsibility for initial assessment and the initial coordination of care.

• Make a physical and psychosocial assessment of all people with a suspected eating disorder.
• Refer all people with a suspected eating disorder to secondary care.
• This is particularly important for people with diabetes and pregnant women, as these groups require increased monitoring.
• The urgency of referral depends on the person's circumstances and on clinical judgement.
• People who are particularly at risk of physical or psychological complications may require admission to hospital.
• People with eating disorders should receive treatment at the earliest opportunity.
• It is recognized, however, that at the current time there are wide variations in the provision of eating disorder services throughout the UK.
• Services range from outpatient treatment provided by community mental health teams and psychological therapy units to specialist eating disorder units.
• Most areas have agreed pathways of care for people with eating disorders that allow the matching of the severity of the illness with the intensity of treatment required.
• Ensure there is a clear agreement between primary and secondary or tertiary care about the responsibility for monitoring people with eating disorders.
• This agreement should be in writing and should be shared with the person and, where appropriate, his or her family and carers.
• 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.