A Royal College of Psychiatrists’ analysis of NHS Digital hospital admissions data for eating disorders shows 11,049 more admissions in the five years to 2020/21, compared to 2015/16. This is an increase of 84% reaching a total of 24,268 admissions.

The full data set of hospital admissions data, covering both primary and secondary diagnoses of eating disorders is available from NHS Digital: Hospital admissions for eating disorders.

RCPsych published this analysis on 18 May 2022, also emphasising the need for GPs and Professionals who are diagnosing eating disorders to be familiar with its latest guidance, which Ellern Mede wrote about here in March 2022. You can read the full source article on the RCPsych website here.

It states: “Signs that someone with an eating disorder is dangerously ill are often missed by healthcare professionals due to lack of guidance and training.”

Referencing its new Medical Emergencies in Eating Disorders guidance (known as MEED), for frontline staff, it states that following this means people with eating disorders who need urgent care can be identified and treated earlier.

The age group most affected by this rise in hospital admissions are children and young people with a rise of 90% in the same five-year period, from 3,541 to 6,713 episodes. There is also more than doubling – a rise of 128% – for young males.

In people aged 19 and over, the increase is 79%.

The Royal College states: “The signs that someone with an eating disorder is severely ill and in need of hospital treatment are often missed in primary care and emergency departments, due to lack of training and accessible guidance for frontline staff. The main barrier to spotting patients at risk is that, even when seriously unwell, people with eating disorders can appear to be healthy, with normal blood tests.”  

The new MEED guidelines replace the Management of Really Sick Patients with Anorexia Nervosa (MARSIPAN) and Junior MARSIPAN guidance.

The guidance aims to help healthcare professionals identify and manage eating disorders before they become life-threatening.

Dr Dasha Nicholls, who chaired the development of the Medical Emergencies in Eating Disorders Guidelines, said: “Eating disorders are mental health disorders, not a ‘lifestyle choice’, and we shouldn’t underestimate how serious they are. Even though anorexia nervosa is often referred to as the deadliest mental health condition – most deaths are preventable with early treatment and support.  We need to raise awareness of common eating disorders symptoms. Our guidance encourages healthcare professionals to spot when someone is dangerously ill and dispel the myths surrounding them. They remain poorly understood with devastating consequences for thousands of patients and their families.”

Case Study that shows the harm of delayed treatment

James Downs, 32 developed anorexia at the age of 15 and it took more than six years from diagnosis to him receiving specialist support. He puts this down to a lack of awareness of the signs of eating disorders amongst non-specialist healthcare professionals. He reports that being a man makes it harder to get treatment. The six year delay gave the illness time to worsen, and he had frequent hospital admissions for low potassium levels, low blood sugar, heart abnormalities and other consequences of malnutrition.

James said: “eating disorders are everyone’s business, not just for specialists.”

Read the new guidance: Medical emergencies in eating disorders: Guidance on recognition and management.

The guidance provides an eating disorders risk assessment tool using a ‘traffic light’ system. There is also an accompanying set of summary sheets of tailored advice for the different target readers of this document, including different medical professionals, as well as people with eating disorders and their families or carers. Recommendations are also given for commissioners on required services for this group of very ill patients.

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