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What To Expect From The NHS

Some of the guidelines on what to expect from the NHS are listed on this page. The clinical guidelines below are based on the NICE guidelines.

Good information and support

  • A supportive and caring relationship between you and the professionals working with you. They should tell you and your family about self help and support groups and how to get in contact with them.
  • Information and support to help you and your family/carers understand your problems better.
  • You could be given information about your illness and the treatment before the treatment start

Confidentiality

  • Consultations are confidential unless you or others are at significant risk.
    As a child or young person you have the same confidentiality rights as an adult.

Support from your GP

  • Your GP should understand and be sensitive to the fact that you may have concerns about being treated negatively and should discuss this with you.

Getting help early

  • It is important that you get help early and that the help could include an assessment of all your needs.

Monitoring your health

  • Your GP should monitor your needs as you go through treatment.
  • If there are other professionals as well as your GP involved in your treatment There should be a written agreement that states whose responsibility it is to check your progress and health and you should be given a copy of this agreement.
  • As a child or young person your growth and development will be monitored closely and your doctor may ask for advice from another doctor if you are not developing or growing properly.

Anorexia specific guidelines

Psychological treatment

  • What you prefer should be a key factor in choosing a treatment.
  • You should be given access to different psychological treatments that are adapted for anorexia such as: - cognitive analytic therapy (CAT) - cognitive behaviour therapy (CBT) - interpersonal therapy (IPT) - focal psychodynamic therapy - family therapy

Monitoring your health

  • The professional responsible for your care should discuss the risks of anorexia and monitor your health.

Taking medication

  • You might be treated with medication and should be informed about any side effects. A note should be put on your medical notes about the possible side effects.
  • You might need to have an ECG (electrocardiograph) to test that your heart is working properly.

Care as an outpatient

  • Most of your treatment will be as an outpatient.
  • Any psychological treatment you have should last for at least 6 months and the person treating you should be competent and experienced in giving that treatment.

Bulimia specific guidelines

Psychological treatment

  • Self help can be recommended and the professional may work through it with you.
  • Cognitive behaviour therapy for bulimia nervosa (CBT-BN) may be offered if self help has not worked for you. Treatment should last for 16-20 sessions over 4 to 5 months.
  • Interpersonal therapy (IPT) may be offered if CBT-BN has not worked for you. It can take a bit longer than CBT-BN.

Taking medication

  • You may be offered antidepressants. The ones most commonly used for bulimia are selective serotonin reuptake inhibitors (SSRIs) – one in particular is fluoxetine (often known as Prozac).

Monitoring your health

  • Your doctor should do a blood test and check your fluid levels if you are taking a lot of laxatives or vomiting often.

Care as an outpatient

  • You should receive most of your treatment as an outpatient.
  • If you have additional issues such as drug or alcohol abuse the professional may have to adapt a standard treatment to your needs.

Care as an inpatient

  • Most people with bulimia do not need hospital treatment but this may be suggested if you are at risk of harming yourself physically.
  • If you are admitted to a unit it should be one where the professionals have experience of treating people suffering from bulimia.

Children and young people and their families

  • You should be offered the same kind of treatment as adults with bulimia but professionals should take into account your age, circumstances and level of development.
  • You and your family should be offered meetings with professionals because involving family members can be helpful.

Guidelines for other types of eating disorders including binge-eating disorder

Psychological treatments

  • What you prefer should be a key factor in choosing a treatment.
  • Self help may be suggested as a first step, and your GP or healthcare provider may give you support in working through the self help.
  • If self help treatment is not working for you, your GP or healthcare professional might suggest psychological treatments such as:
    • Cognitive behaviour therapy for binge-eating disorder (CBT-BED)
    • Interpersonal psychotherapy (IPT)
    • Modified dialectical behaviour therapy (DBT).

Taking medication

  • You may be offered antidepressants. The ones most commonly used are selective serotonin reuptake inhibitors (SSRIs) – one in particular is fluoxetine (often known as Prozac).
  • Taking the anti-depressants might be the only treatment some people with BED need. 16 You can read these guidelines and more information and details on them here: www.nice.org.uk/Guidance/CG9

Care as an outpatient

  • Most of your treatment should be received as an outpatient.
  • Any psychological treatment should last for at least 6 months and the person who treats you should be competent and experienced in giving this type of treatment.

Care as an inpatient

  • Most people with BED will be treated as outpatients but you could be asked to attend a specialist day unit for advice on planning and eating meals.

Children and young people and their families

  • You should be offered the same type of treatment as adults with BED but they should take into account your age and what you know about your eating disorder.
  • You should be offered meetings with your family and professionals as well as meetings on your own.
  • Your family will normally be told about your progress.