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At the heart of general practice since 1960

NICE urges GPs to spot eating disorders earlier

By Rob Finch

New Government guidance on eating disorders puts GPs at the forefront of a drive to diagnose and treat the conditions.

The guidance on anorexia and bulimia nervosa and

related disorders from the

National Institute for Clinical Excellence said GPs' inexperience and lack of training could lead to delayed diagnoses. It added: 'GPs may think issues and symptoms are trivial.'

The guidance said fewer than half of new diagnoses were currently made in primary care and called on GPs to take responsibility for the initial assessment and co-ordination of care.

It also said links between primary and secondary care were patchy and fraught with obstacles for eating disorder patients.

Among a swathe of advice for the NHS as a whole, the guidelines' key primary care recommendations were for GPs to increase their index of suspicion in:

·young women with low body mass index for their age

·patients with unfounded weight concerns or signs of starvation or repeated vomiting

·women with menstrual or gastrointestinal problems

·children with poor growth.

GPs could screen using

direct questions such as 'Do you think you have an eating problem?' and 'Do you worry excessively about your weight?'.

Dr Robert Mayer, a GP in north London and a member of the NICE guidelines development group, said: 'It is not fair to lay the problem at the feet of GPs alone, but there may be educational needs.'

He added that GPs sometimes did not ask questions even when they were concerned the patient may have a problem. Most patients with eating disorders did not resent being asked direct questions, he stressed.

Dr Mayer said he hoped the guidance would let GPs know what services their patient should expect and what GPs could advocate for them if such services were unavailable in their area.

Dr Paul Robinson, chair of the eating disorders special

interest group of the Royal College of Psychiatrists, said that currently, less than

half the UK population had access to services as good

as those demanded by the guidelines.

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