With the collaboration of the Consumers' Association, the Eating
Disorders Special Interest Group recently surveyed specialist
eating disorders services for adults in the UK, as a follow-up to a
previous survey in 1991 as Council Report CR14, Eating Disorders.
We found that specialist services had increased in number since
1991 but that many areas remain without access to nearby specialist
services. Many patients are sent long distances for specialist
care, and adequate follow-up after such care is frequently
impractical. Eating disorders are of high prevalence, representing
a major source of morbidity, predominantly in young women, and the
standardized mortality ratio of eating disorders is among the
highest of all psychiatric disorders. There is a substantial
evidence base for treatment of anorexia nervosa and bulimia
nervosa, although research is urgently required to establish the
most effective treatment for many groups of patients. We recommend
the following action:
- For each area of the country, specialist services should be
established, with one consultant psychiatrist per million
population.
- These services should provide a combination of outpatient,
inpatient and day patient services, with an appropriate range of
therapeutic interventions.
- Expenditure on staffing should be approximately £1 per head of
population.
- Steps should be taken to increase the number of consultant
psychiatrists with special expertise in the assessment and
treatment of eating disorders.
- Similar problems apply to the treatment of children and
adolescents with eating disorders. Services for this group should
be fully surveyed and recommendations developed for improving
provision.
The Eating Disorders Special Interest Group has undertaken to
develop criteria for specialist training in eating disorders in
view of the particular mix of psychiatric, psychological, medical
and nutritional problems faced by this severely ill group of
patients. Our aim is to correct the unacceptable variation in care
between different parts of the UK caused by unequal distribution of
services.
Dr Paul Robinson
Chairman
Eating Disorders Special Interest Group