There is also a Summary of Junior MARSIPAN (CR168s)
document to download.
checklist may also be useful (it is suitable for use
with all ages.)
This report is only available online –
there are no printed copies available to
Please use the link above to view and download a PDF
file of the report. Please note, in
November 2014, the currency period for this report was extended to
The Junior MARSIPAN working group was formed to develop
guidelines for young people with anorexia nervosa to complement the
report from the MARSIPAN group (CR162.
MARSIPAN: Management of Really Sick Patients with Anorexia
Nervosa) which addresses the care of adult in-patients with
The rationale for a separate document is that the definition of
very sick patients with anorexia nervosa differs in young people,
because serious underweight varies with age and gender; other
aspects of risk differ in young people (e.g. blood pressure norms);
consent and capacity are addressed within different legal
frameworks for young people than adults; there are differences in
service organisation for specialist child and adolescent mental
health services (CAMHS); and paediatric services have a central
role in the care of young people.
The Junior MARSIPAN report provides guidance and recommendations
- Risk assessment, physical examination and
- Location of care and transition between
- Compulsory treatment.
- Paediatric admission and local
- Management of re-feeding.
- Management of compensatory behaviours
associated with an eating disorder in a paediatric setting.
- Management in primary care and paediatric
- Discharge from paediatric settings.
- Management in specialist CAMHS in-patient
Junior MARSIPAN Working Group
Executive summary and recommendations
- History of the project
- Procedure followed in producing the
- The problem
Issues arising in all
- Risk assessment: how ill is the patient?
- Location of care: where will the patient be
- Transfer between services
- Compulsory admission and treatment
- Policies and protocols
Management of children and adolescents
with anorexia nervosa in different sectors
- Management in general practice
- Management in out-patient paediatric
- Management in in-patient paediatric
- Management in SEDBs
- Audit and review
A. Calculating the degree of
underweight for females: comparison of two methods
B. Comments from general
practitioners and parents/carers group
C. Re-feeding syndrome in children
and adolescents: literature summary
D. Some cases reported to the
Junior MARSIPAN group
E. Protocols for managing very ill
young people with anorexia nervosa
F. Example of a care pathway
designed to improve speed of referral