Eating disorders

Assessment: the first step in your treatment

Before they can work out how to help you, your health-care team will need to do an assessment. The assessment is a consultation in which a health-care professional will speak to you about things like your medical history, your thoughts and feelings, and your eating habits.

They will also check your physical health and arrange tests if needed. Your health-care team will use the assessment to gain a thorough understanding of you and your individual circumstances, so that they can:

• make sure the diagnosis of an eating disorder is correct
• find out if you have any other medical or mental health conditions
• understand which treatment may be best for you.

The health-care team will usually ask for your permission to talk to your family or carers, and to your GP and other health professionals who are involved in your care. During the assessment, you may be asked about:

Collecting this information may take time and might continue over several sessions.

Your health-care team will also need to check your physical health. This will involve measuring your weight, height, pulse rate, blood pressure and temperature. If you are underweight or you purge (or both), you will need blood tests and an electrocardiogram (to measure the speed and rhythm of your heartbeat). You may also need a scan to measure your bone mineral density.

These tests are necessary to check if you have any serious or urgent medical problems and need to be seen by other medical services or specialists.

After your assessment is complete, the next step is to put together a treatment plan.

Your treatment plan

After your assessment, your health-care team will work with you and your family and carers to make your treatment plan. Your treatment plan is a written document that lists your goals for recovery, and the treatments that will be used to help you achieve those goals.

You will be given information about which available treatments are suitable for you. If there is more than one option, your doctors will help you decide what’s best for you. Your treatment plan will be guided by your wishes and choices, as well as your health needs. The goals should be reasonable and achievable.

Some aspects of your treatment may have a higher priority than others; for example, if you need to be admitted to hospital for medical care to keep you safe, this will be the first priority.

For people with long-term anorexia nervosa, the first aims of treatment may be to improve your quality of life, keep you safe, and deal with crises when they happen. How well you respond to treatment will determine the length of your treatment. Treatment may last for several years.

Aims of treatment

Aims of treatment differ between individuals, but usually include:

• preventing medical problems, including life-threatening conditions
• overcoming dehydration
• getting enough nutrients and fluids to become healthy again
• preventing your health getting worse
• learning to eat without stress or anxiety
• overcoming unhealthy ways of thinking and acting
• overcoming depression or other mental illness
• enabling your body and mind to develop normally (if you are a child or a young person)
• learning to think and act for yourself, to keep yourself safe in future
• helping you to get back to work or school or helping you not to miss days because of your illness
• helping you to get involved in your community
• helping you to cope with your eating disorder and still live a full and meaningful life
• supporting your family or carers.

Adjusting your treatment plan

After you have begun treatment, your health-care team will regularly review your treatment plan and adjust it, if needed. Your treatment will depend on the progress you are making towards recovery. This is generally measured by whether you have a healthier eating pattern, whether you are less distressed, and whether you are able to participate in everyday activities more easily than before treatment.

For people with anorexia nervosa, progress towards recovery is also measured by medical checks such as your blood glucose levels, blood pressure, and brain and heart function. For women and girls with anorexia nervosa, the return of your periods is a good sign that you are getting better.

If you are not making progress towards recovery, your health-care team will talk to you about changing your treatment.