Health

EDA's Online Course written for the Royal College of General Practitioners (RCGP)

With a reach of over 90,000 primary health care professionals and with credits towards CPD and revalidation, this course establishes best practice for GPs in their care for patients. This is vital as waiting times for more specialist services are so long; because many patients prefer to rely only on their GP; and since many are deemed ineligible for further care and support. With only 46% of people recovering from an eating disorder, and increasing prevalence, GPs are under increasing pressure to monitor and safeguard the physical health of these vulnerable patients and also deliver care, support and signposting for parents and partners. The course was examined and approved in two rounds of peer review through GP members of the Royal College, practicing in various parts of the UK and then by the RCGP’s Director of E-learning. This course will underpin all further training courses that EDA delivers to medical, educational, sporting and business organisations. It offers an accreditation beyond that conferred by the CPD Association.

The following information is a sample of the course material (copyright of The Royal College of General Practitioners (RCGP) and EDA: Eating Disorder Advice)

Eating disorders can affect all groups of people, not only young women. Emotions rather than food are at the root of an eating disorder and are the key to understanding a patient suffering from one.

Monitoring of those with an eating disorder must include medical and psychological parameters and should be undertaken even if the patient has been referred for specialist services and/or is on a waiting list. Don’t focus on specific limits or criteria for referral. If there is concern about a patient, discuss with specialist services.

Eating disorders have long-term consequences and the potential for relapse. The eating disorder may re-emerge as a different type/subtype. Patients need to be encouraged that recovery can be achieved with good treatment and a supportive network.

At the root of an eating disorder is usually an emotional issue or trauma, for example, bullying, a breakdown in relationships, redundancy, bereavement or abuse. Low self-esteem and perfectionism are also risk factors. Other elements such as academic or social pressure and the effects of the media and the dieting culture also play a role. There is felt to be a genetic predisposition in terms of personality. Those at risk often exhibit perfectionism, anxiety, sensitivity and an inability to assert or express feelings and to communicate. Those with autistic spectrum disorders are at risk as are those in certain professions such as ballet, performing arts, gymnastics and sport. Looked-after children and those in boarding schools or prison are also at greater risk.

Recognising an eating disorder or spotting the signs of an emerging eating disorder can be challenging and often patients will not admit to having an issue with their mental and physical health and an increasingly difficult relationship with food. It is important to remember that many patients have disturbed thinking about themselves, and their weight and shape, well before the effects on their body or weight become noticeable. If these are recognised and the patient is supported, the eating disorder may not fully establish. Early intervention for recovery is supported in the NICE 2004 guidelines.

Basic physical checks

Weight
Height
Calculate BMI in adults, plot height and weight on centile charts for children
Blood pressure (lying and standing) and heart rate
Temperature
Blood tests - FBC, U and E, LFTs, CK, Glucose
Tests of muscle strength; squat-stand test and sit up test (these would not routinely be done within general practice but can be very helpful in the assessment of those for whom there are significant medical concerns)