We offer assessment and treatment to young people under 18 years who are registered with a GP in the boroughs of Ealing, Hounslow and Hammersmith and Fulham who have or are suspected to have anorexia nervosa, bulimia nervosa and other eating disorders not otherwise specified.

Treatment for young people we see will be based on their individual eating difficulties,  presentation and diagnosis. We offer online and face to face contact depending on risk and following the current trust guidelines for coronavirus. If you would like to know more, feel free to contact us.

Referrals can be made by a professional clinician. We also accept self-referrals, but require a GP to see the young person for the physical health review - this information will need to be included in the referral form.

For those presenting with avoidant restrictive food intake disorder (ARFID), we would recommend a local community dietician referral via GP. However, if this has been tried and there remain concerns around low weight and eating difficulty, then we can offer an assessment.

We currently do not provide direct treatment for ARFID cases, but we can refer to the feeding clinic at Great Ormond Street Hospital (GOSH).

For young people over 16, we would recommend a community dietician, as GOSH is for those aged below 16.

If you are worried about a young person’s eating difficulties and physical health, we do encourage you to call so we can provide support on whether a referral needs to be made. If you are a clinician, parent or young person, you can call the service between 9 am and 5 pm Monday to Friday on 020 8354 8160 and ask to speak to the duty eating disorders clinician who will discuss your concerns with you.

Referrals should be made using the online referral form

In order to make a referral to the service, you will need to obtain the following information:

  • Weight and height (with no shoes)
  • Information on the history of weight loss – amount lost, rapidity and intention
  • Blood pressure and pulse sitting and standing
  • Temperature
  • ECG if clinically indicated
  • History of excessive exercising, vomiting, abuse of laxatives or other diet pills
  • Menstruation history in females
  • Bloods to include blood glucose, FBC, U+E, LFT, TFT, magnesium, calcium, albumin, creatinekinase, ESR and phosphate.

You should be concerned, and make a referral if the following are present:

  • Heart rate of less than 50bpm, symptomatic postural tachycardia - ECG indicated
  • ECG-prolonged QT, heart rate less than 50bpm - arrhythmia associated with malnutrition and/or electrolyte
  • disturbance
  • Blood pressure-systolic, diastolic or mean arterial pressure below the 0.4th centile for age/gender
  • and/or postural drop of more than 15mmHg
  • Signs of significant dehydration and malnutrition
  • Temperature less than 36 degrees
  • Evidence of purging (induced vomiting) - hypokalaemia, uncontrolled vomiting with risk of oesophageal and other visceral tears
  • Hypokalaemia - less than 3mmol/l - admit under paediatrics
  • Hyponatraemia or hypernatremia- related to dehydration or water loading - less than 130mmol - admit
  • under paediatrics
  • Rapidity of weight loss, even when seemingly a healthy weight range.

Suspected or diagnosed eating disorder – referral guide for general practitioners

Due to the complex medical and mental health presentation of eating disorders, the young person does require an assessment by a GP as part of the initial referral pathway to the community eating disorders service for children and young people.

This will:

  • Assist with the prioritisation of the referral
  • Assess whether a more immediate paediatric obtained intervention is necessary
  • Ensure that the young person is responded to following the appropriate pathway.

It is recommended that for a fuller assessment the Junior MARSIPAN Risk Assessment tool is referred to as in Appendix 2 page 14 of the full eating disorder care pathway document.

Prior to a referral to community eating disorders service for children and young people the information listed below should be obtained and sent with the referral or as soon as the results are received:

  • Weight and height (no shoes)
  • Information of history of weight loss – amount lost, rapidity and intention
  • Blood pressure and pulse sitting and standing
  • Temperature
  • ECG if clinically indicated
  • History of excessive exercising, vomiting, abuse of laxatives or other diet pills
  • Menstruation history in females
  • Bloods to include blood glucose, FBC, U+E, LFT, TFT, magnesium, calcium, albumin, creatine kinase, ESR and phosphate.

When to be concerned:

  • Heart rate less than 50bpm, symptomatic postural tachycardia - ECG indicated
  • ECG-prolonged QT, heart rate < 50bpm, arrhythmia associated with malnutrition and/or electrolyte disturbance
  • Blood pressure-systolic, diastolic or mean arterial pressure below the 0.4th centile for age/gender and/or postural drop of more than 15mmHg
  • Signs of significant dehydration and malnutrition
  • Temperature < 36 degrees
  • Evidence of Purging –hypokalaemia, uncontrolled vomiting with risk of oesophageal and other visceral tears
  • Hypokalaemia - <3mmol/l –admit under paediatrics
  • Hyponatraemia or Hypernatremia- related to dehydration or water loading- <130mmol/l admit under paediatrics
  • Rapidity of weight loss, even when seemingly a healthy weight range.

Psychiatric/mental health risk

  • Suicidality
  • Evidence of self-harm
  • Young Person not coping
  • Family not coping.

We recommend that while awaiting referral to CAMHS the referring GP continues to monitor the young person regularly taking into account the above information.

Safeguarding risk

  • Child/young person identified as child in need
  • Child/young person lacking support and or identified as being at risk of abuse and harm.