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Issue date: January 2004

Quick reference guide

Eating disorders
Core interventions in the treatment
and management of anorexia
nervosa, bulimia nervosa and
related eating disorders

Clinical Guideline 9
Developed by the National Collaborating
Centre for Mental Health

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Ordering information
Copies of this quick reference guide can be obtained from the
NICE website at or from
the NHS Response Line by telephoning 0870 1555 455 and
quoting reference number N0406. Information for the public
is also available from the NICE website or from the NHS
Response Line…

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Grading of the recommendations 2
Key priorities for implementation 3
Guidance 4
Care across all conditions 5
1. Assessment and coordination of care 5
2. Providing good information and support 5
3. Getting help early 6
4. Management of physical aspects 6
5. Additional considerations for children and…

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Grading of the recommendations

Grading of the recommendations
This guidance is evidence based, and the recommendations are
graded as follows:
AA At least one randomised controlled trial as part of a
body of literature of overall good quality and consistency
addressing the specific recommendation (evidence level I)
without extrapolation

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Key priorities for implementation
Key priorities for implementation
The following recommendations have been identified as key priorities
for implementation.
Anorexia nervosa
· Most people with anorexia nervosa should be managed on an
outpatient basis with psychological treatment provided by a service
that is competent in giving that treatment and assessing…

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The following guidance is evidence based. The grading scheme
used is shown on page 2. Further information on the grading of
the recommendations and on the evidence used to develop the
guideline is presented in the full guideline (see back cover for
details). This guideline applies to adults,…

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Care across all conditions

Care across all conditions

Care across all conditions
1 Assessment and coordination of care
· Assessment of people with eating disorders should be
comprehensive and include physical, psychological and
social needs, and a comprehensive assessment of risk to self. C

· The level of risk to…

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Care across all conditions

3 Getting help early
Care across all conditions

· People with eating disorders seeking help should be assessed
and receive treatment at the earliest opportunity.
· Early treatment is particularly important for those with or at
risk of severe emaciation and such patients should be…

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Care across all conditions

· In children and adolescents with eating disorders, growth and

Care across all conditions
development should be closely monitored. Where development
is delayed or growth is stunted despite adequate nutrition,
paediatric advice should be sought.
· Healthcare professionals assessing children and adolescents
with eating disorders…

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Anorexia nervosa

Anorexia nervosa
Assessment and management of anorexia nervosa in
primary care
· In anorexia nervosa, although weight and BMI are important indicators
they should not be considered the sole indicators of physical risk (as
they are unreliable in adults and especially in children).
· In assessing…


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