Health Professionals

Early intervention is key to improved health and quality of life when it comes to providing primary care for people affected by eating disorders.

While early intervention depends on early detection of symptoms, research shows there is currently on average a delay of approximately four years between the start of disordered eating symptoms and first treatment, reaching at times 10 or more years.

But armed with the right information and screening and referral tools, health professionals can play an important role in reducing this delay.

Health professionals at the forefront

Most people with eating disorders have contact with health professionals, but they will often present with apparently unrelated complaints. While people may not volunteer information about their eating problem, asking questions and allowing the person to see that their eating habits are important may offer a non-judgemental environment for them to start seeking help.

Indeed, for many people with eating disorders, their first attempt at seeking treatment is a test of attitudes and responses. If the first help seeking is a positive experience then the person is more likely to engage successfully with future treatment.

For more information, see the NEDC booklet: Eating Disorders: A Professional Resource for General Practitioners

Common health presentations include:

• emotional problems

• weight loss

• gastro-intestinal problems

• infertility issues

• injuries caused by over-exercising

• fainting or dizziness

• feeling fatigued or not sleeping well

• feeling cold most of the time regardless of the weather

• swelling around the cheeks or jaw, calluses on knuckles, damage to teeth and bad breath (signs of vomiting).

Screening questions

Screening questions help to initiate a disclosure which may then lead to earlier access to treatment. Screening for eating disorders involves asking a small number of evidence based questions posed on an opportunistic basis when the patient presents for other reasons (e.g. weight related concerns, depression or anxiety). The questionnaires do not diagnose eating disorders but detect the possible presence of an eating disorder and identify when a more detailed assessment is warranted.

Eating Disorder Screen for Primary Care (ESP)

• Are you satisfied with your eating patterns? (A “no” to this question is classified as an abnormal response).

• Do you ever eat in secret? (A “yes” to this and all other questions is classified as an abnormal response).

• Does your weight affect the way you feel about yourself?

• Have any members of your family suffered with an eating disorder?

• Do you currently suffer with or have you ever suffered in the past with an eating disorder? 

Screen for Disordered Eating

• Do you often feel the desire to eat when you are emotionally upset or distressed?
• Do you often feel you cannot control what or how much you eat?
• Do you sometimes make yourself throw up (vomit) to control your weight? 
• Are you often preoccupied with the desire to be thinner? 
• Do you believe yourself to be fat when others say you are thin?

InsideOut Screener

For an online, digital screening tool please see the InsideOut Screener.

Screening for high risk groups

Eating disorders occur in both males and females; in children, adolescents, adults and older adults; across all socio-economic groups and cultural backgrounds. Within this broad demographic however there are some groups with a particularly high level of risk.

Based on the known risk factors for eating disorders, high risk groups who may benefit from screening for eating disorders include:

• Adolescents

• Women, particularly during key transition periods

• Women with Polycystic Ovary Syndrome or Diabetes

• Athletes

• People with a family history of eating disorders

• People seeking help for weight loss

 For more information, see Risk and Protective factors.

Risk Assessment

Patients must be screened for physical health risks and risk of suicide. Medical stabilization, where required, must be provided before or simultaneously with other interventions. Eating disorders can impair a person’s insight and ability to make informed decisions.

Decisions regarding treatment must always take into consideration the person’s capacity to make decisions for their own safety.

Referral to appropriate services

The eating disorders treatment team requires a multi-disciplinary approach to address the physical components of the illness, the eating behaviours, the psychological thought processes, and the social and work needs of the person.

Members of the multidisciplinary team will vary depending on the needs of the patient but a minimum treatment team should consist of a medical practitioner (e.g. a GP) and a mental health professional.

More information about treatment and recovery including treatment approaches for specific diagnostic presentations approaches can be found on the NEDC’s treatment options page.

Specialist medical interventions may also be required by some patients to prevent or treat a wide range of physical health conditions including gastrointestinal disorders, malnutrition, osteoporosis, damage to teeth, infection, cardiac complications, kidney failure, menstrual problems and treatment of comorbid conditions such as diabetes.

Some patients may require referral to a hospital emergency department or an eating disorder specific inpatient or outpatient program. More information about treatment options including inpatient treatments, outpatient treatments, day programs, community based support and rural options can be found on the NEDC’s Eating Disorder Stepped System of Care page.

Key national and state/territory organisations, guidelines and policy documents

Access the key eating disorder national and state/territory policies and guidelines, in addition to national and state/territory-based service development and lived experience organisations here.

For information about treatment and support services, refer to NEDC’s Service Locator.