Prevalence and management of people with eating disorders presenting to primary care: a national study

Why is this research important?

GPs (also known as primary care practitioners) are often the first point of contact for people experiencing eating disorders. This study found that annually, less than 0.32% of the Australian population were managed by a GP for an eating disorder or probable eating disorder. This rate is alarmingly low when compared with the estimated 15% of the population who have an eating disorder. This study also found that the majority of GP visits for people with an eating disorder were initiated for reasons other than an eating disorder such as ‘weight management’. This discrepancy between prevalence of eating disorders and attendance to GPs indicates an unmet need in the system of care. Further research is needed to establish the reasons for this discrepancy, however it may indicate the need for workforce development to improve the detection and management of eating disorders by GPs.

Authors: Lorraine Ivancic, Sarah Maguire, Jane Miskovic-Wheatley, Christopher Harrison and Natasha Nassar

Abstract/Summary:

Objective: Primary care practitioners are well placed to support diagnosis and appropriate treatment of eating disorders as they are often the first point of contact with the health care system. However, little is known about management of eating disorders in primary care. We aimed to estimate the prevalence of management of eating disorders in primary care and identify how these disorders are managed.

Methods: This study used data from the Bettering the Evaluation of Care of Health programme, which annually surveys 1000 randomly sampled general practitioners in Australia who each record details of 100 successive patient encounters. In total, data were utilised from 1,568,100 primary care encounters between 2000/2001 and 2015/2016.

Results: Eating disorders were managed in less than 1% of primary care encounters between 2000/2001 and 2015/2016. When extrapolated to the Australian population, up to 0.32% of the population were managed in primary care for a primary or probable eating disorder. In the majority of encounters where an eating disorder was managed (58.5%), the encounter was initiated for reasons other than the eating disorder itself. Of a group of patients identified with a clinically significant low body mass index (N = 5917), a small number (n = 118) had either no other diagnosis or a related condition that may be indicative of an eating disorder. In encounters where an eating disorder was managed, referrals to a mental health specialist/service, medical specialist and nutritionist/dietician were provided in 20%, 8% and 6% of encounters, respectively. Mental health treatment plans, which provide subsidised access to mental health services, were ascribed in approximately 7.7% of encounters where an eating disorder was managed.

Conclusion: Primary care provides an opportunity to improve detection and management of eating disorders, particularly when patients present for ‘other’ issues or with unexplained low body mass index and one or more symptoms related to an eating disorder.

Link: journals.sagepub.com/doi/abs/10.1177/0004867421998752

Access: Closed access

Citation: Ivancic, L., Maguire, S., Miskovic-Wheatley, J., Harrison, C., & Nassar, N. (2021). Prevalence and management of people with eating disorders presenting to primary care: a national study. Australian & New Zealand Journal of Psychiatry, 55(11), 1089-1100.