EMERGENCY ASSESSMENT REQUIRING A&E
Those at very high risk – who are at risk of metabolic derangement or cardiovascular collapse, where weight loss is rapid and severe – may need immediate intervention to avoid potential loss of life. Please see referral details below for further information.
Eating disorders affect both boys and girls, can be very secretive and not everyone with an eating disorder is underweight.
Lothian CAMHS will see children and young people up to the age of 18 years. If you are not sure about the referral or want other advice, please access the CAMHS Consultation Service.
Anorexia Nervosa: is characterised by a restriction of nutritional intake and/or other weight influencing behaviours e.g. excessive exercise/activity, laxative use, which results in weight loss and low body weight. Rapid weight loss at any weight should be responded to with the same urgency; In children and adolescents this might present as failure to gain weight as expected, based on the individual developmental trajectory rather than weight loss; an intense fear of gaining weight and disturbances in the way that a young person see’s their weight and shape. The onset of Anorexia Nervosa is often during adolescence or early adulthood (between the ages of 10 and 24). Children with Anorexia Nervosa may not be able to express body image concerns. Instead, this might be expressed by stating another reason for not eating or experiencing tummy pain or in their behaviour, e.g food refusal.
Bulimia Nervosa: Bulimia Nervosa: is characterised by recurrent episodes of eating large volumes of food in one sitting (bingeing) and associated compensatory behaviour to prevent weight gain such as vomiting, misusing laxatives, fasting, diuretics or other medication and excessive exercise. Binge eating episodes occur once a week or more over a period of at least 1 month and is characterised as a discrete period of time (e.g. 2 hours) during which the individual experiences a loss of control over their eating behaviour. There will also be excessive preoccupation with body weight or shape, this includes behaviours such as repeated body checking. Children do not typically engage in binge-eating due to a lack of access and control of food and more typically begins during or shortly after puberty.
Other Specified Feeding or Eating Disorders (OSFED) present in those young people who may have symptoms of the categories above, presenting with abnormal eating or feeding behaviours but who do not meet all the required diagnostic criteria. They can be just as severe and complex in presentation.
Binge Eating Disorder (BED): is characterised by binge eating episodes, but these eating episodes are not regularly accompanied by inappropriate compensatory behaviours aimed at avoiding weight gain. BED is associated with weight gain, increased body fat and concealing one’s eating. There is marked distress around the pattern of binge eating or impairment of functioning. The onset of Binge Eating Disorder occurs during adolescence or young adulthood but can also begin in later adulthood.
Avoidant Restrictive Food Intake Disorder (ARFID): is characterised by an eating or feeding disturbance (extreme lack of interest in eating/food, severe avoidance based on sensory characteristics, distress about aversive consequences of eating) leading to significant and severe weight loss /absence of expected weight gain, nutritional deficiency, with no evidence of disturbance in experience of body shape or weight.
C.M & L.S 11-04-24