All eating disorder referrals will be assessed for need and seen as appropriate. We can also provide a liaison service to referrers for advice and consultation.
The inclusion criteria for the Early Intervention Pathway is patients aged 18-25 years old who are within the first 3 years of the illness, to provide a critical window for early effective intervention in eating disorders. Eating disorders have the potential to cause significant structural and functional brain changes, which worsen and persist the longer a young person is unwell. Therefore, offering early intervention helps to reverse significant changes to brain, body and behaviour, whilst also avoiding disruption to social, educational and emotional development.
The specific nature of the evidence-based primary intervention offered within the EI framework may differ somewhat depending on the age and/or developmental stage of the person. Given available evidence and NICE recommendations, for young adults with bulimic disorders (bulimia nervosa, binge eating disorder) the treatment of choice is Cognitive Behavioural Therapy (CBT), delivered as guided self-help via a manual or individually face-to-face. For young people with bulimic eating disorders, family therapy may constitute an alternative primary intervention.
For young adults with anorexia nervosa, family therapy and evidence-based individual therapies can equally be used, such as CBT or Cognitive Analytic Therapy (CAT). Sessions with family members/carers are an integral part of treatment. For young people presenting with EDNOS/OSFED the type of intervention and intensity will depend on clinical need, availability and patient preference. For all patients, pharmacotherapy (for example, antidepressants) is added as appropriate.
In treatment there is an emphasis on early and proactive change; emphasis on family and carer involvement; continued attention to social media use; consideration to transitions (university, college, work, CAMHS, to adulthood) and emerging adulthood (finances, independence, relationships, studies/work, identity, separation from caregivers).
An Occupational Therapy Group is open to young people on the Early Intervention pathway to help develop life skills and coping strategies, and build a bigger life outside of their eating disorder. It is an 8-week closed group that focuses on topics such as identity, routine, work and university, managing eating and behaviours around food, shopping, social media, relationships and self-esteem. The group also provides opportunities for young people to support one another through discussion and problem solving.