Managing anorexia nervosa in primary care

Abstract

Anorexia nervosa is a potentially debilitating mental illness, with significant physical and psychological sequelae. It has the highest mortality of any psychiatric illness. Early intervention is associated with better outcomes. However, patients typically experience long delays in accessing definitive treatment. Patients experience on average a three-and-a-half year delay between falling ill and accessing treatment, 6 months of which elapse between visiting a GP and receiving treatment. Patients often present to primary care either directly, with anorexia, or indirectly, with related symptoms such as amenorrhea. GPs play a vital role in recognising the signs and symptoms of this disease, identifying whether the patient has acute and potentially life-threatening symptoms, and referring them promptly and appropriately to secondary care. The current pressures on mental health services may also require GPs to provide ongoing support and management for patients while they await treatment from secondary care.