Three in four with eating disorders face 'barriers to treatment' - as doctors are urged to look beyond body weight
It is estimated that about 3.5 million people in the UK are affected by an eating disorder
Around three in four adults diagnosed with an eating disorder by their GP are not referred to specialist services, a study suggests.
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Patients who have disorders other than anorexia may “encounter barriers” to treatment, according to researchers.
They suggest that bodyweight may be a factor, as doctors may be less likely to recognise problems in people who are heavier.
It is estimated that about 3.5 million people in the UK are affected by an eating disorder, the equivalent of one in 20 people.
The study led by King’s College London included more than 35,400 adults in England and Northern Ireland.
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About three quarters (75.8%) did not receive a referral to specialist eating disorder services.
However, those with anorexia who were classed as underweight on the body mass index scale were four times more likely to be referred when compared to patients with the same diagnosis who were not underweight.
The findings, published in the Lancet Primary Care, suggest patients in England and Northern Ireland “encounter barriers” when accessing NHS treatment.
“Disparities in eating disorder referral by diagnosis indicate a need to improve recognition of eating disorders beyond anorexia nervosa,” they added.
Ulrike Schmidt, a professor of eating disorders in the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, said: “Being underweight isn’t compatible with a current diagnosis of bulimia nervosa, so this pattern may point to GPs not always having the training, the diagnostic tools and the time to diagnose eating disorders accurately in primary care.
“We need referral pathways that recognise eating disorders regardless of a person’s body weight, and specialist services that are appropriately resourced to provide effective treatment and care to all who need it.”
Umairah Malik, research manager at the eating disorder charity Beat, said: “The findings are shocking but sadly not surprising.
“Every day we hear from people affected by eating disorders who have plucked up the courage to visit their GP, only to have been turned away for help.
“All too often, this is because their weight has been reviewed in isolation without considering other accompanying symptoms.
“Unfortunately, there’s still a common misconception, even amongst some healthcare professionals, that eating disorders can only affect underweight people, when this isn’t the case
“Single measures such as weight should never be the only criteria used to determine whether to offer someone treatment, and instead healthcare professionals should take a wide range of factors into account in line with best practice guidance.
“It also highlights the importance of self-referral, which currently isn’t consistently available in the UK.
“We know that GPs are doing their best to support patients, but they can’t do so without the right training.
“If this is allowed to continue, frontline services won’t be able to shift from crisis response to early intervention and prevention, which means that more people will be wrongly turned away and left to become even more unwell.”
An NHS spokesperson said: “NHS guidance is clear that services should assess people based on clinical need, not weight alone, and that BMI must never be used as the sole factor in deciding whether someone can access treatment.”