New research suggests that three out of ten people with eating disorders do not receive a referral from their GP to a mental health service for treatment, despite medical guidance that stresses the need for immediate referral. While half of those with eating disorders have received ‘good or very good’ care from their GP, half rated it poor or very poor according to a survey of nearly 1,700 people.
Beat, the UK’s eating disorder charity which undertook the research, is calling for increased training for medical students specialising in general practice so that all GPs are able to properly diagnose the psychological and behavioural symptoms of eating disorders so they can refer immediately.
The survey to mark Eating Disorders Awareness Week starting Monday 27 February, asked people about their first visit to a GP about their eating disorder. The results showed that 55 per cent felt that the GP did not understand the importance of early intervention and only 34 per cent felt that their GP knew how to help them.
In addition, the survey also revealed that only one in five of these GPs provided their patients with information about eating disorders, despite the recommendation by the National Institute of Clinical Excellence, or signposted them to services which would help, such as peer support networks or Beat’s national helpline. Meanwhile almost one in six, nearly 200, of these respondents switched to a different GP after not receiving the care or help they needed for their eating disorder. Most reported a more positive experience with the second GP they saw.
Beat is launching a public awareness campaign to ensure that GPs and family members and friends are better equipped to spot the tell-tale signs. This comprises a booklet for carers, an information guide for people to get the best outcome from their visit to their GP and a poster to provide useful pointers on how to recognise the first signs of an eating disorder and get a person on their road to recovery. This is available at www.b-eat.co.uk/tips.
The charity is also calling for more funds to be made available so that everyone can get the treatment they need once they have been referred to mental health services.
Beat Chief Executive Andrew Radford said: “We know that early intervention and speed in referring people with eating disorders is critical if they are to make the best possible recovery.
“It takes great courage for sufferers of eating disorders to come forward and often the first person they talk to is their GP. Unfortunately many of our respondents identified poor care from their doctor with many GPs not knowing what the real signs and symptoms are.
“We are calling for increased eating disorder training for medical students specialising in general practice so that all GPs are equipped to support eating disorder sufferers.
“This isn’t about blaming GPs, it’s about enabling the 50 per cent of GPs who didn’t provide good care to be as supportive of eating disorder sufferers as the 50 per cent who did.”
Dr. Elizabeth McNaught, a junior doctor aged 25, had eating disorders when she was younger. She has recently undergone five years of medical training.
She said: “Taking the first step to visiting the GP can be a really positive experience or a negative one. But in my situation it was the latter. My GP clearly had very little knowledge of the subject. She was insensitive, making unhelpful comments and asking inappropriate questions. My story is not unusual: Many doctors do not know enough about eating disorders because they don’t feature very highly in medical training. We had just two hours on the subject throughout five years of study. And since many students didn’t see it as core to their training, only half of them turned up for it. The prevalence of eating disorders is growing at an alarming rate and their complexity is such that only two hours of training is not enough. I believe that if my GP had had more training I wouldn’t have lost so many years of my life. Things could and should have been different.”
A GP who provides training on eating disorders said: “I have been a doctor since 1993 and a GP since 1998. I had no formal teaching in eating disorders whilst I was training. I know from our younger associates that this still appears to be the case.
“Having developed a special interest in eating disorders over the last 18 years, I provide an afternoon training session for all third year GP registrars in Liverpool which they have been very grateful for and hasn’t been onerous.
“GPs, in my experience, are dedicated in supporting their eating disordered patients but as they often only have limited exposure of eating disorders in training and in practice, they have appreciated the availability of support and guidance and quickly gain confidence. “GPs are competent at identifying their training needs and courses are available but an opportunity for training at the beginning of their careers would be beneficial.
“Practice nurses may also be the first contact for an eating disordered person and they have also benefited from training sessions.”