CPG for Eating Disorders

TREATMENT OF CHRONIC EATING DISORDERS9.19. How are chronic eating disorders treated?Tertiary prevention aims to resolve the most serious symptoms, palliate the most severecomplications and avoid vital risk in chronic cases, which have generally been refractory totreatment and in which expectations of remission are low or inexistent.In chronic eating disorders, tertiary prevention includes management of the organic(cachexia, electrolyte imbalance, immune deficiency, etc.) and mental (loss of impulse control,risk of self-aggression, suicide prevention, etc.) state, maintenance pharmacological treatment,behavioural pact within the family (acceptance of certain behaviours and reaching agreement onothers, indications for the family to identify relapse in maladaptive symptoms, etc.) and socialreinsertion measures in which family, health care resources and support associations for patientswith eating disorders and their family members play a very important role.There is no evidence on the effect of different interventions aimed at chronic eatingdisorder cases.Tertiary prevention of eating disorders was not addressed in the NICE CPG (2004) 30 . Fourof the documents 10, 16, 19, 147 elaborated in our setting formulate recommendations on this aspect andbased on them the working group has formulated the recommendations for its approach.Recommendations 9.19.1. The health care professional in charge of the care of chronic eatingdisorder cases should inform the patient on the possibility of recovery andadvise him/her to see the specialist regularly regardless of the number ofyears elapsed and previous therapeutic failures. 9.19.2. It is necessary to have access to health care resources that are able toprovide long-term treatments and follow-up on the evolution of chroniceating disorder cases, as well as to have social support to decrease futuredisability.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS172