CPG for Eating Disorders

– Initiating nutritional treatment that includes the following objectives: restoring normal weightin the patient, correcting malnutrition, avoiding the refeeding syndrome, managing or curingmedical complications, carrying out nutritional education with the objective of normalisingaltered dietary behaviour, both in the patient and in his/her family, and preventing andmanaging recurrences.Initiating nutritional restoration by means of adequate renutrition or refeeding (See question 9.1.chapter 9, “Treatment”) and performing nutritional education (nutritional counselling) (Seequestion 9.2. chapter 9, “Treatment”).– Monitoring cases that are managed in primary care centres (in AN: the patient will berequested to record daily consumption, hyperactivity, laxative abuse and use of diuretics;he/she will be not be allowed to weigh him or herself and weight will be recorded weekly atthe practice, results to which the patient will not have access; in BN: binge-eating episodes andself-induced vomiting, substance abuse and other behaviour disorders (impulse, etc.) will berecorded, as well as recurrence prevention.– Conveying clear and true information regarding eating disorders to patients and relatives (SeeAnnex 3.1.). Also detecting and correcting maladaptive ideas about weight and health (SeeAnnex 2.9.).– Carrying out interventions with affected families (See chapter 7, “Diagnosis”).– Managing physical complications (See chapter 9, “Treatment”).8.1.2. Specialised care interventionsEating disorder patients are provided with specialised care, the second and third levels of accessto health care, in the form of inpatient care resources (psychiatric and general hospital),specialised outpatient practices (mental health centres for adults and children), day hospitals forday care (centres specialised in eating disorders and general mental health centres), emergencyservices, medical services pertaining to general hospitals and specific units (for eating disorders,borderline personality disorder and toxicology).– Assessment and diagnosis visits are performed at an outpatient level (CSMA and CSMIJ) afterreferral from PC. In the case of vital emergencies or autolytic risk that stand in the way of thisassessment, the patient must be referred to internal medicine and psychiatry services and willbe admitted if indicated by the physicians on-duty.– The clinical history must update and complete what has been established in PC.– After establishing a diagnosis, the mental health team will design an ITP which includes: a)definition of the problem based on the diagnosis and altered areas, b) formulation ofpsychotherapeutic objectives, c) election of treatment (psychological therapies,pharmacological treatments, medical measures and social interventions) (See the “treatment”CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS79