Assessment of child or young person with a possible eating disorder

A mother presents to discuss her 13 year old daughter’s changed eating patterns. The daughter is involved in a lot of sport at school and is running cross country for the county, but is no longer eating properly and seems withdrawn. The daughter appears to be losing weight, but she does not want to be weighed and alludes to thinking she is fat. She doesn’t know her mother has come to see you; the mother wants to know what she can do without you seeing her daughter, as she is worried her daughter will become upset and withdrawn if others are involved.

Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. This Practice Pointer is aimed at non-specialist doctors and will offer advice on building therapeutic relationships in consultation with a child or young person, and with their parent(s), what information to gather, and how to do so sensitively, and the role of the parent or carer in treatment. We recommend that it is read alongside the accompanying Clinical Update for the evidence base and detailed notes on examination, investigations, when to refer, and risk. The advice in this Practice Pointer is based on expert experience.