Understanding and supporting children and young people with eating disorders
Eating disorders can have devastating effects on individuals and families. Maddie Burton explains the crucial role practice nurses can play in identifying and supporting patients
Children and young people's mental health conditions have continued to increase. The NHS Digital 2017 survey found that 1 in 8 children have a diagnosable mental health condition. During the current COVID-19 pandemic numbers are set to increase. Eating disorders make up a relatively small proportion of these statistics but have some of the most devastating effects on individuals and families. Anorexia nervosa, as discussed here, has the highest morbidity of any mental health condition. The issues are complex and a challenge to understand for both professionals and families, over typically a protracted period of illness. However, all work with children, young people and their families presents a ‘window of opportunity’ in being able to resolve issues within a developmental phase prior to the more concrete adult phase. The risk is highest for young people between the ages of 13 and 17 years. There are several theoretical models that aid understanding of how and why eating disorders emerge and are maintained. Practice nurses in primary care can have a crucial role in early identification and can be found to be less stigmatising than mental health professionals. Practice nurses can have an ongoing role in remaining involved with the young person and their family and as part of the wider specialist support system.
It is important to consider eating disorders in children and young people, why they develop and how they may present in primary care settings. The primary focus of this article will be anorexia; given its seriousness in terms of morbidity, the effects of starvation and the requirement for early specialised support. Anorexia nervosa is not a disease of the middle classes as is sometimes thought, but crosses all cultural and social backgrounds. It has the highest death rate of any mental illness (Treasure and Alexander, 2013). In older adolescents, mortality rates are higher than any other serious chronic disease (Hoang et al, 2014). Eating disorders can develop at any age in childhood or adolescence, in keeping with other mental health disorders; that is, half of lifetime mental health problems (excluding dementia) are beginning to emerge by age 14 and three-quarters by the mid-20s (Department of Health, 2011). The risk is highest for young people between the ages of 13 and 17 years (National Institute for Health and Care Excellence [NICE], 2017).
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