Medical Emergencies in Eating Disorders (MEED)
Introduction
The incidence of Eating Disorders is on the rise – hospital admissions for eating disorders, across all ages, have increased by 84% in the last 5 years.1
 
This guideline applies to all paediatric patients, up to the age of 18, who present to the Emergency Department or Children’s Assessment Unit with food and/or fluid avoidance, phobia or refusal. This is based on the all age MEED guideline from the RCPCH May 2022. ​
Scope
Not only do Eating Disorders pose a risk to physical health, they are also associated with an increased risk of self harm and suicidal ideation.
 
This guideline has been written with the aim of enabling doctors and nurses in the Emergency Department or in Children’s Assessment Units to assess and risk stratify a patient with an eating disorder safely and inform ongoing plans for discharge to community safely and or admission if necessary for medical stabilisation/ safety.
Definitions
Eating disorder
A behavioural condition characterised by severe and persistent disturbance in eating behaviours and associated distressing thoughts and emotions. They can be very serious conditions affecting physical, psychological and social function. Types of eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica and rumination disorder [2]
Flowchart
Communication and Training Plans
Guideline will be made available on the PIER website and locally with the assistance of the Eating Disorders lead clinician.
Process for monitoring compliance
The PIER network will review problems associated with this guideline through governance process.
Document Review
Guideline to be reviewed after three years or sooner as a result of audit findings or as any changes to practice occurs.​
References
  1. Royal College of Psychiatry. May 2022. Press Release: “Hospital admissions for eating disorders increased by 84% in the last five years”. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2022/05/18/hospital-admissions-for-eating-disorders-increased-by-84-in-the-last-five-years
  2. American Psychiatric Association. Feb 2023. What Are Eating Disorders? URL: https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders
  3. Royal College of Psychiatrisis, 2023.  Medical Emergencies in Eating Disorders. https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/college-reports/2022-college-reports/cr233.​
Appendix 1 - Paediatric Eating Disorders Risk Assessment Tool
Appendix 2 - Discharge Meal Plan
Appendix 3 - ED Admission Care Plan
Document Version: 
1.0

Lead Authors: 
S. Williams, Consultant Paediatrician, UHS
R. State-Davey, Specialist ED Dietician, UHS
M. Yelland Gilmartin, Paediatric CAMHS Liaison Nurse
E. Lindell, Paediatric Registrar
​
Approving Network:
General Paediatric and CAMHS Networks
​
Date of Approval: 
January 2025

Review Due:
​January 2028