Eating disorders are common and every clinician will at some point be faced with a patient seriously unwell as a result of anorexia nervosa, bulimia nervosa, binge eating disorder or avoidant restrictive food intake disorder.
This website allows you to access authoritative guidance on how to approach the assessment and management of these conditions when they present as medical emergencies.
The MEED guidance and this website are intended for clinicians’ use. They are evidence-based risk assessment and signposting resources, and are not tools for diagnosis. All clinical decisions must be made by clinicians with knowledge of the history and circumstances of the individual case. Under no circumstances should clinical decisions be made solely on the basis of the results of risk assessment criteria being met or not met. Although a contact email address is provided on this website, this is for methodological queries and feedback only. We do not provide medical advice to individual patients or carers.
Here are the areas on which we signpost to advice:
- MEED Risk Assessment (online diagnostic questionnaire, option to receive results by email)
- Refeeding Risk Assessment (risk that a patient might develop Refeeding Syndrome – only for eating disorder patients. See: NICE advice for managing non eating disorder patients)
- Checklist for front line staff
- Summary sheets for each professional and supporter
Links to the relevant sections of Guidance on Recognising and Managing Medical Emergencies in Eating Disorders published by the Royal College of Psychiatrists are available here:
- Location of care
- Refeeding
- Behaviours that can interfere with recovery
- Helping parents, carers and friends
- Compulsory admission and treatment
- T1DE: Type 1 Diabetes Mellitus and Disordered Eating
The MEED checklist
The MEED checklist (PDF) is intended for use by front line clinicians eg Emergency Department staff. It covers three areas: Assessment, Refeeding and Management. In the assessment column, three questions are posed:
- What is the diagnosis?
- Is the patient medically compromised?
- Is the patient consenting to treatment?
The refeeding column covers high and low risk of refeeding syndrome and what to do in each case. The Management column covers
- Medical-Psychiatric collaboration
- Nurse training
- Risk increasing behaviours
Summary sheets for each professional and supporter
The summary sheets (PDF format) are introductions to MEED for each of a large number of groups, including professionals and people affected by an eating disorder:
- Psychiatrists
- Physicians
- GPs
- Nurses
- Relatives and carers
- People with eating disorders
- Paediatricians
- Liaison psychiatrists
- Dietitians
- Managers and commissioners coordinating care
- Psychologists and therapists
- Generic psychiatry teams
- Emergency department staff, on-call medical and paediatric staff
- Physiotherapists