Community Treatment of Eating Disorders

Patients with eating disorders can be helped to improve their lives through the voluntary sector, primary care, outpatient, day patient, outreach, and inpatient care. In this chapter we review the community options for treatment in specialist units in the UK. Services for the under 18s have been favored by government support and we strongly advise that the same support be extended to adult services, especially in view of the upsurge in referrals during the 2020–21 pandemic. Moreover, eating disorders can begin around the transition age of 18 and those patients should not be left out of increased funding and improvements in care. We advocate the multidisciplinary community team approach for all ages, providing evidence-based interventions as soon after the onset of the disorder as possible, monitoring outcomes, managing transitions, and avoiding admission when it is safe to do so. Coexisting conditions such as personality disorder and autism provide substantial challenges and teams need to adapt their services in order to accommodate these combined presentations. Patients with SEED (Severe and Enduring Eating Disorder) can benefit from psychological and nutritional treatments but if they choose, should be offered treatment aimed at enhancing quality of life. We believe that specialist community treatment of eating disorders is the most effective way to deliver care and, by reducing dependence on inpatient care which can be prolonged, also makes financial sense.