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Restrictive eating disorders in children and young people: the role of the paediatrician and paediatric ward
  1. Simon Chapman1,2,
  2. Lee D Hudson3,4,
  3. Karen Nicola Street5
  1. 1 Child Health, King's College Hospital NHS Foundation Trust, London, UK
  2. 2 Maudsley Centre for Child and Adolescent Eating Disorders, South London and Maudsley NHS Foundation Trust, London, UK
  3. 3 Population, Policy & Practice Research Programme, University College London, London, UK
  4. 4 General Paediatrics, Great Ormond Street Hospital NHS Foundation Trust, London, UK
  5. 5 Community Eating Disorder Service, Devon Partnership Trust, Exeter, UK
  1. Correspondence to Dr Simon Chapman, Child Health, King's College London, London SE5 9RS, UK; simon.chapman{at}nhs.net

https://doi.org/10.1136/archdischild-2021-322745

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    Introduction

    It will not have escaped any paediatrician that the COVID-19 pandemic has seen a marked rise in presentations of children and young people with restrictive eating disorders. The surge has spilled onto paediatric wards, with young people in distress often admitted for weeks at a time awaiting more specialist care.1 In some centres in the UK, however, admission rates have been lower through closer collaboration between paediatricians and eating disorder teams who offer a different, more pre-emptive approach to the medical management of affected young people and their families. We discuss how paediatricians and the proactive paediatric admission, sanctioned and supported by the eating disorder team, can influence the journey to recovery of a young person with a restrictive eating disorder.

    Another way?

    Restrictive eating disorders are an important cause of lifetime morbidity and mortality, with much of the risk attributable to complications from starvation. In addition to the acute risk, the main legacy is the impact on the skeleton, with higher prevalence of osteoporosis in adulthood. Given this, one might imagine that every young person with an eating disorder would have a paediatrician. In fact, though, most cases are managed by outpatient eating disorder teams alone, even when very low weight. Only a minority may meet a paediatrician, usually as part of an unplanned hospital attendance in crisis, where their experience of care is variable. The doctors they meet in the acute setting often feel unequipped to assess their physical risk2 and absence of pathways leads to …

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    Footnotes

    • Twitter @eatyourpeas, @leehudson111, @karenstreetkhan

    • Contributors SC was commissioned to write the piece. SC conceived the idea and wrote the draft. The draft was reviewed and commented on by LDH and KNS. SC made the final changes.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; externally peer reviewed.