Talking to your GP

It can be hard to talk to your GP for the first time if you are worried that you, or your loved one, may have an eating disorder, but it’s important that you ask for help. The sooner you get treatment, the better the chance of recovery.

If you are spending a lot of time worrying about your weight and shape, limiting foods in a way that concerns you or those around you, are making yourself sick after eating, have very strict habits or routines around food, you’re exercising too much, or showing any of the signs of a specific eating disorder, please make an appointment to see your GP as soon as you can. They will be able to discuss your worries with you, explore whether you may have an eating disorder, and explain the next steps for getting treatment.

It may feel quite nerve-wracking to talk to a GP about how you are feeling or what you are experiencing. We regularly hear from people who tell us they feel ashamed or worry they are not ‘ill enough’ to deserve help; or that they realise they need help but don’t feel quite ready to change their disordered eating behaviours. Please remember that you do deserve and need help, as soon as possible.

We recommend making a double appointment to ensure you have enough time to discuss your concerns and ask the questions you need to. If you don’t feel comfortable talking to your own GP, you can make an appointment with another one, or ask whether there is a GP or practice nurse who has experience of eating disorders or mental health.

It’s important to know that eating disorders are mental illnesses and can become serious if not treated. If an eating disorder is suspected, treatment should be received at the earliest opportunity. Your GP should assess a range of both mental and physical considerations, and not make a decision of whether to refer to an eating disorder specialist based on one particular factor such as weight or BMI. If your GP does not make a referral and you think you or your loved one does have an eating disorder, please seek a second opinion from another GP.

Preparing for your appointment

Your first appointment is a good opportunity to share your concerns with your GP. It’s important to be open and honest about how long you’ve been experiencing problems with food and eating, and how it makes you feel. Here’s some tips to help you prepare:

• Write a list of the questions you’d like to ask. You can also consider emailing them to your doctor’s surgery beforehand, so they understand what you are going to ask ahead of time.
• Make a note of any symptoms, and changes in health, appearance, behaviour, and how you’re feeling. You can include how long you have been experiencing these symptoms and when you first started noticing changes.
• Ask someone to go with you to your appointment, so that they can help you remember things that you might forget to say or ask on the day and take notes of what the GP says. It’s good to have someone there who can help support you emotionally as well.

If the appointment is for your child, you may also want to ask their teacher or friends if they have noticed any symptoms or changes outside the home and include these in your notes.

If you’d like to speak to a member of our team for some support and advice before you go to your GP, please book a 1:1 support call, we’re here to help.

What to expect during your appointment

Your GP is likely to ask about your eating patterns and any connected issues such as ongoing weight loss/gain, as well as your thoughts, feelings, and behaviours around food, and how they affect your daily life. They will also check your overall health, including:

• Your weight, blood pressure, and for adults your body mass index (BMI).
• If you usually menstruate, whether your periods have become irregular or have stopped, or if they have not started during puberty.
• Whether you have any symptoms of starvation, like feeling cold or dizzy, fainting, or problems with your circulation.
• Any stomach or digestive problems.
• Any problems with your teeth (if you are vomiting regularly).

You may be offered some physical checks such as blood tests to check your electrolyte levels, and an ECG (electrocardiograph) to check how well your heart is working. Some of these checks may need to be repeated regularly. It’s important that your GP checks for any potential problems that exist now, or that you may be at increased risk of developing.

GPs often don’t have extensive knowledge or experience of eating disorders. If you feel this is the case, or they do not consider a range of mental and physical factors such as those above, please refer them to the NICE Guidelines for Recognition and Treatment of Eating Disorders.

What will happen next?

If your GP thinks you may have an eating disorder, they should arrange a referral for you to see a professional who specialises in eating disorders. This will either be at a local children and young people’s mental health service (CYPMHS – often still known as CAMHS), or an adult eating disorder service.

If an eating disorder is then confirmed there are different types of treatment, depending on your age, health, and type of eating disorder. Treatment usually involves psychological therapy, also known as talking therapy. You should also have regular checks of your physical health.

What if I don’t get a referral?

The NICE guidelines recommend that GPs make an immediate referral to an eating disorder service for specialist assessment if an eating disorder is suspected, to ensure that treatment is received at the earliest opportunity. Some GPs have not experienced many patients with eating disorders or may not have had training so they may not be aware of how serious eating disorders are.

If your GP did not refer you, this does not mean that you don’t need or deserve help. Don’t give up – please make an appointment with another GP as soon as possible.