How can I support a patient with an eating disorder who is resistant to treatment or referral?

Supporting a patient with an eating disorder who is resistant to treatment or referral involves several key approaches.

• Provide ongoing support and care even if the patient is not currently engaging with specific interventions, including psychoeducation about the disorder and regular monitoring of weight, mental and physical health, and risk factors.

• Maintain a multidisciplinary and coordinated approach between services to ensure continuity of care and support.

• Respect the patient’s autonomy and readiness to engage, offering them the option to request referral or treatment again at any time if they initially decline.

• Offer support and information to family members or carers, as they may experience severe distress, but also respect the patient’s wishes regarding family involvement, especially in children and young people where Gillick competence applies.

• Arrange regular reviews to monitor physical and mental health risks, adjusting the urgency of referral or treatment as needed based on clinical changes.

• For patients with severe or complex problems who decline treatment, specialist eating disorder services should provide ongoing support tailored to their needs.

These strategies aim to maintain engagement, monitor risk, and provide support while respecting patient choice, thereby facilitating eventual acceptance of treatment or referral when the patient is ready.

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