Anorexia: only a third of sufferers under medical care
29 April 2016
Many GPs are missing the warning signs for anorexia nervosa, which delays treatment and puts patients at risk, psychiatrists say.
Dr Fiona Wagg from the Royal Hobart Hospital says it’s still common for GPs not to recognise the severity and nature of anorexia.
“A lot of young people who come to us are so severely ill they need to be admitted to intensive care and they need heart monitoring because they are at a risk of having a sudden heart arrhythmia and dying,” says Dr Wagg, a child psychiatrist who specialises in eating disorders.
“It would be very true to say that many general practitioners in their 15-minute consultations don’t necessarily do physical examinations … in a way to identify the illness.”
New data shows only half of Australians with a low BMI see a doctor, according to a sample of over 2000 patients recruited for the Anorexia Nervosa Genetics Initiative (ANGI) study.
Interim results from the study show that just one-third of participants with anorexia are being actively monitored by a medical professional.
Dr Warren Ward, who directs the Royal Women’s And Children’s Hospital Eating Disorders Service in Queensland, says a minority of GPs and psychiatrists indicate confidence with managing patients with anorexia.
He says some of his colleagues believe myths such as eating disorders are self-inflicted and people can get better with willpower.
However, Dr Ward says the situation in Queensland is improving thanks to statewide guidelines and better resources. Besides providing care, the Eating Disorders Service helps trains over 2,000 clinicians a year on caring for patients with anorexia.
“You need to medically stabilise the person. You need to get nutrition back into their brain and you need to offer psychotherapy for six to twelve months,” says Dr Ward.
“That’s a long journey of recovery. The first step is to get them to health services to be medically monitored,” says Dr Ward.
But these services may not always be available, says Dr Wagg. In Tasmania, there is no dedicated eating disorders service for adults with anorexia nervosa.
While most patients under the age of 18 recover with the appropriate care, some patients require ongoing specialist care that is beyond the expertise of their GP, says Dr Wagg.
“It’s a gap that adult mental health services have been pointing out for many years and it hasn’t been addressed.”