Scenario: Eating disorders

Kelly, the counter assistant, tells Parveen she is worried that a couple of teenage customers may have eating disorders...

“Teenage girls often are skinny but they really do look like they would fall over in the wind! I know that anyone with an eating disorder needs to be under specialist care because it is a very complicated area, but I wondered if there are any practical things we could suggest to them or their parents that might help a bit?”

Answer

Practical ways that pharmacy teams can support individuals with eating disorders and their families include:
• Checking that they understand any information they have been supplied with
• Encouraging people with anorexia nervosa to take an age appropriate oral multivitamin/mineral
• If vomiting is a symptom, highlighting the need for regular dental checks, and suggesting rinsing with non-acidic mouthwash (but not brushing teeth) after vomiting plus avoidance of highly acidic foods and drinks
• Advising anyone who may be misusing laxatives or diuretics that these drugs do not reduce calorie absorption and so do not aid weight loss
• Discouraging excessive exercise.

In addition, it is wise to be alert for any physical effects of malnutrition, as well as signs of mental health problems commonly associated with eating disorders, such as depression, anxiety and self-harm. Also to be available to answer any questions patients may have about the medicines they take.

The bigger picture

Eating disorders need careful handling. People with an eating disorder (and their parents or carers) may find it difficult or distressing to discuss the condition and be vulnerable to stigma and shame. Being able to provide appropriate education and information on eating disorders, the risks they pose, the pros and cons of available treatments and addressing any misconceptions held is hugely valuable.

Pharmacy also has a role in signposting suitable resources on eating disorders, particularly for individuals who have not yet sought medical help. Reliable sources of information include:
• NHS Choices: nhs.uk/Conditions/Eating-disorders
• The Royal College of Psychiatrists: rcpsych.ac.uk/expertadvice/problemsdisorders/anorexiaandbulimia.aspx
• Men Get Eating Disorders Too: mengetedstoo.co.uk.

For those who have acknowledged they have an issue, support is crucial. Among the organisations that can help is Anorexia and Bulimia Care (anorexiabulimiacare.org.uk).

Extend your learning

• Do you know what the first signs of an eating disorder may be? See b-eat.co.uk/spotting-signs-eating-disorder
• Refresh your understanding of different eating disorders at mind.org.uk/information-support/types-of-mental-health-problems/eating-problems/types-of-eating-disorders/#.WSbYpoWcGM8.

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