What exactly will happen if I go to my GP with a suspected eating disorder?

[Username90210]

I need some help with my eating but I keep putting off calling my GP.

Can anyone give me a bit of advice about what sort of questions I might be asked and what the next steps might be if I do work up the courage to make an appointment?

I've just eaten an entire cheesecake, a swiss roll and two steak pies, then thrown it all up, so I do realise I need help but I'm conflicted.

They would probably prescribe you with mild antidepressants which can help appetite control. I know people who have been prescribed Prozac for binge eating disorders

https://www.beateatingdisorders.org.uk/get-information-and-support/get-help-for-myself/going-to-the-doctor/

This is a really useful website and this particular page gives you some answers

Thanks Durdledore - that looks useful. Will have a good read.

I don't want to have to take antidepressants, so hopefully there are other options. And possibly appetite control isn't the best idea because I am very underweight (objectively, I know this is true, but also, I don't want to gain any weight)

I don't think it's binge eating disorder. It's bulimia isn't it? It depends on your bmi- if you are significantly underweight with it they will characterise it as anorexia purging type. I think the criteria for bulimia is bingeing and purging 3 times a week or more but I'm not up to date on that. They shouldn't dismiss you about this- it's dangerous. They might suggest antidepressants but they will refer you to nhs eating disorder service who will offer you therapy. Usually cbt based but it can be something else. It's a multidisciplinary team. Bulimia is usually treated on an outpatient basis.

When I went to the doctors with an eating disorder they prescribed me medication (for either depression or anxiety, I can't remember) which I didn't take - and referred me to talking therapies where I went on the waiting list for eating disorder group therapy.

I don't think my doctors were really that experienced with it - not sure if that's common - so the appointment really was a formality to get the referral, they didn't ask me a huge number of questions as I recall.

It took quite a few months for the proper therapy to start, they gave me access in the interim to an online platform but that didn't do a lot for me really. Ultimately post the group therapy I was referred for CBT.

It's really good you're open to getting help, which is very much the first step. There were a couple of books that I read while I was in therapy that were probably more useful than anything else in getting over the disorder, and I'll happily recommend them to you if you're interested, particularly given there's likely to be a wait after referral.

According to the NHS calculator, my BMI is 15.4. I am open-ish to getting help, but my feelings definitely fluctuate. I need to catch myself on the right day and call the GP to get things moving so I can't back out

Yes go to your gp. That's the most important thing to do. Just call and then turn up for the appointment. Try not to think about it. It is very conflicting. It's very hard but it's also very important.

What would help you do it OP? It’s good that you are able to recognise you need medical help here.

I have bulimia and have tried to go to the GP 3 times in the last 2 years. Twice I cancelled, the third time they did blood tests, an ecg and I had to get weighed. All of that really frightened me so I just didn't go back! I have been on fluoxetine before, for depression, they stopped the bulimia for a month but it came back sadly.

If you get past the GP first appointment please do let me know what happens next OP!

For anyone struggling I can strongly recommend Brain over Binge, the recovery guide by Kathryn Hansen. Also the Bulimia Help Method by Alison Kerr.

The former in particular was probably the main thing that helped me overcome bulimia.

I would write down what you want to say to them in a brief letter. If you get overwhelmed in the appointment you can refer to the letter or just hand it over to read. Well done you are being very brave to reach out for help x

You should go and dont b e put off by what Im going to say (which others have already said) but GPs are not great at anything like this unless they have a special interest or special training

Anything MH wise will just be normally a bog standard anxiety or depression medication and a referral for CBT (which then cuts out after 6 sessions, useless for the vast majority of people with MH issues)

However you might get lucky and at the same time investigate the other resources that others have directed you to here.

When I went to my GP, I said I was having problems with my eating. He gently asked me some yes/no questions to ascertain what was going on, asked if he could weigh me (I declined) then said he'd refer me to ED services.
I received an appointment for an assessment pretty quickly, and from there began community based intensive treatment (ED nurse, psychiatrist and later psychologist).

I think it helped that I'd seen the GP quite a lot in the couple of years prior (depression and support with domestic abuse) and he could see the ED was something that had got out of hand post awful divorce.

OP, who are the significant people in your life? They must notice you are very, very underweight.
Can someone go to the GP with you?

That’s a dangerously low BMI, you need to see a doctor as an emergency - also call the BEAT helpline.

Hugs, OP

I live alone, work mostly from home, and don't have family or friends nearby, other than my son who is away at uni and has a flat there for the summer. I see him every couple of weeks and he knows I'm struggling with my eating, but I don't feel like it's his job to support me. He has started nagging me to book a GP appointment though.

I'm planning to call on Monday. But then I will have to navigate getting time off work for an appointment in my last week in my current job. I'm starting a new job in September so the timing isn't ideal.

I think part of the problem is that my current job is extremely boring and solitary, but very easy, and I have some level of anxiety about the new more challenging job (which I applied for in December so I have had plenty of time to worry about it). Maybe things will naturally work themselves out once I get started in the new job.

Hi OP
You likely have Anorexia binge purge type, though a trans diagnostic approach is often used by services because the categories are not necessary for treatment.
Your gp will need to weigh you and a blood test might be indicated to check your potassium and other important health markers.
Go, tell them what you are doing to restrict weight and what you are struggling with.
I hope you get a referral to a specialist eating disorder service but you can also inform yourself and start to learn - 'overcoming binge eating' by Chris Fairburn is the key book for patients and professionals and despite the title it's about anorexia, bulimia and binge eating. You need to know the stuff in this book. Good luck, go slow and steady and learn how to overcome this.

Thanks for telling us a bit more about your day to day life, OP.
In the depths of my ED, being alone at home (DS2 was still seeing his Dad now and again at the time) was The Worst thing for me.
If an ED has taken hold of you, it's incredibly hard to fight it alone. It's very hard even with support.

Speaking to your GP will be hard, but it does sound like you are ready to accept that you can't get out of this yourself.

You can keep it simple:

I am having trouble with my eating.
It's hard to talk about.
I would like professional support.

My GP saying "I'm going to refer you to the psychiatric team, is that OK?" was SO hard to hear. I knew it's what I needed, but hearing it out loud scared me.

You do not have to consent to being weighed or bloods, ECG from your GP, but once you are taken on by the ED team you will need to, otherwise they won't be able to help you.

Please make the appointment. Try not to worry about work issues, your health takes priority.

I started a new job while undergoing ED treatment. It was a really positive thing for me. A new start, a new challenge (you wouldn't have got the job if you weren't capable of it). Doing a boring job isn't good for your self worth.

I called the GP at 8:30 on the dot and I was number 56 in the queue so I gave up.

I haven't needed a doctor since about 2004, so I'm a bit shocked at how complicated it is to get hold of one these days. There was a very extensive recorded message listing all the other places you should try before attempting to see your GP.

Can you email them OP and set out that you have the type of difficulty which means you avoid seeking help and so have given up this morning but you know you do need help. Set out your height and weight and the issues and that you need an appointment?

I will try again tomorrow - maybe Monday morning is extra busy since people can't call over the weekend?

Well done OP, you've made a big step.

Does your surgery have e-consult?

Not sure how widespread it is, but on my NHS app, I can book a phone appt with my local GP surgery