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.

Well done for calling op, when I call I put the phone on speakerphone and go about my day, though that queue was exceptionally long. I also tend to walk in and speak to reception but realise you may have a schedule that makes it difficult. I had a relative diagnosed with anorexia and she did binge eat. I don’t know full details but she did recover. Try again this afternoon if you feel you can as mornings are always the worst. Wishing you well op you have made the first few steps, admitting you need some help.

I called again and waited in the queue and actually talked to reception and got a call back from a GP quite quickly.

They asked a few questions, told me they think I have anorexia and told me to go on the Beat website and self refer for support. I'm not sure where I should be referring myself to.

They also told me to call reception again and book blood tests.

I don't think I will take this any further at the moment, it's too difficult.

I'm recovering from anorexia

Your GP should of referred you to an ED clinic. If you can face it you need to make another appointment with the GP and ask to be referred to an eating disorder clinic

Appalling they didnt just do that for you straight away

If you dont take this further your going to die. You know that right? Your body is going to shut down on you soon, then theres the potential to develop sepsis, then your dead.

Push through and ring them back and ask to be referred to an eating disorder clinic. They can and will help you

They asked a few questions, told me they think I have anorexia and told me to go on the Beat website and self refer for support. I'm not sure where I should be referring myself to.

Jesus....that's appalling. BEAT is excellent, but they are not a referral service for NHS ED clinics. You need more support than BEAT can offer. BEAT will be able to advise on how to talk to your GP though.

Please don't give up. We are rooting for you, and you deserve to get well and be happy.

Hi OP, I was worried about this. The reason you are having such difficulty seeing your GP and have had this inadequate response of referring yourself to ?BEAT ? Specialist Eating Disorder Services is not because it isn't serious, it is. But GP services are broken and beaten. And there's an article in The Times today saying that Eating Disorders in children have doubled in 8 years, so services are of course over subscribed. A lot of people are suffering, like you are suffering. It shouldn't be like this.
You should book yourself in for that blood test. If it shows any markers that mean you need some medical treatment, then your GP will be able to help with the immediate health issue. This would be reassuring for your son.
You can stay on the road you are on for a while longer or for a lot longer - I guess eating behaviours numb feelings or help you feel something, they are doing something you like and need. It just might get harder to ignore the problems that you are storing up on top of the original problems.
Is it ok to share summarised key info which I hope can help you minimise harm with these problems? - low weight can affect your white blood cells and the body's ability to repair, your muscles get weaker because the body takes nutrition from them and your heart is a muscle so this is what doctors worry about when your BMi is below 16. Don't do exercise that raises your heart rate. Vomiting can cause low potassium which is another cause of death from eating disorders. If your blood test shows low potassium your GP can prescribe a supplement. Vomiting can also affect your tooth enamel - advice is do not clean your teeth after purging because this makes it worse. And can cause throat abrasions, loss of tightness of the sphincters leading to acid indigestion problems, and eye pain and (rarely) retinal detachment. Low weight over a number of years can lead to osteoporosis which means your bones break easily.
You mentioned feeling different on different days - notice that - your system is in a bit of a battle because the ED part is trying to protect you one way, but another part is trying to raise the alarm because that good intention to protect you from difficult feelings is unintentionally causing harm. You need to get to know the ED part, and the other parts and eventually negotiate a way forward together.
Let your son know you rang x

In our area you can self refer to the eating disorders service, could that be an option?

Ah ok most services have been told to operate under self referral - OP whereabouts are you? If the GP gave you a link your son might be happy to help you do it? Or we might be able to find the right info for you
www.beateatingdisorders.org.uk/about-beat/policy-work/self-referral/

The GP didn't give me a link - he said go on the Beat website and self refer. That's literally all the information he gave me.

I'm in Glasgow. I did a bit of digging online and ended up here Eating Disorders - NHSGGC, which says the GP should refer me to a Community Mental Health Team.

Maybe he didn't think it was too serious. He asked my weight and height (38kg, 157 cm), if I had lost consciousness or if I ever felt weak (no, and no) and if I did much exercise (just walking the dog and walking to work).

Calling this morning was hard and I felt really positive when the receptionist I spoke to said someone would call back within an hour, but now I feel like I'm worse off than I was before. At least before I called I thought there would be some support available when I wanted it. Apparently not.

I think this is for children and young people's services. I think most adult services require GP referral, but do check OP (google "eating disorder service [your county]"

I wouldn’t expect any help. At 17 I went to the GP about my bulimia and they said there was nothing they could do as children services stopped at 16 but adult ones didn’t start until 18 so there wasn’t a suitable service to help me. About 20 years later I was referred to a psychiatrist for self harm and whilst there I also disclosed that I have been bulimic since my teens. The psychiatrist wrote to my GP to request a referral to the local eating disorder service, when I saw my GP afterwards he took one look at me and said that as I wasn’t significantly under or overweight I clearly didn’t have an eating disorder and refused to refer me to the service. I wouldn’t bother trying to seek help again and have accepted I will just have to live with this disorder.

OP, I'm wondering if the GP misheard your weight. I simply cannot fathom a GP learning a patient has a BMI of under 16 not wanting to see you straight away.
Can you ask to speak to a different GP, or the practice manager? Surely you should be seen as a matter of urgency, not bloody wait until you lose consciousness!

I am sorry this happened to you.
I have received considerable help from adult ED services. It seems that the first hurdle is getting a good GP. Do you have access to a different GP now?

I would ring back, or go in, or go for the blood test and tell the nurse in person that you can't self refer and need a GP to refer you to the CMHT.

Oh OP please try to get the blood tests... I know it's such a horrible process but your son will feel so relieved when you do. Keep updating if you can x

If phoning again feels too much OP could you contact PALS by email and tell them what has happened and what you've been told and that you don't know what to do? I've contacted them before and found them extremely helpful. Your GP sounds shite but please get the blood tests done as well if you can.

Unfortunately mental health has been decimated. Only those who really dig deep and fight tooth and nail to get well again will get help. There is no hand holding until you're ready type of service available.

Get the blood tests and take it from there. First steps .

This was not my experience. I felt very supported and listened to.

They will weigh you. Probably dependent on your weight they may offer you nutrition supplement shakes to have at home. They may also offer CBT?
I'm a bit different in that I refused to admit my ED until it was picked up in hospital when I broke my hip. By that time it was life threatening.
So I'm really pleased you're taking the brave step to admit to it and seek help.
ED services are very overstretched. There's two for the whole of London and the south east, so there will be a waiting list unless you've reached a BMI of below 13. But they may offer outpatient support.

Having been to a GP a couple of times previously about disordered eating, it's gone something like this:

• telephone conversation
• in-person appointment (including weighing - I've always refused to be told/look at the scales here)
• subsequent appointment for bloods/ECG
• referral to local eating disorder services
• follow up phone call with initial GP

I am so sorry with the position you've been put in - believe me, I know how hard it is to even attempt reaching out for help and what it feels like when you reach out and feel like you've hit a brick wall. I would encourage you to see if you can speak with another GP at the same surgery/try and research what the support in your local area is like. Sending you so much support - feel free to message if it would be helpful.

Excellent. Was that in the past couple of years? Could you walk the OP through the self refer process?

So sorry you're going through this and your GP didn't help. It sounds like there's not a direct referral path for you to the ED service in Glasgow.

Every GP surgery in the country by law has to have an econsult service (sometimes they hide it on their website but it should be there). I suggest filling in an econsult and saying you've tried to self refer but it's not possible and that your bmi is 15 and your son is worried about you. Hopefully a different (more useful!) gp will read it and action a referral and bloods ecg etc.

Sorry this is so hard. You've done great to do this first step.

I have a similar bmi and basically if you aren't losing anymore weight they just say you are stable... its insane. I'm not sure how long you have been 38kg for... did they ask?

I have been this weight 5 years now and other then a Dietitian, there hasn't been anything else. Though I note you are Scotland and I'm England, so hoping you get better help. Well done for taking the first step but unfortunately you to keep pestering for help.

I really hope the new job settles your eating / purging and you don't have to rely on the nhs- because frankly it's not great.

I didn't self refer, sorry.
The referral was through the GP in both instances. My last referral was just as Covid lockdown started, so more than a couple of years ago.

OP, I'm sorry you had this experience and they fobbed you off. But please don't give up on getting support. At the end of the day if you don't, it hurts only you. Yes the system should be better, and no it's not acceptable that they didn't refer you on straightaway, but you've got to fight for yourself because nobody else will do it for you.

I do understand where you're coming from. When I was in the depths of my ED and I found out there was a several month waiting list before I could start therapy I was almost relieved, because I could put off the uncomfortable process of having to change my behaviour. Having barriers is a convenient reason not to have to change, and it's rhetorical easy option to take to say "well I tried but they didn't help so I'll just carry on as I am." But it's your life, and you have to take responsibility for getting better. So call them back and ask for a referral.

In the mean time please consider reading some of the books and other resources suggested on this thread. There's nothing stopping you from doing that today, and starting the process yourself of getting better.

I'm somehow managing to persevere with this today. Funnily enough, I think the GP doing pretty much nothing has made me more determined to get help. Fingers crossed this mood lasts.

I've booked blood tests for the earliest available time, which is the middle of next week.

I've emailed the GP practice to ask what exactly was meant by "go to the Beat website and self refer".

The receptionist replied with a link to the Beat helpline (open from 3pm) but in the meantime I had contacted Beat by email and they responded almost immediately to say the GP should have discussed referring me to the local NHS eating disorder service (they also provided a lot of other links and suggestions for support).

So I replied to the GP receptionist to ask if a referral is an option and they have said they will pass my request to the GP.

Will wait and see what happens.