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Severe and enduring eating disorders: recognition and management

  • Paul Robinson

Summary

Patients with severe and enduring eating disorders (SEED) may constitute a specific group. It is proposed that patients with anorexia nervosa (SEED-AN) or bulimia nervosa (SEED-BN) that requires the regular attention of a multidisciplinary team and is of a duration known to have a low recovery rate should be included in the SEED group. These patients present with a combination of severe symptoms and long-term illness, and may experience serious chronic physical sequelae (e.g. osteoporosis and renal failure), marked social isolation and stigma. Their carers suffer from the stress of caring for them over a prolonged period. Symptoms, treatment and crisis management of SEED-AN are discussed. SEED is a relatively recently described area of eating disorders psychiatry that requires research and service development so that patients and carers are helped to cope with very serious chronic, but not incurable, conditions.

Learning Objectives

  1. Understand the definition of SEED-AN and SEED-BN.
  2. Be able to assess the physical and psychological state of patients with SEED-AN and SEED-BN.
  3. Be able to plan the monitoring and treatment of patients with SEED, involving their carers and families.

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Copyright

Corresponding author

Dr Paul Robinson, Barnet, Enfield and Haringey Mental Health NHS Trust, St Ann's Hospital, Block H, St Ann's Road, London N15 3TH, UK. Email: p.robinson@ucl.ac.uk

Footnotes

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For a commentary on this article, see pp. 402–404, this issue.

a.

All of the case vignettes in this article are fictitious accounts based on real cases.

Declaration of Interest

None.

Footnotes

References

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Severe and enduring eating disorders: recognition and management

  • Paul Robinson
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