Portsmouth CAMHS Specialist Eating Disorder Service

We offer specialist treatment for young people with a diagnosed eating disorder. This may be anorexia, bulimia, binge eating disorder or other specified feeding disorder.

Self Referrals can be made from young people themselves, parents/carers or professionals using the forms below:

Referral Form for Young People (form opened in a new window)

Referral Form for Parents/Carers (form opened in a new window)

Referral Form for Professionals (form opened in a new window)

We are a multi-disciplinary team including a Child and Adolescent Psychiatrist, Systemic Family therapist, Clinical Psychologist, Eating Disorder Practitioner, Family Support worker and Business administrator. We are a small team who work closely together to ensure that children and young people within our service receive the most appropriate care for their eating disorder. We are developing links with paediatric teams to ensure young people at high physical risk have their needs assessed and met.

How quickly are people seen:

The Access and Waiting Time Standards for Children and Young People with an Eating Disorder was published in 2015 and states that 95% of those referred for assessment or treatment for an eating disorder should receive evidence-based treatment within one week in urgent cases, and four weeks in routine/non urgent cases. Our ability to meet this standard as a service is regularly monitored and we are currently meeting it.

Assessment:

Once referred, a member of our team will first call to gather more information, assess level, or risk and work out if we are the right team to offer assessment. If we are not, then recommendations and signposting will be given to the family.

If we do offer an assessment this will take place on a Thursday morning at Falcon House, St James Hospital. This is a comprehensive assessment that will last 3 hours including an hour break in the middle. The assessment will be conducted by 2 members of the team and the young person and parent/carer will be offered individual time during the assessment.

During the 1-hour break, our multidisciplinary team will meet to discuss the assessment, diagnosis, and formulate a plan. This will then be fed back to the family immediately after the break.

During the assessment you will be asked several questions across a range of different areas including current and historical eating and drinking patterns, compensatory behaviours (such as restriction, exercise, and/or purging) and shape / weight concerns. We will also ask questions about your social situation and wider physical and mental health difficulties. We appreciate for some people this may be the first time you have spoken about these issues with anybody and understand this can be a difficult and emotional process. The information you share will help us to consider the most appropriate treatment pathway for you.

We will also carry out some physical monitoring during your assessment. This will include weight and height measurement, blood pressure and temperature check.

Treatment

After a comprehensive assessment that includes screening for neurodevelopmental factors, we offer NICE (National Institute for Health and Care Excellence) concordant treatments.

There is a range of treatments which can include:

Family Based Therapy:

This has the best evidence base for treating young people with eating disorders. It requires the whole family to attend weekly sessions where the family are supported and empowered to help the young person recover from their eating disorder.

Enhanced Family Support:

This includes medical management where physical observations are done weekly with our family support worker. Home visits can be offered to understand what happens around mealtimes. Psychoeducation and nutritional advice are given, and the aim is re-establishing regular eating and weight restoration.

Cognitive Behavioural Therapy (CBT):

CBT is a structured treatment that helps explore thoughts, feelings, and behaviours that the individual wants to change.

Adolescent Focused Therapy (AFT):

Individual therapy that focuses on identifying, tolerating, and managing emotions as well as developing strategies to deal with the tasks of adolescence.

Parent/Carers Support Group:

Aim of this group is to give parents/carers a space to share their experiences and learn from one another.

Multidisciplinary Review:

All care plans and interventions are regularly reviewed by our whole team and under the over-arching supervision of the team’s Consultant Psychiatrist.

Any questions? Contact us:

For Young People, Parents & Carers:

Telephone: 0300 123 6632
Email: CAMHSEastEatingDisorders@solent.nhs.uk

How to tell if your child is developing an eating disorder?

As a parent or a friend, you may notice that an individual is losing weight. However, an eating disorder can be hard to spot – the majority of those with eating disorders are either normal weight, or overweight. Eating disorders can often go unnoticed for a long period – symptoms can be easy to hide and are frequently associated with secrecy and shame. An eating disorder is a serious illness which can affect males and females of any ethnicity or weight.

All young people are growing, so it is crucial that they eat regular nourishing meals to give them energy. If they are also doing a lot of activity, they will need to eat more to keep up with their energy needs.

When and how to get help?

It can be hard to know when to ask your GP or school nurse for help – maybe you worry you’d be wasting their time, or it would mean admitting that there is a problem. However, people are more likely to get better if they ask for help early so don’t hesitate to ask for help if you’re worried: eating disorders are serious illnesses and can be life-threatening.

General practitioners (GPs) are a good first step to accessing specialist support. For children at school, you (or they) could also approach the school nurse for help. GPs and school nurses can use our consultation sessions to seek advice from our team. Our service is also open to self-referrals from parents/carers, young people, and professionals. More information on making a self-referral further down.

The guidance below details what to look out for and what steps to take to get help:

Early Warning Signs and When to Seek Help

Early Warning Signs

Many young people go through phases of erratic eating or not eating enough during childhood and adolescence. If this is short term and has not started to impact on physical health or daily functioning (e.g. going to school, seeing friends, engaging in hobbies) then this can be managed with clear boundaries alongside love and support from parents/carers.

It is important that early warning signs are picked up by family as they could increase the risk of developing an eating disorder. Things to look out for are:

Wanting to ‘eat more healthily’ or ‘clean eating’.
Wanting to be more active or go to the gym.
Talking about body dissatisfaction or worrying about the way they look
Fussy eating – only eating certain foods.
Wanting to be more involved in the preparation of food and meals.
Checking food labels or packets and talking about calories.
Feeling anxious about eating in front of others.

What to do next:

Insist upon the young person eating breakfast, lunch, and dinner plus snacks. This is important for all young people.
Encourage a balanced lifestyle that does not exclude any food groups and model that it is ok to have treats and snacks.
Ensure young people are well hydrated – aim for 6-8 glasses per day (water, squash, milk)
Be active with your young person so you can monitor and ensure that they are not excessively exercising.
If you are concerned about your child’s eating:

See your GP and ask for physical observations to be done (height, weight, blood pressure, pulse)
Inform your child’s school to share concerns.

Monitor the use of apps such as ‘Myfitness pal’ and smart watches that calculate calories and step count.
Monitor the use of social media to ensure not looking at unhelpful accounts.

Seeking Help:

It is important to seek help if the young person experiencing eating difficulties starts becoming noticeably distressed or if there is any impact on their ability to cope with everyday life such as school, seeing friends or taking part in hobbies. These difficulties will have been going on for a few weeks. The family may also have noticed more arguments or disagreements around food, exercise, or suspected vomiting. There may also be noticeable difficulties around food or changes in weight.

What you might notice:

A desire and conscious effort to lose weight or control weight/shape through:

Restricting food intake
Increasing exercise
Purging
Taking laxatives

OR

Eating excessive amounts of food, binging, or feeling guilty after eating.

Other signs:

Getting upset or distressed after eating.
Dissatisfaction about the way they look.
Becoming more irritable or withdrawn, particularly around food or exercise.
Noticeably more emotional or sensitive.
More arguments around food/mealtimes.
Preoccupation around food (e.g counting calories, looking at food labels).
Physical compromise e.g. gradual weight loss, tired, difficulties concentrating, feeling cold.
May avoid social situations and seeing friends.
Isolating self and avoiding eating in front of others.

What to do next:

Continue to follow the advice in the above section.
Seek advice and consultation from the Specialist Eating Disorder Team: 0300 123 6632 or CAMHSEastEatingDisorders@solent.nhs.uk
Support young person during mealtimes.
Share concerns with school/college.
Seek pastoral support from school.
See your GP and ask for physical observations to be done (height, weight, blood pressure, pulse, blood test). This must be completed before self-referral.
Complete our online self-referral form.

Urgent Response and When to seek Specialist Help

This is required when difficulties are causing a significant impact on a young person and their physical health is at risk. The difficulties may have had a sudden onset or may have been gradually deteriorating over a period of time.

If experiencing any of the following symptoms, seek immediate medical advice:

Sudden or rapid weight loss
Fainting/dizziness
Refusing food and fluid for more than 24 hours
Chest pains
Vomiting daily

Other things to look out for:

Significant restriction of food leading to rapid weight loss (the young person does not necessarily need to be underweight – it is the speed at which weight is lost that is concerning).
Avoiding eating in front of anyone else. Saying things like ‘I have already eaten’, ‘I am not hungry’, or ‘I don’t feel well’.
Unusual behaviours around food – pushing food around the plate, eating very slowly.
Hiding or throwing food away.
Secrecy around food.
Physical Symptoms such as dizziness, constipation, feeling cold, stomach pains, lightheaded.
Frequent trips to the bathroom after meals
For girls: periods may have stopped)
Preoccupation with body and checking themselves in the mirror.
Wearing baggy clothing
More argumentative particularly around food and mealtimes.
More emotional, irritable, and sensitive.
More withdrawn and isolating self.

What to do next:

Make a referral to our specialist eating disorder team using self-referral form (link below) or ask GP/school nurse to make a referral.
Continue to follow all the advice given in the sections above.
Ensure physical observations have been completed by the GP (height, weight, blood pressure, request a blood test).
Seek immediate medical advice if experiencing any of the emergency symptoms in red bold above.