When should I consider referring a patient with anorexia nervosa to specialist mental health services?

Refer a patient with suspected anorexia nervosa immediately to a community-based, age-appropriate eating disorder service for assessment and management, without using a watchful waiting strategy ¹.

Consider referral urgently if the patient is at risk of serious physical complications, such as severely compromised physical health, electrolyte imbalance, or rapid weight loss exceeding 1kg per week ².

Refer if there is evidence of acute mental health risk, such as risk of suicide or serious self-harm, or if the patient has a lack of support at home that impedes recovery ².

In cases where physical health is severely compromised or the patient cannot be safely managed in outpatient settings, urgent referral to specialist services is indicated ².

Additionally, consider referral if the patient presents with complications like malnutrition, endocrine disturbances, or physical signs of deterioration, or if they are involved in activities at high risk of eating disorders (e.g., professional sport, dance) ¹.