HEALTH experts say a specialist service is needed for the effective treatment of eating disorders.
A national survey published last week by the Eating Disorders Association (EDA), during its Eating Disorders Awareness Week, revealed GPs are struggling to meet treatment guidelines set by the National Institute of Clinical Excellence (NICE).
The Association says eating disorders are responsible for the highest number of deaths from psychiatric illness and 55% of sufferers are not treated by a specialist.
According to Nikki Louw, community dietician for the North East Wales NHS Trust, treatment for conditions such as anorexia nervosa and bulimia nervosa is dealt with through a fragmented method, as it is in many other parts of the UK, where patients are referred to departments which do not necessarily work together.
She said she hopes to see future investment in eating-disorder services become a priority in North East Wales.
'It's a big problem and we are struggling to meet the guidelines set by NICE, but we just don't have the funding,' she said. 'We are lacking a local, co-ordinated and multi-disciplinary approach.
'We try to work alongside the NICE guidelines, that most people with eating disorders should be managed on an out-patient basis, with psychological treatment and assessment of the physical risks of those with eating disorders.
'However, because of the lack of a local co-ordinated approach, we are having difficulties meeting these guidelines.'
She added: 'My job is to try to improve nutritional status and offer some kind of counselling and behavioural therapy parallel to that.
'Ideally I'd like psychological input working alongside me. Although we do have consultant psychologists and psychiatrists at the Wrexham Maelor Hospital working with eating disorder patients, we lack a multi-disciplinary team.
'I would like an eating disorder centre with a consultant psychologist, specialist dietician, specialist nurse and other relevant support networks working together as a team.
'At the moment all these people are around but we cannot get the service working together.
Nikki says she has noticed an increase in eating disorders in North East Wales.
'Eating disorders are not as specific to females as we first thought and they are developing in younger age groups,' she said. 'This could be down to factors such as family breakdown and school bullying.
'Modern society and the influence of images in the media can also put pressure on people to think they have to fit into a perfect image.
'In the long term I think, if eating disorders aren't treated appropriately and thoroughly, the chance of a relapse in the patient is high.
'The closest in-patient specialist unit for eating disorders is in Cheadle, near Manchester, which can provide the necessary re-feeding and psycho-social interventions.
'They have very limited spaces and strict admission criteria because they can't open the floodgates.'
Nikki says people should be careful not to criticise GPs.
'Eating disorders are very complex and difficult to diagnose in a 10-minute appointment,' she said.
'My eating-disorder patients get 45-minute appointments. I think the key with eating disorders is early detection and early diagnosis. This is where we need training for school nurses.'
A spokesman for the Welsh Assembly said eating disorders are among issues being addressed in the overall mental health policy of the Assembly.
'Services for people with eating disorders aren't just about providing specialist services,' he said.
'People with eating disorders are treated and cared for in a range of settings, primary care, general hospitals, children's wards, psychiatric hospitals, community and so on.
'We take very seriously any concerns about NICE guidelines not being met.
'As part of our inspection process, we require evidence of compliance with NICE guidelines from all Local Health Boards and Trusts.'