Going to the doctor

We’ve put together a resource for anyone visiting the GP for the first time – this is intended to help you get a referral for specialist assessment, and you can download it from our information library. Before you visit the GP, you might find it helpful to write down questions you want to ask, the symptoms you’ve experienced, or any behaviour that you’re worried about, so that you won’t feel put on the spot during the appointment. A family member or friend could also do this for you, or you may want to bring them along with you so that they can support you.

Your first appointment may involve talking with them about your eating habits, being weighed and having a blood test so that they can check your physical health. Try not to worry about this; they need to weigh you to monitor your health and to decide what type of treatment is best for you. If you don’t want to know your weight, you can ask to stand backwards on the scales and for them not to tell you the result.

According to guidelines from the National Institute for Health and Care Excellence, your GP shouldn’t only focus on physical measures to assess whether you have an eating disorder, but take into account a wide range of both physical and mental factors. They should also consider the concerns of friends or family members. Our “First Steps” leaflet explains this further, and contains a section for the GP that should help them give you the best quality care.

If the doctor feels after their initial assessment that you have an eating disorder, they should immediately refer you to a specialist for further assessment or treatment.

You may feel very nervous or fearful about seeing the doctor. There are some things that can help people feel more confident about talking to your GP:

• Our “First Steps” leaflet is specially designed to help you prepare for a GP appointment. You can take it with you to refer to it throughout the appointment, and use it to help you get a referral to a specialist.
• It may be that there is a doctor who has a special interest in mental health at your surgery. Perhaps you could ask the receptionist or check the surgery's website if they have one. There may also be a nurse practitioner at your surgery who you could talk to as a first step.
• Perhaps there is someone, such as a friend, who could recommend someone they have seen before or you know a doctor at your surgery who you felt listened to you and was supportive when you have seen them before.
• You might feel more comfortable taking along a friend or family member for support. They could sit in the waiting room with you or come into the appointment, either to provide support or to help you explain to the doctor what is happening. You might prefer to go on your own. The important thing is to decide what is right for you.
• If after speaking to someone, you have not felt heard or supported, do not be afraid to ask to see a different doctor. Finding the right doctor can make a huge difference.
• Perhaps you could write the doctor a letter or take along some bullet points. Here are some things you might want to include: 
  • When you think your eating difficulties first started.
  • Your thoughts, feelings and behaviours around food.
  • The physical and emotional impact of your eating difficulties, including how it impacts you on a day-to-day basis, for example in social situations or in terms of your relationships.
  • How you have been feeling more generally.
• It may be that there are things worrying you about seeing the doctor. For example, you may be worried about confidentiality. It is okay to go and talk through any concerns you have before speaking to them about your eating difficulties.
• It may help to book a double appointment to give you a bit more time to talk about things.   
• If you have seen the doctor and come away with additional questions or feel that there are other things you would like the doctor to know, don’t be afraid to go back. It can take time to feel comfortable with the doctor.
• In addition to our “First Steps” leaflet, the DocReady web app can be a useful tool in preparing to talk to a doctor. It has information on going to the doctor, as well as a checklist builder that you can print out to take with you.

Remember you can ask to see a second GP if you don’t get a good outcome from your appointment with your first one. If you feel the need, you can also change your doctor.

You can change your doctor within the practice you usually attend, or you can change your surgery. If the surgery you wish to change to is accepting new patients, you can call them and ask to fill out a registration form. To find out the contact details of medical practices in your area you can search for services on the NHS Choices website.

If seeing a GP is not the best route for you, there are other ways to access treatment. Our HelpFinder pages list private clinics as well as counsellors and therapists.

The first doctor I saw didn't understand eating disorders very well and was insensitive about my illness. I'm so glad I changed to a new GP who treated me as a person, not a statistic.

Your doctor should refer you to specialist treatment immediately if they suspect you have an eating disorder, although they may still be involved in the coordination of your care. If your doctor is not able to find the specialist treatment you need in your area, you can ask them to find out about specialist treatment out of your area and if you can be referred for this treatment.

There is often a waiting list for these services and it can take a few weeks to get a letter telling you when your first appointment will be. The letter should tell you everything you need to know, such as the name of the specialist you will be seeing, how to get to your appointment and the date and time of your appointment. It is important that you seek and can access treatment as soon as possible.

Whilst you are waiting for your appointment, you should still be able to see your GP regularly so that they can monitor how you are doing. If they don’t offer you further appointments, ask them or arrange to see a different GP.

The kind of treatment you get should take into account your personal needs and preferences, and address the psychological aspects of your eating disorder as well as any physical complications. Treatment is individual – what works really well for one person may not work for another. If you don’t feel that the treatment you’ve been offered is working, be sure to let your healthcare team know so that they can look at different options. The NICE guideline for eating disorders gives more information about what kinds of treatment might be offered for each type of eating disorder.

It felt so scary to go to a psychiatrist to begin with, but gradually I began to really appreciate having someone who understood eating disorders and could help.

Most people who are diagnosed with an eating disorder receive treatment within primary or secondary care.

If your eating disorder requires more help than secondary care can offer, you may be referred to a specialist setting such as a hospital, eating disorders unit or mental health unit. They will assess your needs and develop an individual care plan for you. You might access this care as an inpatient, day patient or outpatient. This level of care is tertiary care.

As a day patient, you will attend the hospital during the day (e.g. 8am-4pm on weekdays) but not stay overnight (you might stay some weekends and the occasional night). While you are in hospital you will have supported meals and snacks, therapy sessions and group activities.

Most people go to the hospital daily for three to six months of treatment before moving back to outpatient support. If your health deteriorates while you are a day patient the team may ask you to come and stay as an inpatient.

I was so scared when I went into hospital, but I soon realised that everyone there just wanted to see me get better – they believed in me, so I was able to believe in myself.

Being in inpatient care means that you would be staying in the hospital all the time during the day and overnight to receive intensive treatment. This would include supported meals and snacks, therapy sessions, nutrition education, art/music therapies and much more. When you arrive, staff should inform you of the rules and ways of working of that hospital. Visitors may come to see you at certain times. If you are well enough and under 17 then you will have school at hospital or work sent from your own school. You can also personalise the room you stay in by bringing some of your own belongings from home.

…things did improve, as all the staff and other young people were so supportive. While I thought originally that it was going to make things worse, I can now recognise that I couldn't have got to where I am now without the help I received as an inpatient.

Your health will be assessed during your stay. This will determine how long your stay is. Sometimes someone who has been an inpatient will spend some time as a day patient for before being discharged; this depends on the patient, the unit and the options available.

The support from nurses, doctors, dietitians, psychiatrists, occupational therapists, psychologist etc. is phenomenal. Their determination to make me better helped me struggle through the hardest times, they may seem evil at the time but looking back they truly saved my life.