Junior Marsipan: Management of Really Sick Patients Under 18 with Anorexia Nervosa

The Junior MARSIPAN working group was formed to develop guidelines for young people with anorexia nervosa to complement the report from the MARSIPAN group (CR162. MARSIPAN: Management of Really Sick Patients with Anorexia Nervosa) which addresses the care of adult in-patients with anorexia nervosa.

The rationale for a separate document is that the definition of very sick patients with anorexia nervosa differs in young people, because serious underweight varies with age and gender; other aspects of risk differ in young people (e.g. blood pressure norms); consent and capacity are addressed within different legal frameworks for young people than adults; there are differences in service organisation for specialist child and adolescent mental health services (CAMHS); and paediatric services have a central role in the care of young people.

The Junior MARSIPAN report provides guidance and recommendations on:

  • Risk assessment, physical examination and associated action.
  • Location of care and transition between services.
  • Compulsory treatment.
  • Paediatric admission and local protocols.
  • Management of re-feeding.
  • Management of compensatory behaviours associated with an eating disorder in a paediatric setting.
  • Management in primary care and paediatric out-patient settings.
  • Discharge from paediatric settings.
  • Management in specialist CAMHS in-patient settings.

View the full report: