The National Institute of Clinical Excellence (NICE) have recently proposed new guidance on the "recognition and treatment of eating disorders". Part of this proposal allows for consultations and feedback from clinicians and other concerning bodies before it is finalised and then made public in May this year. SEDIG took the opportunity to discuss the proposed changes and offered a response. You can read this below.
“The Scottish Eating Disorder Interest Group welcome a number of recommendations in the draft NICE guideline for eating disorders, particularly the clear consideration of the role of carers and family and advice pertaining to the full range of eating disorder presentations. However, we would like to note some concerns regarding any clinical guidance or recommendations which are predominantly based around one therapeutic modality e.g. CBT.
SEDIG is strongly in favour of evidence based practice, but also the need for treatment choice for service users instead of a one size fits all approach. While we acknowledge the need for more research into stepped care models, this will take a number of years to develop. Clinicians, commissioners and service users need support and guidance for alternative or secondary therapeutic modalities based on the current evidence base. Such advice has been present in previous NICE guidance e.g. highlighting psychological therapies such as IPT-BN where equivalent levels of remission to CBT were met at longer term follow up. We would welcome such guidance from the expert group to support clinicians, service users and their families, in making informed decisions.
Furthermore, while we welcome the use of robust systematic review methodology, we are unclear why some methodological information was unable to be obtained as part of the risk of bias ratings, when the authors of some of these studies were an active part of the expert group. Taking into account the poor research quality across the board, we would have thought that clarification of this information would have been sought to support a more robust risk of bias assessment”
Dr Fiona Duffy, Chair of SEDIG
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