{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:16:31Z","timestamp":1791497791331,"version":"4.3.4"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec id=\"S2056472426110060_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The treatment of eating disorders by the National Health Service in England and Wales adheres to the National Institute for Health and Care Excellence (NICE) guidelines, which were informed by an experimental evidence base.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110060_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>As the presentation and treatment of eating disorders have been shown to vary on the basis of age, we aimed to review the representation of older people in the evidence base for the NICE guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110060_as3\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The evidence base was reviewed by identification of participant ages and the recruitment methods used in the experimental literature. The use of clinician referral was of particular interest, owing to the age-dependent risk of eating disorders being misdiagnosed in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110060_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results highlighted low participant ages across the evidence base, most notably in anorexia nervosa samples. In accordance with the age data, a high frequency of clinician referral was used to recruit participants, with the highest rate identified in anorexia nervosa samples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S2056472426110060_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>NICE guidance fails to consider the economic, social, political and health contexts around onset or chronological development of an eating disorder, with no reference to comorbidities which are commonly reported with older people or how this might affect diagnosis, formulation and treatment recommendations. Research is urgently required to inform clinical recommendations for older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjo.2026.11006","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:13:01Z","timestamp":1777435981000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["NICE guidance, eating disorders and older people"],"prefix":"10.1192","volume":"12","author":[{"given":"Suzanne","family":"Heywood-Everett","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yzcrs31","id-type":"ROR","asserted-by":"publisher"}],"name":"Bradford District Care NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louisa J.","family":"Shirley","sequence":"additional","affiliation":[{"name":"University of Manchester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Aqsa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yzcrs31","id-type":"ROR","asserted-by":"publisher"}],"name":"Bradford District Care NHS Foundation Trust"},{"name":"University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Fitzgerald","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yzcrs31","id-type":"ROR","asserted-by":"publisher"}],"name":"Bradford District Care NHS Foundation Trust"},{"name":"University of Leeds"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0395-8823","authenticated-orcid":false,"given":"Ryan","family":"Horsfall","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03yzcrs31","id-type":"ROR","asserted-by":"publisher"}],"name":"Bradford District Care NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"S2056472426110060_ref20","volume-title":"ICD-11 Revision","year":"2023"},{"key":"S2056472426110060_ref26","doi-asserted-by":"publisher","DOI":"10.3390\/nu8020069"},{"key":"S2056472426110060_ref2","doi-asserted-by":"publisher","DOI":"10.1002\/erv.2745"},{"key":"S2056472426110060_ref23","unstructured":"23 National Health Service. The NHS Long Term Plan. NHS, 2019 (https:\/\/www.longtermplan.nhs.uk\/wp-content\/uploads\/2019\/08\/nhs-long-term-plan-version-1.2.pdf)."},{"key":"S2056472426110060_ref40","volume-title":"A Framework for Good Practice in Delivering Support to Adults and Older Adults with Avoidant and Restrictive Food Intake Disorder (ARFID)","year":"2023"},{"key":"S2056472426110060_ref30","unstructured":"30 National Institute for Health and Care Excellence. Principles for Best Practice in Clinical Audit . NICE, 2002 (https:\/\/www.nice.org.uk\/media\/default\/About\/what-we-do\/Into-practice\/principles-for-best-practice-in-clinical-audit.pdf)."},{"key":"S2056472426110060_ref10","unstructured":"10 NHS England. Adult Psychiatric Morbidity in England \u2013 2007, Results of a Household Survey. NHS England, 2007 (https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/adult-psychiatric-morbidity-survey\/adult-psychiatric-morbidity-in-england-2007-results-of-a-household-survey)."},{"key":"S2056472426110060_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-023-02296-z"},{"key":"S2056472426110060_ref16","first-page":"48","article-title":"Eating disorders in late-life","volume":"6","author":"Luca","year":"2015","journal-title":"Aging Dis"},{"key":"S2056472426110060_ref27","doi-asserted-by":"publisher","DOI":"10.1192\/apt.bp.116.016568"},{"key":"S2056472426110060_ref33","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-025-01202-4"},{"key":"S2056472426110060_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000893"},{"key":"S2056472426110060_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2012.04.037"},{"key":"S2056472426110060_ref3","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-2433-8"},{"key":"S2056472426110060_ref19","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"S2056472426110060_ref28","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16875"},{"key":"S2056472426110060_ref24","unstructured":"24 Royal College of Psychiatrists. Rolling out the Community Mental Health Framework: 2021\/2022 Planning. Royal College of Psychiatrists, 2021 (https:\/\/www.rcpsych.ac.uk\/docs\/default-source\/improving-care\/better-mh-policy\/cmhf-key-messages-2021-22.pdf?sfvrsn=cca9a6bd_2)."},{"key":"S2056472426110060_ref31","doi-asserted-by":"publisher","DOI":"10.1017\/ipm.2015.24"},{"key":"S2056472426110060_ref29","doi-asserted-by":"publisher","DOI":"10.2196\/38015"},{"key":"S2056472426110060_ref32","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.2871"},{"key":"S2056472426110060_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2019.05.012"},{"key":"S2056472426110060_ref18","unstructured":"18 National Institute for Health and Care Excellence. Eating Disorders: Recognition and Treatment . NICE, 2017 (http:\/\/www.nice.org.uk\/guidance\/ng69)."},{"key":"S2056472426110060_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30059-3"},{"key":"S2056472426110060_ref25","doi-asserted-by":"publisher","DOI":"10.1186\/s40337-015-0065-z"},{"key":"S2056472426110060_ref7","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22030"},{"key":"S2056472426110060_ref17","doi-asserted-by":"publisher","DOI":"10.7748\/nop.2022.e1399"},{"key":"S2056472426110060_ref36","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000641"},{"key":"S2056472426110060_ref37","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24302"},{"key":"S2056472426110060_ref9","unstructured":"9 NHS England. Health Survey for England 2019. NHS England, 2019 (https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/health-survey-for-england\/2019)."},{"key":"S2056472426110060_ref21","doi-asserted-by":"publisher","DOI":"10.1080\/10640260590932841"},{"key":"S2056472426110060_ref34","first-page":"193","article-title":"Never too old for eating disorders or body dissatisfaction: a community study of elderly women","volume":"40","author":"Mangweth-Matzek","year":"2006","journal-title":"Int J Eat Disord"},{"key":"S2056472426110060_ref35","unstructured":"35 Royal College of Psychiatrists. Position Statement on Early Intervention for Eating Disorders. Royal College of Psychiatrists, 2019 (https:\/\/www.rcpsych.ac.uk\/docs\/default-source\/improving-care\/better-mh-policy\/position-statements\/ps03_19.pdf?sfvrsn=b1283556_2)."},{"key":"S2056472426110060_ref15","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01823-1"},{"key":"S2056472426110060_ref1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2019.153"},{"key":"S2056472426110060_ref6","doi-asserted-by":"publisher","DOI":"10.3200\/GENP.135.4.343-358"},{"key":"S2056472426110060_ref38","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22373"},{"key":"S2056472426110060_ref22","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(97)00267-5"},{"key":"S2056472426110060_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-81174-7_4"},{"key":"S2056472426110060_ref39","doi-asserted-by":"publisher","DOI":"10.1002\/gps.5618"},{"key":"S2056472426110060_ref5","doi-asserted-by":"publisher","DOI":"10.1017\/S1041610210000104"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472426110060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:13:19Z","timestamp":1777435999000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472426110060\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,29]]},"references-count":40,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["S2056472426110060"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2026.11006","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,29]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e123"}}