Introduction
This guideline relates to eating disorders (ED) in paediatric patients.
For more information please visit: Adolescent
Medicine:Eating Disorders Service
Before you refer directly to our service:
Public care model involves integrated medical care and mental health
care. Regular appointments are often needed and sometimes admissions to
hospital. This is why public care for those with an eating disorder is provided
locally and based on the mental health service that looks after the region
where the patient lives. Services are regionalised to ‘catchment areas’. The
State Government mental health services website provides contact details for
Victoria’s regionalised mental health services. Use this tool to find the
public mental health service for the patient’s residential area (search by
suburb or postcode).
The Royal Children's Hospital (RCH) Eating Disorder Service is specifically for adolescents and
their families living in the North Western Metropolitan Region. Please note
that referrals for patients living outside of this region will likely be
redirected or rejected and referred to the appropriate local mental health
service.
When to refer
- Patients <17.5 years of age
- Patients with:
- Anorexia nervosa
- Atypical anorexia nervosa
- Avoidant restrictive food intake disorders in
young people >12 years
- Other restrictive eating problems
If any of the following are present or
suspected, please direct the patient to the Emergency Department (no referral
required):
- Resting HR ≤ 50bpm
- Postural systolic drop ≥ 20mmHg
- Hypoglycaemia BSL < 4.0
- Significant electrolyte disturbance (K
< 3.0)
- Hypothermia <35.5C
- Clinical dehydration
- No oral intake for >48 hours
- Arrhythmia or prolonged QTc >0.45s
Wait time for appointments
Specialist Clinic wait times
Services available closer to home
For alternative paediatric services available in
Victoria please see:
Accessing Mental Health services
Referral
criteria/required information
- Detailed history and
assessment, including:
Please note: patients without evidence of
weight loss, or other significant physical health impacts, are likely to not
require tertiary level eating disorder services.
- Growth charts,
including current weight, height and BMI
- Observations including temperature, lying and
standing HR and BP (at base, 1 mins and 5 mins post standing)
- Blood tests:
- B12
- Calcium, magnesium, phosphate (CMP)
- Coeliac serology
- Electrolytes, urea, creatinine (EUC)
- Erythrocyte sedimentation rate (ESR)
- Full blood count (FBC)
- Glucose
- Iron studies
- Liver function test (LFT)
- Red cell folate
- Thyroid function
- Venous blood gas (VBG)
- Vitamin D
- 12-lead ECG
- Care team in the community (e.g.
paediatrician, dietician, psychologist)
How to refer
Eating Disorder Service Referral Form and
Specialist Clinics Referral
Please complete the above and submit via:
Facsimile (03) 9345 5034 or
Email screferrals@rch.org.au
Urgent referral or clinical query:Call RCH on (03) 93455522 and as to speak to the Emergency Department or Adolescent Medicine on-call or RCH Eating Disorders CNC on (03)93456533
Resources and links
Acknowledgements
The development of this guideline was coordinated by the Department of Adolescent Medicine (Dr Claire May). Guideline reviewed in August 2025