There are approximately 1 million Australians living with eating disorders, comprising approximately 25,000 with anorexia nervosa, 100,000 with bulimia nervosa, 500,000 with binge eating disorder and 350,000 with other forms of eating disorders.¹ Anorexia nervosa has one of the highest mortality rates of any mental illness, with approximately 450 deaths from anorexia nervosa every year in Australia.¹ The prevalence of eating disorders is higher among athletes, women, younger adults aged 18–29 years and transgender individuals. It is also important to understand that eating disorders in men and individuals from diverse or minority populations (eg LGBTQIA+/gender diverse, ethnic minority groups, Aboriginal and Torres Strait Islander people) are often missed and that they may face poorer outcomes due to delayed diagnosis and a lack of access to services.^2,3 Various biological, psychological, social and environmental factors, such as genetics, the presence of other mental health conditions, trauma, perfectionism, rigidity, social pressure related to appearance and childhood adversity, are associated with a higher risk of developing an eating disorder.
 
Eating disorders are serious and potentially life-threatening mental illnesses with complex aetiology that can present to primary care in myriad ways. Patients will more often present with an eating disorder than for an eating disorder, and, as such, GPs with their skilled generalist approach are ideally placed with curious questioning to provide a safe space for patients to explore help seeking at any stage.⁴
 
There is an opportunity to improve the detection and management of eating disorders in Australian primary care settings, particularly when patients present for ‘other’ issues or with unexplained low body mass index (BMI) and one or more symptoms related to an eating disorder.⁵
 
Although the evidence for screening is insufficient,⁴ implementing opportunistic case finding in high-risk groups is likely to improve access to early intervention, accurate diagnosis and treatment, which will improve outcomes for individuals and the community.²

Screening for eating disorders has the potential to improve health outcomes, such as quality of life or function, if it leads to early detection and effective treatment. However, the current evidence on whether screening improves health outcomes is unclear.⁶ 

GPs can also implement sensitive weighing practices at every opportunity, being mindful of the Academy of Eating Disorder position statement on preventing Childhood Obesity,⁹ which states:

Weighing [children] should only be performed when there is a clear and compelling need for the information. The height and weight of a child should be measured in a sensitive, straightforward and friendly manner, in a private setting. Height and weight should be recorded without remark.

Refer to the Preventive activities in childhood chapter for information on measuring the height and weight of a child. Further, BMI assessment should be considered just one part of an overall health evaluation and not as the single marker of a child’s health status.

There are no specific recommendations or advice for Aboriginal and Torres Strait Islander people.

It is important to understand that men and individuals from diverse or minority populations (eg LGBTIQA+/gender diverse, ethnic minority groups) with eating disorders are often missed and may face poorer outcomes due to delayed diagnosis and a lack of access to services.²

Eating disorders: A professional resource for general practitioners | National Eating Disorders Collaboration
Weighing an individual with an eating disorder | Inside Out Institute for Eating Disorders
Weekly weighing | Centre for Clinical Interventions