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Care and mobility considerations

Function is usually well preserved in people with Anorexia Nervosa (AN) and Bulimia Nervosa (BN). If the disorders are mixed e.g. AN and BN, the symptoms tend to be worse. If there is comorbidity with diabetes medical risks are exponentially increased.

Functioning may be very impaired in the presence of severe OCD symptoms and may potentially make a mild or moderate condition more severe. Females who are pregnant or care for infants may need extra assistance. Driving is not recommended for people with a BMI <15 as concentration and attention may be impaired.

In AN most people are physically capable of feeding themselves, but they may require prompting to do so. If the person’s weight loss becomes extreme and they become severely ill, they require intensive attention to feeding and maintaining normal body chemistry. Such people will usually be admitted to hospital. People with AN, unless weight loss is extreme, would not normally be expected to have any mobility needs.

In BN because weight loss is usually absent, care needs are likely to be significantly less than for AN

Mild Functional Restriction

Category Description

Effects

People with a mild functional restriction are likely to:

  • Not be receiving psychiatric care or supervision
  • Be at low physical risk (See Annex 1)

Mobility

They would normally have no physical difficulty in getting around.

They should not have difficulty finding their way around unfamiliar places and should not require guidance.

Care

They should not normally exhibit significant self-neglect.

They should not normally have any significant functional loss that will result in a reduction of their ability to carry out normal day-to-day activities.

Moderate Functional Restriction

Category Description

Effects

People with a moderate functional restriction are likely to:

Mobility

They would normally have no difficulty walking several hundred metres.

They should not have difficulty finding their way around unfamiliar places and should not require guidance.

Care

They may require encouragement to eat and plan and prepare a meal.

They should not normally have any significant functional loss that will result in a reduction of their ability to carry out normal day-to-day activities.

Severe Functional Restriction

Category Description

Effects

People with a severe functional restriction:

  • Are likely to be at severe physical risk (See Annex 1)
  • May have severe OCD symptoms (see separate guidance) or co-morbid medical conditions, for example, diabetes
  • May be at high risk of self harm

Mobility

Walking distance may be severely restricted due to muscular weakness secondary to dehydration and salt imbalance. Salt imbalance may also cause muscle spasms, fits and faints. Renal failure may occur in severe cases. The distance that they are able to walk will be determined by the degree of muscular weakness which will vary from person to person.

They should not have difficulty finding their way around unfamiliar places and should not require guidance.

Care

They are likely to require encouragement to eat and plan and prepare a meal.

They are likely to have a significant functional loss that will result in a reduction of their ability to carry out normal day-to-day activities.

They are likely to require observation to stop compensatory behaviours, for example exercise or vomiting.

Amended June 2008