The Management of Really Sick Patients with Anorexia Nervosa (MARSIPAN) working group arose out of concerns that a number of patients with severe anorexia nervosa were being admitted to general medical units and sometimes deteriorating and dying on those units because of psychiatric problems, such as non-adherence to nutritional treatment, and medical complications, such as re-feeding syndrome. Sometimes overzealous application of NICE guidelines led to death from underfeeding syndrome. It seems there are also worrying variations in practice.
This report aims to clarify the situation and provides recommendations and unambiguous guidelines on the management of this patient group in a number of settings, in order to help reduce the number of avoidable deaths of patients with severe anorexia nervosa. It provides:
The report updates and replaces CR162: MARSIPAN: Management of Really Sick Patients with Anorexia Nervosa, from 2010.