Clinicians’ Perspectives on Managing Medical Emergencies in Eating Disorders (MEED) in Adolescence—A Reflexive Thematic Analysis

Our findings support the MEED guidance as a helpful and widely used clinical resource. The MEED guidance was most helpful as a tool to clearly communicate acuity of medical risks between services to aid multi-agency working required to manage both physical and mental health risks of young people with eating disorders. Risk stratification of parameters within the guidance and streamlining of refeeding guidance across the age range were highlighted as areas that future research should focus on. Highlights: Objective: Despite the UK national guidance for Managing Emergencies in Eating Disorders (MEED) being widely used, little is known about how the guidance has been embedded into clinical practice or implemented across services. Methods: Clinicians (n = 13) working in community child and adolescent eating disorder services and medical wards were interviewed about their experience of using the MEED guidance in their clinical practice. Open-ended questions were used. Reflexive thematic analysis was used to analyse interview data. Results: Reflexive thematic analysis of responses identified three main themes. These were the following: (1) a common language, (2) looking beneath the surface, and (3) refeeding syndrome—a rare event in youth. These themes evidenced the important role of the MEED guidance in child and adolescent eating disorders and highlighted both the benefits and limitations of the current guidance. Conclusions: This study demonstrated that MEED was most helpful as a tool to clearly communicate acuity of medical risks between services, aiding multi-agency working required to manage both physical and mental health risks of young people with AN. The absence of parameter risk stratification and the lack of consistency on refeeding guidance across adolescent and adult guidance were highlighted as areas that future research should focus on.