Explain anorexia nervosa care and refeeding safety to a parent — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar on the paediatric/adolescent medical ward with eating disorder liaison. [5]

Candidate instructions. Explain the diagnosis of anorexia nervosa in plain language, why medical monitoring matters (heart rate, electrolytes), what refeeding syndrome is and how the team prevents it, why family-based treatment is recommended after stabilisation, and give a balanced answer on medication (not first-line in this adolescent scenario). Check understanding and invite questions. The examiner plays the parent. [1][2][5]

Candidate scenario

Your patient meets criteria for restricting anorexia nervosa with medical instability on admission (bradycardia). The team is refeeding with protocolised monitoring of phosphate, potassium and magnesium. After medical stability, the plan is outpatient/day FBT with parents taking charge of meals initially. The parent fears “force-feeding will destroy trust” and asks whether a “weight-gain tablet” (olanzapine) would be simpler. [1][2][3][4]

Marking domains

• Empathy, structure, non-blaming stance toward parents
• Accurate plain-language model of AN (restriction, fear of weight gain, body image)
• Clear explanation of medical risk (bradycardia, collapse, multi-system effects)
• Refeeding syndrome: phosphate/electrolytes, why monitoring and thiamine/protocol matter
• FBT rationale and phases at carer level; evidence that family leadership helps
• Medication: not first-line fix for adolescent AN; olanzapine evidence mainly adult adjunct
• Safety-net and collaboration; teach-back [1][2][4][5]