When they refuse eating-disorder help

Contact their eating-disorder team immediately, or seek assessment at A&E, if they are fainting when standing, too weak to climb stairs, have stopped taking food or fluids, or are physically deteriorating. MEED guidance also flags additional illness such as vomiting or diarrhoea in someone with a severe eating disorder.

Call 999 if they are unresponsive, not breathing normally, having a seizure, or faint with chest pain or an irregular heartbeat. If there is immediate danger from suicide, call 999.

Tell the service if they refuse to attend. Describe the symptoms and ask what to do next. Do not try to physically force them into treatment yourself. If you are unsure which service is needed, use the urgent medical help for their UK nation.

This is not a complete checklist. Do not wait for them to look underweight or for every sign to be present.^[1]

Choose a private time away from a meal. One person they trust is usually a better starting point than a family confrontation. Use one or two observations and explain why they concern you; avoid presenting a dossier of everything they have eaten or done.

If the conversation becomes an argument, pause it and return to the concern later. Keep ordinary contact going. Pausing an argument does not mean putting off urgent medical help.^[2]

Find out which part is stopping them: being weighed, not being believed, a previous experience or not knowing what will happen. Respond to that barrier rather than making the same offer again.

• Worried about explaining it? Help prepare a note they can hand over.
• Worried about weighing? They can ask the clinician not to announce or show the result. Physical checks may still be needed.
• Worried about going alone? Offer transport or company, with time alone with the clinician if they prefer.

Beat explains the first GP appointment and links to its First Steps guide. Do not promise that an assessment cannot lead to hospital care; explain that the clinician will discuss what is needed.^[3]

You can give a doctor information even if the person does not want you involved. Confidentiality may prevent the doctor discussing their care in return; it does not prevent the doctor listening.

Confidentiality: what you can tell the care team and what they may share.

Give the person's details, your relationship, what you have observed, dates and any physical symptoms. Separate what you saw from what you suspect. State if they are refusing assessment and ask for the information to reach the clinician responsible.

If safe, tell the person you are contacting the service. The clinician may need to discuss your information with them, and they may be able to read it in their records. Raise any concern about your own safety before sharing.

Write your concerns to their GP. For an urgent concern, phone the service rather than relying on a letter being read in time.^[4]

Missing meals, appointments or agreed checks needs a conversation with the treatment team. Describe what is happening and where the plan breaks down. Ask for a review, practical coaching and clear instructions about when to call.

Be specific about your own role: which meals you can be there for, what you have been asked to do and what you cannot manage. If the plan assumes support that is not available, tell the team.

Do not invent replacement meal plans or make abrupt changes to established support. After prolonged very low intake, increasing food may need medical supervision; seek prompt clinical advice rather than trying to manage it alone.

The mealtime guide covers practical support alongside professional advice. Supporting over time covers routines that have become difficult to change.^[5]

Ask the service what it will do with the concerns you have reported, whether an assessment is needed and what changes require urgent action. An adult declining help does not stop you asking for professional advice about serious risk.

Decisions about consent, capacity and compulsory treatment belong with qualified professionals. If there is doubt about whether the person can make the particular decision, ask how that will be assessed. Diagnosis or disagreement alone does not settle it. Our capacity guide covers England and Wales; other UK nations have different law.

If services themselves decline a referral, use the assessment and follow-up questions. Keep reporting deterioration while a review or complaint is under way.

You can use Beat's support for families and friends for your own advice and support. It is not an emergency or medical service.^[6]