At Breathe we are here to listen, support and help you overcome the difficulties you may be facing. You are not alone!

GPs & Commissioners

Breathe Therapies is a not for profit organisation and the treatment arm of the charity S.E.E.D.

At Breathe, we wish to ensure that anyone in Preston and the surrounding areas in Lancashire who are experiencing an Eating Disorder, Weight Management issues, Obesity or Psychological problems can have access to the most appropriate help and sufficient treatment to overcome the difficulties they may be facing.

Why Are We Different?

Our goal is to provide safe and effective therapeutic interventions for those suffering with Eating Disorders, Weight Management, Obesity, and Psychological issues. We acknowledge that Eating Disorders have other psychiatric co – morbidities such as anxiety, depression and OCD therefore individuals need a care plan catered to their specific needs which Breathe can provide.

Our aim is to address the deep rooted issues and developing individuals in all aspects of their life such as; the social aspects in a person’s life, to preparing them to adjust to life outside of their eating disorder through encouraging them to engage within the community, which in-patient clinics are often unequipped to do.

We aim to ensure a longer term benefit and relapse prevention rather than the historically delivered short term solution with a higher possibility of relapse. Our dedication and energy is captivated through the work we provide, we are different as we wholeheartedly believe recovery is possible!

Quality Therapeutic Care

challnge 6The outcome of the work we deliver has proven the success of the service.

Breathe has shown to be a reliable, trustworthy and established service in providing quality therapeutic care and meets and works in accordance with Nice guidelines, Lancashire County Councils Health and Wellbeing board outcomes and Kings College Guidance.

In order for patients to get the right help at the right time they need for a positive health and wellbeing, referrals and funding is imperative.By working in partnership we can build establishing trusting relationships between one another to simplify the transition between GP and treatment whilst tackling and overcoming GP’s concerns. By doing this we can improve the quality of life for many, as we believe recovery can be achieved.

Together we can make a time for change, a time to overcome the mental health barrier and to open up the restrictions put in place for treatment.

We do not cover up the problems. We face them!

“Treatment enables individuals to explore and understand themselves and their needs better.

Clients find out what precipitates, perpetuates and pre-disposes them to what currently keeps them unhappy and in self-destructive behavioural patterns and habits.

Through this new self awareness they will develop new goals and strategies in every area of their life and learn how to work towards them.”

Breathe Aims 2

Provide a local and accessible specialist service for those with eating distress including failed dieting

Provide a confidential, professional and individualised treatment package in a safe and therapeutic environment

Provide a challenging but positive journey experience towards emotional and physical wellbeing

Engender hope and a message of recovery and wholeness

Breathe believes that all individuals have a plan and a purpose for their lives and that with encouragement and support they can be released to find it and enjoy it!

Ten Things GPs Should Know About Eating Disorders

From time to time a really helpful golden nugget of revelation appears in the public domain to move our understanding of eating disorders and their treatment forward.

One such nugget is the article below written by a doctor for the Eating Disorders Resource Catalogue in July 2014.

You can view this superb article in its original form by clicking here >Eating Disorders Resource Catalogue

Dr Tyson practices in Texas, USA to visit his website, click here >

Shelley Perry – Clinical Director, Breathe Therapies

Ten Things I Wish Physicians Would Know About Eating Disorders

by Edward P. Tyson, M.D., Austin, TX

The most important things physicians need to know have to do not with technical aspects of assessing or treating physical aspects of an illness, although those are important. It is about the physician first addressing his or her own attitudes about eating disorders and those who have those illnesses.

1. Physicians are lucky to have people with eating disorders as their patients. People who suffer from eating disorders are a special group. Almost without exception, they are empathic, creative, intuitive, hard working, and usually gifted in at least one of the following (and quite often in all 3): academics, creative expression, and athletic endeavors. When these sufferers are free of their illness, they are incredible people to know and be around. And their recovery encompasses all the reasons why, hopefully, most doctors go into that profession.

2. Don’t be afraid of an eating disorder. It is an illness, with signs and symptoms and causes, and really good treatment. What other illness would a physician feel so inadequate about and also not seek the advice of colleagues or the literature? Sadly that happens so frequently and it is the topic of sufferers, family members, and professionals in the eating disorder field. Please do not be one of those people we talk about like that. Get educated or get help, but do not ignore, dismiss, or fail your professional responsibility.

3. Eating disorders will test one’s ability to be humble. These are some of the most complicated illnesses there are, as they involve both complex medical and psychiatric issues. In addition, there are not that many medical experts around, so, yes, most doctors will feel like they are in unchartered territory. And you will make mistakes; we all do. But learn from them and approach the problem in the way that patients expect of physicians—with a cool head and keen mind, unfettered from a sensitive ego.

4. You will likely need help at some point. A physician cannot know all details about every illness, especially ones as complex as eating disorders. As with any illness one encounters as a physician, the professional approach is to determine what the best assessments and treatments are. Again, be humble enough to ask for or seek advice. One can seek opinions of experts in the field in any number of ways—a phone call (a so-called “sidewalk consult”), go to the literature, use the AED medical guide, or any number of texts on the subject (consider the books by Mehler & Andersen, and Birmingham & Treasure, or, maybe even my chapter in the book by Maine, McGilley & Bunnell).

5. You will not be able to successfully separate out the physical from the psychiatric. Both must be treated at the same time. It is no longer appropriate to say, as a physician, that these are psychiatric illnesses. Nor is it permissible for psychiatrists to say that they are not the ones to deal with the medical. Again, if you do not know, do not reject the patient—instead, call in a consultant and work with that other physician.

The same applies to medical and psychiatric hospitals. Eating disorder patients should never be placed in a medical “no-mans land” where they are ping-ponged back and forth from one to the other, each claiming they cannot treat an eating disorder. These hospitals, by the way, do not have a sign outside saying, “WE TREAT EVERYTHING…except eating disorders.”

6. Keep checking every organ system every time. Use screening tools and a consistent pattern to the history and physical to make it easier, faster, and more likely not to miss something important. Use a BMI graph in those who have restricted to predict how serious the decline is, as the more dramatic the drop or angle of decline on the graph, the more likely that cardiovascular complications are present. A dramatic drop of the BMI can be very alarming and convincing to family members and to patients (see example). As I say often in those cases, “Imagine you’re flying Southwest Airlines and this is how the plane is going down. What would you want the pilot to do about now?” The answer is universally: “Pull up”…How soon? “Now!”

7. While they are complex, eating disorder’s medical complications follow specific, predictable physiological patterns resulting from the ED behaviors. However, physicians must consider the specific circumstances of that individual patient and what behaviors and conditions can predict certain medical (or psychiatric) complications. If they are purging, for example, they could have bleeding, electrolyte and dehydration issues, and signs and symptoms consistent with those conditions. Always consider cardiac complications, and in those who are restricting, screen for Refeeding Syndrome. Those who restrict should have signs of hypometabolism, with low body temperature, bradycardia, capillary refill delay, acrocyanosis, and such.

8. Check lab values frequently, including electrolytes and especially phosphorus and magnesium in those at risk of Refeeding Syndrome. Purgers are at risk of bleeding, so the CBC needs to be followed. The AED medical guide provides a good summary of labs needed.

9. Remember that many of the psychological issues may be a result of medical issues and vice versa. What one may think is anxiety or panic could easily be hypoglycemia. What may appear to be depression, bipolar disorder, or personality disorder may actually be malnutrition, brain starvation, and such. And the medical issues will tend to worsen what psychiatric issues are present.

10 Athletes can get eating disorders, too. Don’t assume because the patient is a high performing athlete, that physical findings that would be considered abnormal in others is due just to the patient being an “athlete.” A common mistake is to assume that one’s bardycardia (slow heart rate) is due to being a fit athlete. However, if the resting heart rate is below 50, evaluate if hypometabolism and energy conservation are ongoing, and not due from a fit heart but one that is losing its exercise capacity.

Do not be surprised how many calories it takes to refeed someone who has been malnourished, especially one who was exercising heavily with their eating disorder. It can be enormous calories and the patient may only then slowly gain weight at first. This is because the metabolism has to be reversed and turned from hypometabolic to hypermetabolic and that requires enormous calories, fat, protein, and carbohydrates. It is not uncommon for someone at a very low weight to be eating 5,000 calories per day at a treatment center and very slowly gaining at a rate of 1 or 2 pounds a week after a few weeks of no weight gain or even weight loss.

If a physician were to follow just the above, he or she would know more about eating disorders than 95% of other physicians. We are not looking just for experts; we’re looking for volunteers to care for these deserving patients.


About Dr. Tyson

Ed Tyson has been treating eating disorders for over 20 years and is in private practice in Austin (

He is a member of the AED’s Advisory Board and the Medical Care Standards Committee, and a co-author of the AED’s Medical Guide for Eating Disorders. He considers himself an advocate for those who have EDs, and teaches medical, nursing students and undergraduates and graduate students about EDs at the University of Texas, and presents at professional meetings whenever he can.

Why Breathe Is A Good Option For GPs

Reducing the prevalence of eating disorders and common psychological disorders is a major public health concern.

In 2012, a b-eat article found that the overall estimated cost of eating disorders to the English economy was at £1.26 billion per year.

We understand the GP’s concerns regarding Eating Disorders in terms of the complications, as treatment is costly in time and is demanding on resources.

GP’s may intervene when a client presents themselves with deteriorating symptoms often with no other alternative than to refer them onto either in-patient units or very long waiting lists for CBT which are often unsuccessful in treatment as they focus primarily on weight gain and not tackling the deep rooted psychological issues.

This as a result, leaves many patients feeling trapped in a continuous cycle of entering admission, gaining weight to a satisfactory level suitable for discharge and then losing the weight once out, whilst often not resolving the underlying cause.

By relying on in-patient units the real deep issues are not faced and it is costly to the economy.

This leaves GP’s feeling that they are faced with no other alternative as they are unaware of local accessible and efficacious care available for Eating Disorders, weight management, obesity and psychological therapies which are accessible within the local community.Nice Guidelines

In line with NICE Guidelines, Breathe believes that a system of detecting early intervention risk management and collaborative care to ensure the best quality of life for all individuals can be achieved.

Referral Process

Reference Document Downloads

Please click on images to download documents.

NICE Guidelines

National Institute For Health & Care Excellence

NICE Guidelines

NICE – Quick Reference Guide

Kings College Guidelines

Kings College Guidelines

GP Referral Form

GP Referral Form

SCOFF Questionairre

SCOFF Questionairre

Guide For Health Professionals

Guidance For Health Professionals

ICD 10 Checklist

ICD 10 Checklist