{
  "abstract": "Restricted intake self-harm (RISH) is a newly described form of disordered eating presentation as a method of self-harm. The function of this behaviour is most typically to regulate emotion, communicate distress and elicit medicalised care for an unmet need. The characteristics of RISH and how it may be distinguished from anorexia nervosa (AN) are considered. A composite case series example, drawn from clinical practice, is presented, which spans a patient’s journey from their first presentation as a child and into adulthood. Optimal approaches to management, including the concept of positive risk management within a multidisciplinary framework, are described. The risks of exacerbation from using an AN treatment approach and from prolonged inpatient stays are highlighted. Awareness of this presentation is important for nutrition support teams and gastroenterologists to support early recognition, optimal signposting and liaison with appropriate services which are detailed.",
  "authors": [
    {
      "affiliations": [
        "Leeds and York Partnership NHS Foundation Trust, Leeds, UK"
      ],
      "name": "Clare Fenton"
    },
    {
      "affiliations": [
        "Cumbria Northumbria Tyne and Wear NHS Foundation Trust, Northumbria, UK"
      ],
      "name": "Clare Ellison"
    },
    {
      "affiliations": [
        "Leeds Beckett University, Leeds, UK"
      ],
      "name": "Ursula Philpot"
    },
    {
      "affiliations": [
        "Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Adeola Adedeji"
    },
    {
      "affiliations": [
        "Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Kelly Cruickshank"
    },
    {
      "affiliations": [
        "Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK"
      ],
      "name": "Hannah Goldup"
    },
    {
      "affiliations": [
        "Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK",
        "Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, UK"
      ],
      "name": "Ingrid Small"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, UK"
      ],
      "name": "Marie McMahon"
    },
    {
      "affiliations": [
        "Northern Care Alliance NHS Foundation Trust Salford Care Organisation, Salford, UK",
        "Manchester Academic Health Science Centre, Manchester, UK"
      ],
      "name": "Peter Paine"
    }
  ],
  "title": "Restricted intake self-harm (RISH): a composite case example and advice for management",
  "uid": "8cec05d4-b28f-5eec-a889-7df558fc74d2"
}