Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management
NICE Guideline Committee · National Institute for Health and Care Excellence (NICE) · 2021 · DOI
Quick Summary
The UK's National Institute for Health and Care Excellence updated its ME/CFS guidelines after a comprehensive evidence review. The updated guidelines removed Graded Exercise Therapy (GET) and Cognitive Behavioural Therapy (CBT) as recommended treatments, as evidence showed they were not effective and could be harmful. Pacing and energy management were endorsed.
Why It Matters
This guideline reversal was a landmark moment in ME/CFS policy. It formally acknowledged that the biopsychosocial model of ME/CFS — underlying GET and CBT recommendations — was unsupported by evidence and potentially harmful. It significantly impacted clinical practice across the UK.
What This Study Does Not Prove
Clinical guidelines synthesize existing evidence but do not generate new scientific knowledge. Removal of GET does not prove a specific alternative mechanism.
Topics
Tags
Metadata
- DOI
- 10.3310/nihropenres.13121.1
- Review status
- Editor reviewed
- Evidence level
- Established evidence from major reviews, guidelines, or evidence maps
- Last updated
- 7 April 2026