Meat pie, served with coffee, sent back, looking anaemic (5-5)
I believe the answer is:
pasty-faced
'looking anaemic' is the definition.
(both can mean pale)
'meat pie served with coffee sent back' is the wordplay.
'meat pie' becomes 'pasty' (pasty is a kind of meat pie).
'served with' says to put letters next to each other.
'coffee' becomes 'decaf' (type of coffee).
'sent back' says the letters should be written in reverse.
'decaf' back-to-front is 'faced'.
'pasty'+'faced'='PASTY-FACED'
(Other definitions for pasty-faced that I've seen before include "Wan" , "Having a pale and unhealthy complexion" .)