Patients ‘not thin enough’ for help as NHS battles eating disorder crisis

‘Patients are being told to lose more weight or come back when you’re more ill’, patient warns

Desperately ill people with eating disorders are being refused NHS treatment for “not being thin enough”, as new figures reveal the health service is in the grips of a growing eating disorder crisis.

Shocking figures obtained by The Independent show at least 5,385 patients – the overwhelming majority, 3,896, of whom are children – were admitted to general wards for conditions such as anorexia and bulimia in 2021-22, more than double the number in 2017-18.

It comes as separate analysis of NHS figures suggests the number of children being treated for eating disorders more than doubled from 5,240 in 2016-17 to 11,800 in 2022-23.

Children’s Commissioner for England Dame Rachel de Souza, who released the figures, also highlighted a huge surge in young people waiting more than three months to begin treatment, from 16 per cent in 2016-17 to 45 per cent.

Doctors and charities warn limited access to community services means both children and adults patients are not able to access treatment quickly enough, which has led to many becoming so ill that they need urgent hospital care.

One young woman told The Independent she had been rejected twice from community eating disorder services in London because her weight was not considered low enough for treatment.

She said: “To actually tell a patient they are not ill enough is so disruptive, it’s bordering on abuse. You wouldn’t tell a blood pressure patient to come back when your blood pressure is even higher or you’ve had a stroke. Yet patients are being told to lose more weight or ‘come back when you’re more ill’.”

Campaigner Hope Virgo, who is leading a campaign for the government to improve eating disorder services in the UK, said she’d been contacted by several eating disorders patients and parents of children who have been refused treatment and even referred to palliative care because mental health services could not help them.

She said: “People are being told they’re too sick for treatment and too well for treatment. Imagine if we said to someone with a broken leg, you have to have broken it in this specific place in order to get treatment.

“People are being discharged for not working hard enough or gaining weight quickly enough. In other situations, if a person wasn’t responding to the treatment, we wouldn’t discharge them but would offer them something else.”

Ms Virgo said she had been contacted about a nine-year-old who had been refused an eating disorder bed despite being “so obsessed with exercise she is wetting herself as he can’t even sit down.”

While The Independent’s figures reveal 5,385 patients were admitted to general hospital wards to be treated for eating disorders, the newly-released NHS data showed just over 24,000 people were in hospital while suffering from an eating disorder. These published figures will include people who were admitted for other reasons such as self-harm, but are also recorded to have a linked eating disorder.

Responding to The Independent’s data, Dr Agnes Ayton, chair of the eating disorders faculty at the Royal College of Psychiatrists, said: “A rise in admissions for eating disorders suggests patients are not receiving timely treatment and are ending up in hospital as a result. Early diagnosis and treatment can save lives.”

Tom Quinn, director of external affairs at the charity Beat, said: “When hospital treatment is needed, it suggests that they [patients] are not getting diagnosed and accessing specialist community-based eating disorder support quickly enough, making recovery and the return to life as ‘normal’ much more difficult.”

Mr Quinn added that more children and adults were needing eating disorder care following the pandemic for reasons such as “being unable to go to school or work as usual, worrying for the health of loved ones and the ongoing uncertainty of everyday life was enormously challenging for people with or vulnerable to eating disorders.”

He said this led to more people becoming unwell and those who were already unwell at higher risk of relapse.

Despite increased pressure following the pandemic, Mr Quinn said eating disorder services were already “overstretched” before Covid-19.

“The government must urgently invest in eating disorder services in order to ensure every person with an eating disorder is treated as soon as possible,” he said.

Dr Rosena Allin-Khan, the shadow mental health minister, said: “Under this Conservative government, waiting lists for mental health treatment continue to grow as services have reached crisis point.

“Children with eating disorders have been abandoned because community resources have been stretched to their limit.”

She said the next Labour government would ensure mental health treatment starts within a month of referral and open mental health hubs for children in every community.

Dame Rachel said: “It’s worrying that children and young people are facing increasingly long waits for treatment for eating disorders – which are often serious and potentially life-threatening.

“Young people deserve timely access to effective care.”

An NHS spokesperson said the pandemic had taken a toll on the nation’s mental health and it was boosting young people’s community eating disorder services by £54m a year and training 2,000 mental health staff in schools by 2023-24.

The Department for Health and Social Care said it was investing almost £1bn in community care for adults with severe mental illness, including eating disorders, by 2024. And £54m was being given to increase capacity at children's community eating disorder services.