Teachers, school nurses, and GPs will be offered NHS support to spot the early signs of eating disorders, so no child is left to ‘suffer in silence’.
The NHS has overhauled eating disorder services in response to rising demand with the number of children and young people treated rising two fifths since the pandemic (from 8,034 in 2019/20, to 11,174 in 2024/25).
New NHS guidance published today goes a step further and clamps down on the use of BMI thresholds to assess whether someone needs eating disorder treatment, with staff reminded not to use the out-dated practice.
NHS clinicians will instead use a range of factors to assess young people with more focus on behaviour changes and family concerns rather than relying on rigid measures.
Online training will also be provided to teachers, GPs, and school nurses to ensure they are aware of signs and how they can refer a child for NHS support, backed by the charity Beat and the Royal College of Psychiatrists.
Every local area in England now has a specialist eating disorder service for children and young people, compared to a handful of areas a decade ago.
Children are now seen and offered treatment within 3 weeks of a referral, on average, for conditions such as anorexia nervosa, bulimia nervosa and binge eating disorders, thanks to the expansion of NHS services.
The NHS has ramped up the support on offer close to people’s home as part of the 10 Year Health Plan, so young people are given treatment earlier before they become seriously unwell and require hospital treatment.
Dr Adrian James, National Medical Director for Mental Health and Neurodiversity at NHS England, said: “NHS staff have worked incredibly hard to transform eating disorder services over the last decade, but we are determined to ensure no child is left to suffer in silence.
“We know the significant pressures young people are experiencing which can be exacerbated by social media bombarding them with content that does not always show realistic body images.
“And we’re seeing the impact of that with growing numbers of young people turning to the NHS for eating disorder support, but it’s vital that everyone knows how to access this treatment which is why we will be offering training to teachers, GPs and school nurses to spot the signs and refer children for specialist help faster.
“So, if you or anyone you know is in need of support please contact your GP”.
Today’s new guidance was co-produced by a variety of stakeholders, including bodies like Beat and the Royal College of Psychiatrists, in the first major overhaul of Children and young people with an eating disorder guidance since 2015.
Tom Quinn, Director of External Affairs at Beat, said: “Demand for eating disorder services has risen steeply since the pandemic and we know that access to these services can vary widely depending on location. The publication of this new guidance is an encouraging step in the right direction, helping to ensure equitable access to eating disorder treatment across the country.
“We worked closely with NHS England during the drafting process and will do all we can to support its implementation. We’re pleased by the focus upon issues we’ve long been campaigning on, including early intervention, addressing inequalities in care, access to intensive community and day treatment options, and support for families and carers. It’s particularly positive that avoidant restrictive food intake disorder (ARFID) has been included – now, it’s crucial that all NHS integrated care boards respond by developing a dedicated and evidence-based care pathway.
“Moving forward, the government must not allow this guidance to be left in limbo and ensures it is implemented promptly. We need the right staffing for this to work, and so recruiting and keeping staff should be a key priority. It’s imperative that funds are made available nationally and locally to deliver on this ambitious guidance and begin to tackle the growing crisis in eating disorder services”.
Dr Ashish Kumar, Chair of the Royal College of Psychiatrists’ Eating Disorders Faculty, said: “We welcome this guidance which has the potential to reduce waiting times and improve care for children and young people who have anorexia, bulimia and other eating disorders. These conditions can be extremely serious and even life-threatening when left untreated, so it is imperative that we are bold in our efforts to innovate the support that is available.
“Community eating disorder services should use this guidance to establish day care and outreach initiatives that can prevent young people from becoming unwell and help others recover more quickly. We also need new care pathways for patients with avoidant/restrictive food intake disorder who often struggle to access treatment.
“This guidance provides a blueprint through which frontline eating disorder services can work with GPs, paediatricians, neurodiversity pathways, schools, colleges and intellectual disability services to better meet the needs of children and young people. We hope integrated care boards will seize this opportunity and support services to implement these national commissioning guidelines as soon as possible with the appropriate resources and funding”.
Further information
- Local integrated care boards are responsible for commissioning eating disorder services, with service commissioning depending on the relevant population size.
- NHS England is following National Institute for Health and Care Excellence guidance on the recognition and treatment of eating disorders.
- There are 93 community teams and 54 inpatient teams for children and young people in England. There are community eating disorder services (CEDS) under every local integrated care board.
- Patients will be referred to eating disorder services through a variety of places. This will include:
- self-referrals from children and young people
- education settings, for example, school nurses or mental health support teams
- primary care, including GP practices
- acute and mental health inpatient settings
- crisis teams
- home treatment teams
- paediatric teams
- children and young people’s mental health teams
- voluntary, community and social enterprises settings
- social care
- other local health and well-being provisions, including weight management services.
- Training will be made for staff in health, social care, education, charities, and community settings who may encounter children and young people with eating disorders. NHS England has commissioned free digital training programmes developed with Beat and the Royal College of Psychiatrists.
- The number of children and young people starting treatment for eating disorders has increased since the pandemic, from 8,034 in 2019/20, to 11,174 in 2024/25, an increase of almost 40%. This has impacted performance against the Children and young people with an eating disorder access and waiting time standard which states that 95% of routine referrals should begin treatment within 4 weeks, and 95% of urgent referrals should begin treatment within 1 week.
- Additional investment of £54 million per year since 2023/24 has enhanced the capacity and capability of community eating disorder teams to better meet the rising demand, and in the rolling quarter September 2025 to November 2025, Mental Health Services Data Set data shows that performance against the target for both routine and urgent referrals has improved, increasing to 78.4% (384/490) of urgent and 81.7% (2,145/2,625) of routine cases starting treatment within 1 and 4 weeks respectively. The guidance published today will further support integrated care boards and providers to better meet the needs of children and young people through timely access to care and support.
- The Royal College of Psychiatrists and NHS England have published their first audit of eating disorder services in England, which includes latest figures on waiting times.
- Free e-learning resources are available online:
