"Children shouldn't be denied eating disorder support based on their weight": Bristol expert backs new NHS guidance
An associate professor from UWE is backing more accessible treatment
A Bristol expert has expressed support for new NHS guidelines aiming to make eating disorder treatment more inclusive, while emphasising the importance of local care provision.
Dr Christine Ramsey-Wade, associate professor of counselling psychology at the Centre for Appearance Research at UWE Bristol, welcomed the move away from reliance on weight and body mass index (BMI) when determining access to treatment.
“These new guidelines are very welcome,” Ramsey-Wade said. “You cannot tell whether anyone of any age has an eating disorder by their weight, shape or appearance.
“Our research has shown that people can struggle to access care due to GPs holding appearance-based stereotypes about what an eating disorder patient looks like.”
The NHS England guidance urges medical professionals, teachers, school nurses, and GPs to focus on behavioural changes and family concerns when assessing young people for eating disorder support.
A shift in focus
The new approach comes amid long-standing criticism that focusing on weight restricts access to care for both adults and children. NHS England has developed the guidelines alongside eating disorder charity Beat and the Royal College of Psychiatrists to address these concerns and ensure that patients in need are not excluded.
The NHS says specialist eating disorder services for children and young people are now available in every region, compared with a handful a decade ago. On average, young patients are seen within three weeks of a referral.
Online training aimed at teachers, school nurses, and other professionals has been launched to help spot signs of eating disorders earlier and direct children to the care they need.
Dr Adrian James, national medical director for mental health and neurodiversity at NHS England, highlighted the increasing pressures young people face.
“And we’re seeing the impact of that with growing numbers of young people turning to the NHS for eating disorder support," he said.
Challenges in care
Despite improvements for younger patients, figures from late last year showed long waiting times for both adult and child community eating disorder services.
An audit revealed that some adults face waits of up to 700 days for care, while children and young people in certain areas wait up to 450 days – though the national median wait is significantly lower at 14 days for assessment and four days for treatment.
Tom Quinn, director of external affairs at Beat, said the new guidance was “an encouraging step in the right direction” but acknowledged continuing disparities across the country.
“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," Quinn said.
The guidance aims to tackle disparities by improving coordination between regional services and local professionals involved in referrals.
Developing care pathways
Dr Ashish Kumar, chairman of the Royal College of Psychiatrists’ eating disorders faculty, called for more innovation in care models, particularly for under-diagnosed conditions such as avoidant/restrictive food intake disorder (Arfid).
"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," Kumar said.
Ramsey-Wade stressed that inclusive approaches are key to overcoming barriers to diagnosis and treatment.
The NHS plans to monitor progress on equity of care with continuing audits and training available to local professionals.