The NHS has announced an overhaul of eating disorder services in response to rising demand, with the number of children and young people bring treated rising by two fifths since the pandemic – from 8,034 in 2019/20, to 11,174 in 2024/25.
And community support services will play a key role in the plans, according to Dr Ashish Kumar, chair of the Royal College of Psychiatrists’ Eating Disorders Faculty, with calls for increased day care and outreach initiatives to be established.
The new guidance 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.
Under the NHS, 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.
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
And children are now seen and offered treatment within three weeks of a referral, on average, for conditions such as anorexia nervosa, bulimia nervosa, and binge eating disorders.
Moving forward, the NHS is also ramping 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.
And private and not-for-profit providers and charities will have a key role to play in this expansion, said Dr Kumar.
He added: “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.”
And 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.
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
“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.”
The 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 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.
Moving forward, the Government must not allow this guidance to be left in limbo and ensures it is implemented promptly
“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”.
There are currently 93 community teams and 54 inpatient teams for children and young people in England.
There are also community eating disorder services (CEDS) under every local integrated care board.
Additional investment of £54m 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% of urgent and 81.7% of routine cases starting treatment within 1-4 weeks respectively.
The new guidance 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.