In a landmark move, the NHS has declared that a child's body weight should no longer be the central consideration when determining their need for eating disorder support. This pivotal shift in policy aims to dismantle long-standing barriers to vital treatment.
Ending the Reliance on BMI
New guidance from NHS England, issued on Tuesday 20 January 2026, explicitly instructs that "single measures such as body mass index (BMI) centiles should not be a barrier" to a child or young person receiving help. This applies to initial assessments, admissions to inpatient care, and decisions about discharge.
The advice marks a direct response to years of criticism that an over-reliance on weight and BMI measurements has prevented both children and adults from accessing timely, potentially life-saving interventions. Professionals are now urged to look beyond physical metrics.
Spotting the Early Signs
The new approach, developed in collaboration with the eating disorder charity Beat and the Royal College of Psychiatrists, focuses on identifying a broader range of warning signs. NHS staff, teachers, GPs, and school nurses are being trained to observe behavioural changes and familial issues, rather than waiting for significant weight loss to manifest.
Online training is now available for these key frontline professionals to ensure they can recognise early indicators and understand how to refer a child for NHS support promptly.
Dr Adrian James, national medical director for mental health and neurodiversity at NHS England, highlighted the pressures on young people: "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."
Service Expansion and Ongoing Challenges
NHS England reports that every local area in England now has a specialist community eating disorder service for children and young people, a vast improvement from just a handful a decade ago. On average, children are now seen and offered treatment within three weeks of a referral.
However, significant disparities remain. Analysis from December highlighted that some adults with eating disorders in England face waits of up to 700 days for community care, while children and young people can wait up to 450 days in certain areas.
The first report from the National Audit of Eating Disorders (NAED), using data from January to May last year, found the national median wait for community care for young people was 14 days for assessment and four days for treatment, underscoring the "real postcode lottery" of care that Beat warns about.
Expert Endorsement and Future Pathways
Tom Quinn, director of external affairs at Beat, welcomed the guidance: "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."
Dr Ashish Kumar, chairman of the Royal College of Psychiatrists’ eating disorders faculty, stated the guidance has the potential to reduce waiting times and improve care. He emphasised the need for new care pathways for conditions like avoidant/restrictive food intake disorder (Arfid) and called for the establishment of day care and outreach initiatives to prevent illness and speed up recovery.
The NHS continues to urge anyone in need of support, or who knows someone who is, to contact their GP.
