The NHS is rolling out support and training for teachers, school nurses and GPs to help spot early signs of eating disorders so children and young people do not “suffer in silence.” New national guidance discourages using BMI thresholds as the sole eligibility measure and instead asks clinicians to assess behaviour, family concerns and other clinical indicators.
Online training modules, developed with the charity Beat and the Royal College of Psychiatrists, will be offered to education and primary care staff so they can recognise warning signs and refer children promptly to specialist services. The guidance is the first major revision of national recommendations for children and young people with eating disorders since 2015 and was co-produced with stakeholders including Beat and the Royal College of Psychiatrists.
Service expansion over the last decade means every local area in England now has a specialist community eating disorder service for children and young people. As a result of NHS investment under the 10 Year Health Plan, children are now seen and offered treatment on average within around three weeks of referral for conditions including anorexia nervosa, bulimia nervosa, binge eating disorder and avoidant restrictive food intake disorder (ARFID).
Demand has risen sharply: the number of children and young people starting treatment increased from 8,034 in 2019/20 to 11,174 in 2024/25, almost a 40% rise. That surge has affected performance against the access and waiting time standard (which aims for 95% of routine referrals to start within four weeks and 95% of urgent referrals to start within one week), but recent quarters show improvement following extra investment.
Since 2023/24 an additional £54 million a year has been directed to expand community eating disorder team capacity. In the rolling quarter September to November 2025 urgent starts improved to 78.4% (384 of 490) and routine starts to 81.7% (2,145 of 2,625) within the target times.
Advocates and clinicians have welcomed the updated guidance but stress implementation requires resources and workforce capacity. Beat highlighted the importance of consistent access across the country, early intervention, family support and better community and day treatment options. The charity also welcomed inclusion of ARFID and called on integrated care boards to develop dedicated, evidence-based pathways and ensure funding and staffing to deliver the guidance.
The Royal College of Psychiatrists’ Eating Disorders Faculty urged services to use the guidance to expand day care and outreach so fewer young people become severely unwell and hospital admissions are avoided. The college also called for new pathways for patients with avoidant/restrictive eating problems and for closer working between eating disorder teams, GPs, paediatricians, schools, neurodiversity services and intellectual disability services.
Referral routes to specialist services are broad: children and young people can self-refer, be referred via education settings (including school nurses and mental health support teams), primary care, paediatric teams, crisis and home treatment teams, inpatient units, voluntary and community organisations, social care and other local health and wellbeing provisions including weight management services.
Further information and resources:
– Local integrated care boards commission eating disorder services, with provision scaled to population need.
– NHS England follows NICE guidance on recognition and treatment of eating disorders.
– There are 93 community teams and 54 inpatient teams for children and young people across England; every local integrated care board now has community eating disorder services (CEDS).
– Free digital training programmes for education and health professionals have been commissioned and developed with Beat and the Royal College of Psychiatrists, including SPOT (Beat) for schools and MindEd (Royal College of Psychiatrists).
– The first joint audit of eating disorder services by the Royal College of Psychiatrists and NHS England has published the latest waiting time figures.
The updated guidance aims to identify problems earlier, improve access to care close to home and reduce the risk of severe illness. Schools, GPs and school nurses are being asked to play a key role in recognising concerns and referring children for specialist help, while national and local commissioners are urged to ensure the workforce and funding are in place to make the changes stick.
