Children's eating disorder treatment to be improved while teachers and GPs taught warning signs, new NHS guidance says

New NHS guidance says BMI should not block children from eating disorder support, with training to help teachers and GPs spot signs earlier.

A healthcare professional engages with a young female patient in a clean, well-lit clinic.

Published: January 21, 2026 at 11:56 AM

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The NHS is overhauling its eating disorder treatment guidance for children and young people as rates increase. Weight will no longer be a determining factor in whether children get treatment, and teachers, school nurses, and GPs will receive training to help them spot warning signs of disordered eating.

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This comes as demand for NHS eating disorder services has risen sharply since the pandemic, with two-fifths more children and young people starting treatment compared with five years ago.

Under new NHS guidance published on Tuesday, clinicians are being told to move away from relying on body mass index (BMI) thresholds when deciding whether a child needs support, focusing instead on behaviour changes, physical health, and concerns raised by families.

The changes are designed to help children access treatment earlier, before they become seriously unwell and need hospital care.

Eating disorders include conditions such as anorexia nervosa, bulimia nervosa, binge eating disorder and avoidant restrictive food intake disorder (ARFID).

Rising numbers of children needing support

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."

Every local area in England now has a specialist eating disorder service for children and young people, compared with just a handful a decade ago. On average, children are now seen and offered treatment within three weeks of a referral.

However, according to NHS England, the number of children and young people starting treatment for eating disorders has increased from 8,034 in 2019/20 to 11,174 in 2024/25.

Before the Covid-19 pandemic, the number of children and young people starting treatment for an eating disorder was rising steadily, but numbers increased sharply following the pandemic, according to analysis of NHS figures by the Nuffield Trust. And waiting lists have struggle to keep up, with over 5,000 children on waiting lists for standard treatment and over 1,000 for urgent treatment in 2023.

With growing numbers of young people turning to the NHS for eating disorder support...we are determined to ensure no child is left to suffer in silence.

Dr. Adrian James

Moving away from BMI as a gatekeeper

A key part of the new guidance is a clear move away from the use of BMI thresholds as a deciding factor for treatment.

NHS clinicians are being reminded not to rely on this outdated practice, as it can miss children who are struggling but do not fit a specific numerical measure.

Instead, assessments will consider a wider range of factors, including changes in eating behaviour, physical and mental health, and concerns raised by parents or carers.

This approach is intended to make access to care fairer and more responsive to individual needs.

Training for teachers, GPs and school nurses

Free online training will be made available for professionals who regularly come into contact with children and young people, including teachers, school nurses and GPs.

The training has been developed with the eating disorder charity Beat and the Royal College of Psychiatrists. It aims to help staff recognise warning signs and understand how to refer a child for NHS support quickly.

"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," Dr. James said.

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.

Dr. Adrian James

Support from charities and clinicians

The new guidance is the first major update to NHS advice on children and young people with eating disorders since 2015 and was co-produced with a range of organisations.

Tom Quinn, Director of External Affairs at Beat, said the guidance was an encouraging step towards more equal access to care.

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.

Tom Quinn, Director of External Affairs at Beat

He welcomed the focus on early intervention, support for families and carers, and the inclusion of ARFID, which he said has historically been overlooked.

Dr. Ashish Kumar, Chair of the Royal College of Psychiatrists’ Eating Disorders Faculty, said the guidance has the potential to reduce waiting times and improve care.

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.

Dr. Ashish Kumar

"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," Dr. Kumar said.

"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."

How children can be referred for help

Children and young people can be referred to NHS eating disorder services through a range of routes, including:

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If you are worried about your child, or a child you care for, the NHS advises speaking to your GP as a first step.

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