Data uncovered by Rachel de Souza, the children’s commissioner, shows urgent cases are waiting over 12 weeks for treatment.

Eating disorders, such as bulimia, anorexia, and binge-eating, are serious mental health problems that can severely affect the quality of life of children and their families. In the UK, it is estimated that there are 1.25 million people with eating disorders, and a disproportionate number are below the age of 25.

Children and young people with eating disorders often wrestle with other serious conditions such as depression and anxiety that need to be managed simultaneously for the best possible outcome. Left untreated, eating disorders can lead to severe malnutrition, family dysfunction, relationship breakdown and sometimes, tragically, death.

Dental practitioners may be the first clinicians to identify the signs of an eating disorder. Anorexia can result in the gums and soft tissue bleeding easily and salivary glands becoming swollen due to malnutrition. A 2022 Oral Health Foundation report showed, “Around nine in 10 (90 per cent) patients with bulimia and one in five (20 per cent) with anorexia suffer from enamel erosion. Tooth decay, sensitive teeth, dry mouth and enlarged salivary glands are also frequent.”

Anorexia is known to have the highest mortality rate of any psychiatric condition. As a result, it is vital that children and young people have access to effective and potentially life-saving treatment in a timely manner.

Published NHS figures show a large and recent increase in the number of hospital admissions for young people due to eating disorders. Of the 24,300 hospital admissions (up from 13,200 in 2015-16) for those with eating disorders in 2020-21, almost half were under the age of 25 (11,700). While the large majority of those affected are young women – 10,800 women and girls admitted in 2020-21, admissions of young men have more than doubled in that time from their smaller base.

Since 2021-22, the NHS has aimed to have 95 per cent of children and young people with eating disorders begin treatment within one week for urgent cases and four weeks for non-urgent cases. Before 2021-22, this target was 80 per cent.

Analysis from the children’s commissioner’s office shows that the NHS is currently missing the 95 per cent target, as only 78 per cent of urgent cases and 81 per cent of non-urgent cases were seen within the target time frame in the third quarter of 2022-23. And concerningly, these proportions have been falling every year since 2019-20, which coincides with a post-covid increase in the number of young people started eating disorder treatment.

Not only has the number of children starting treatment more than doubled since 2016-17, also worrying is that in the last quarter of 2022-23, 45 per cent of urgent cases were waiting more than 12 weeks to start treatment. For routine cases, this percentage drops to 34 per cent.

Knowing this, it is important that the NHS ensures that all children are able to swiftly access community care for eating disorders. Offering evidence-based, high-quality care and support as soon as possible can improve recovery rates, lead to fewer relapses and reduce the need for inpatient admissions. Ultimately, with the right treatment and support, recovery is possible.

The commissioner says children must be robustly protected from harmful eating disorder-related content online and supported to deal with the body image issues which social media can drive.

The Department for Health and Social Care’s Major Conditions Strategy is a perfect opportunity to tackle this growing issue. It is critical that in merging the Mental Health and Wellbeing Plan with other major conditions in this strategy, several of which disproportionately affect older people, the urgent need to focus on children’s mental health is not diluted. This strategy must have a distinct focus on the needs of children, acknowledging that both promoting good health and preventing or treating ill-health will look different for children, and require the involvement of different partners.

References available on request.

Author: