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Eating Disorders in Children and Young People: a major public health concern

Eating Disorders in Children and Young People: a major public health concern

Tamsin Ford

Professor Tamsin Ford

Professor of Child and Adolescent Psychiatry at the University of CambridgeTamsin is Research Advisor at Place2Be. She is an internationally renowned Child Psychiatric Epidemiologist who researches the organisation, delivery, and effectiveness of services and interventions for children and young people’s mental health.

Clara Faria

Clara Faria

Clara Faria is a junior doctor and aspiring child and adolescent psychiatrist. She is currently doing a MPhil at the University of Cambridge (Department of Psychiatry). Her research focuses on eating disorders and in the epidemiology of mental health disorders in young people.

Eating disorders (EDs) are serious mental health conditions that can develop when people use repeated disordered eating behaviours as a way of coping with feelings and situations. Examples include restricting the amount of food the person eats, inducing vomiting to prevent weight gain, and eating very large quantities of food at once.

Since the Covid-19 pandemic, there have been growing concerns about an increase in the number of young people with eating disorders (EDs). In England, for example, the number of urgent referrals to specialist eating disorder services doubled post pandemic, with a smaller but still substantial increase in non-urgent referrals.

There are many ways in which EDs compromise the quality of life of young people and their families. For example, anorexia has the highest mortality rate of any mental health condition.

However, recovery is possible with the right type of support and treatment. That is why a precise estimate of the number of children and young people living with EDs is important for service provision and planning. Early access to treatment offers the best possible chances of recovery, and every child or young person with an ED should be able to access timely care.

Have the number of children and young people with eating disorders increased?

NHS England’s 2023 follow-up to the Mental Health of Children and Young People survey revealed some very concerning figures.

  • In 2023, 12.5% of 17 to 19 year olds in England are living with an ED compared to 0.8% in 2017.
  • The figures for 11 to 16 year olds were 2.6% in 2023 compared to 1% in 2017.

We can be reasonably sure that differences in methods cannot completely explain this large difference in findings. In 2023, NHS England’s main survey asked screening questions from the diagnostic assessment used in 2017. In 2023, those screening positive were invited to complete the rest of the assessment. Parents reported on 11-16 year olds, while 17-19 year olds reported on themselves (but could invite their parents to fill in the questions too). There were some differences that we could not avoid between 2017 and 2023. In 2017, the interviews were carried out in person, but in 2023, they were completed online or via telephone.

Eating disorders can affect anyone regardless of their background. But girls and young women are more severely affected.

  • In 11-16 year olds, ED prevalence was 4 times higher in girls (4.3%) compared with boys (1.0%).
  • Similarly, among 17-19 year olds, young women (20.8%) had an ED compared to 5.1% of young men.

Overall, these statistics show there was a dramatic increase in the prevalence of clinically impairing eating disorders among school aged children and young people in 2023. We don't know the exact causes driving this increase, but all those working with children and young people need to be alert to how EDs may present and how to access help.

What needs to happen next?

We must work to ensure improved early identification. Every professional working with children and young people, including the healthcare workforce, should be adequately trained to identify young people with potentially impairing eating behaviours.

We should ensure that every young person facing significant eating difficulties receives timely and evidence-based treatment. Shortly after the covid-19 pandemic, there was a sharp increase in waiting list times in response to escalating referrals. According to the latest statistics released by the NHS England, for the 4th quarter in 2022-2023:

  • 78.7% of patients started urgent treatment within one week and 82.5% of patients started routine treatment within four weeks. Although this is an improvement, it is still below the eating disorder referral-to-treatment standards of 95%.

More research is urgently needed to better understand the driving factors behind this increased ED prevalence, and to identify ways to improve prevention and treatment. Research must consider the diversity of patients' experiences as different groups of patients have different needs.

These figures indicate that the increased number of referrals reflects an increased need rather than an increase in help-seeking, and send a challenge to all those working with and caring for children and young people to be alert and respond to difficulties with eating.

Useful resources

If you need immediate advice, support or want more information about eating disorders or caring for someone with an eating disorder, we have listed a few helplines and charities who do a fantastic work below

Beat: Beat is a UK charity supporting anyone affected by eating disorders or any other difficulties with food, weight and shape. They have a fantastic website and also free helplines available:

  • Helpline: 0808 801 0677
  • Youthline: 0808 801 0711

National Centre for Eating Disorders: Professional support for anybody with an eating disorder in London and all over the UK.

  • Phone line: 0845 838 2040

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