Eating Disorders Awareness Week

Tuesday 28th February 2023 Westminster Hall

09:30

[Wera Hobhouse (Bath) (LD)]

I beg to move,

That this House has considered Eating Disorders Awareness Week.

It is a pleasure to serve with you in the Chair, Ms Harris. I thank the Backbench Business Committee for granting the debate, and all colleagues across the Chamber who have supported it.

Across the United Kingdom, an estimated 1.25 million people have an eating disorder. That includes binge eating disorder, bulimia, anorexia and other specific feeding or eating disorders—indeed, any disorder that avoids or restricts the intake of food. Left undiagnosed and untreated, eating disorders can be a silent killer. Anorexia has the highest mortality rate of any mental illness, and results from one study have shown that a third of people with binge eating disorder are at risk of suicide.

[Margaret Ferrier (Rutherglen and Hamilton West) (Ind)]

Increasing awareness and our understanding of the causes of eating disorders are crucial to providing the right care. Eating disorders are still hugely misunderstood. Does the hon. Member agree that Ministers must fund more research on that, because just 1% of mental health research funding is directed to eating disorder studies?

[Wera Hobhouse]

I completely agree. Indeed, the all-party parliamentary group on eating disorders inquiry on research funding found how crucial it is, and in particular that eating disorder research should be ringfenced. Some progress has been made, and the eating disorder charity Beat has made good progress on the issue, but more research needs to be done.

For too long, sufferers have been left feeling trapped and alone. Here in Parliament, we have been raising the alarm for some years about this rising epidemic, which still needs more urgent action from the Government. However, I want to acknowledge the good working relationships the eating disorders APPG has had with various Ministers. I hope that will continue, and that today’s debate helps us to make progress together.

The theme for this year’s Eating Disorders Awareness Week is eating disorders in men. Eating disorders do not discriminate. Many people think that eating disorders affect only women, but at least one person in four affected by an eating disorder is a man, and 89% of men and boys aged 16 to 18 in my county of Somerset worry about how they look. Those experiences are often overlooked.

Toxic stereotypes are pervasive, and half of respondents to a recent survey of men’s experience carried out by Beat did not believe that someone like them would develop an eating disorder. One male sufferer in five has never spoken out about their struggle. That is why the debate is so important. We must encourage men to speak up and get the help they need.

Other rigid perceptions of eating disorders persist. Eating disorders are frequently misunderstood and viewed as a lifestyle choice. Contrary to popular belief, eating disorders are most common among people with severe obesity. Too many people are still being turned away from treatment because their body mass index is too high. To imply that someone seeking help for an eating disorder is not skinny enough is a terrible mistake that can lead to added suffering, and I commend Hope Virgo for her tireless campaign, Dump the Scales, which has made a significant difference.

Owing to those perceptions, people with eating disorders face a postcode lottery in trying to access specialist treatment. Beat has found large inconsistencies in the availability of treatment for binge eating disorders. Only 12 of the 51 providers in England that responded to Beat’s freedom of information request offered all three services for binge eating disorders recommended by the National Institute for Health and Care Excellence.

In some areas, treatment for people with bulimia is being rationed according to the frequency of binging and purging episodes. In others, treatment is simply not available. The Somerset and Wessex Eating Disorders Association, also known as SWEDA, has seen a 150% increase in people seeking help for eating disorders compared with pre-pandemic figures. Its children’s service has been overwhelmed with young people and their parents desperately trying to get support.

Eating disorders can take years to recover from, and many children and young people need to continue their treatment into adulthood. Young people miss out on so many educational and social opportunities. These years are stolen from them, and that is not to mention the potentially irreversible effect on their physical health. Again, this affects girls and boys, men and women—eating disorders do not discriminate.

[Sir George Howarth (Knowsley) (Lab)]

I thank the hon. Lady for securing this important debate. She will be aware that the variation of eating disorders called T1DE—type 1 diabetes with disordered eating—is a growing problem that affects young men as well as young women. The right hon. Member for Maidenhead (Mrs May) and I have been co-chairing an inquiry into that variation of eating disorders. I will not pre-empt what our report will say, but one thing is clear: professional support, both psychological and physical, is vital to these young people, who could otherwise end up seriously ill if they do not take their insulin—in some cases, it is fatal.

[Wera Hobhouse]

I thank the right hon. Member for his intervention. As I mentioned, eating disorders manifest themselves in different forms. We need to increase our understanding of the different types of eating disorders, and much more specialist treatment needs to be available to cater for people’s different needs. I thank him for mentioning that specific form of eating disorders among people who are suffering from diabetes.

As I mentioned, eating disorders result in years being stolen from young people, and they can take many years to recover from. Some of the figures are just staggering. A third of people with eating disorders recover fully, a third never really recover, and a third get worse. For the third that never really recover, it is a lifetime sentence of a life that is not as good as it could be. That is why early intervention and understanding the symptoms of eating disorders are so crucial. The earlier someone receives intervention for their eating disorder, the more likely they are to make a full recovery. The longer symptoms are left untreated, the more difficult it is for the person to recover.

Healthcare should focus on prevention before cure, and early access to the right treatment and support can be life-changing. Some 75% of SWEDA’s staff and volunteers have lived experience of an eating disorder, which is another aspect of this issue that is so important: we need to hear from more people who have lived experience of an eating disorder. Their speaking up and leaving behind the stigma that is still associated with eating disorders is so important, and I commend everybody who has come forward and talked about their lived experience. I understand how difficult that can be, but we need them to do it. All those working for SWEDA say that they wish they could have accessed help long before they were offered it. That is why such organisations are so important: they offer specialist therapy and support to people with eating disorders and body image issues before they become ill enough to need more intensive treatment.

However, those organisations cannot cope on their own. Waiting times for eating disorder patients are out of control, and waiting lists for children’s eating disorder services have doubled since March 2020. From 2021 to 2022, only 61% of urgent cases started treatment within a week—well below the current NICE standard of 95%. I hope the Minister will be able to respond to that. For adults, there are not even targets in place. The Independent has revealed that more than 80,000 adults with eating disorders are waiting to be seen for therapy—a record number—while just 30% of adults got treatment within four weeks of their referral. Again, I hope that the Minister will refer to adult eating disorder services, where we do not have any waiting list targets or targets for support. It is very important that adult services get the same support as children’s services, where we have made progress because there are targets.

Data from the eating disorder charity Beat showed an average delay of three and a half years between someone’s eating disorder symptoms emerging and their accessing treatment. That is simply not good enough. Targets are crucial if we are to tackle this epidemic. An access and waiting time standard for adults would provoke significant extra funding and focus. If we want to encourage people to seek help, we need to give them a guarantee that they will be seen.

Having clear standards can facilitate service improvements. Standards introduced in 2015 for waiting times for children and young people’s eating disorder services have been crucial in driving service improvements. However, similar standards have been lacking in adult services. Shockingly, sufferers are reaching the point of emergency hospitalisation before they can access care. Again, that is not good enough. It also costs a lot more money if we reach people only at that crisis point.

Clinicians have reported a significant increase in the proportion of young people first presenting when they are already severely ill. NHS figures show that hospital admissions for people with eating disorders in England have risen by 84% in the past five years. For children and young people, there was a 35% increase in the past year alone—and among men and young boys, hospital admissions have risen by 128%. There is an increasingly alarming picture that eating disorders in men and boys are being overlooked and not treated early enough. That is why today’s debate is so important.

Tragically, people are losing their lives. Take the terribly sad death of Zara Taylor after two years of struggling to get the right treatment for her eating disorder. An investigation by the Health Service Journal found that at least 19 lives were lost to eating disorders in England over the past five years. At least 15 of those were deemed avoidable and resulted in coroners issuing formal prevention of future deaths reports. Coroners described patients’ safety risks being missed or poorly managed because of limited knowledge of eating disorders among doctors and health professionals, and delays in accessing appropriate treatment. That is why it is so important to have more research into eating disorders, and focus on the more specialist and rare forms of eating disorders. Those same failings were among the key issues identified five years ago by the Parliamentary and Health Service Ombudsman in its report “Ignoring the Alarms”. Surely, we need to do more and to do better.

I was disappointed that the Government decided against publishing a 10-year cross-Government mental health and wellbeing plan for England. Instead, they have developed and published a major conditions strategy that would include mental health alongside other groups of conditions, including cancers, cardiovascular disease and dementia. That is not helpful. Compared with physical health, mental health has been a Cinderella service; for years, we have been asking for parity. If everything is put together again, we run the risk of losing special attention to mental health.

Can the Government not see that for targeted and varied issues we need targeted and varied strategies? I point them to Hope Virgo’s eating disorder manifesto, which calls on the Government to implement an evidence-based national eating disorder strategy, with a plan outlining how they will tackle the huge rise in people affected by eating disorders.

I want to single out Hope Virgo for her tireless campaign. She has made such progress in helping us to understand what it is to suffer an eating disorder and access services. She has continually engaged with us and Government in order to achieve improvements. She has done fantastically well. The strategy that she calls for should integrate obesity and eating disorder prevention plans, given the overlapping factors between the two. The Government should also look at reforming treatment approaches. I hope they are looking seriously at Hope Virgo’s manifesto and strategy.

A recent University of Oxford study found that using the integrated CBT-E—enhanced cognitive behaviour therapy—approach over the current in-patient approach reduced readmission rates for people with anorexia by 70% over a year. That means that we need to treat this as a mental health condition first and foremost, and to treat people’s physical health as a result of the mental health issues. If we do not tackle the mental health issues, we will not cure the physical problems.

The strategy should also include better training. According to Beat, 20% of medical schools do not include eating disorders in their teaching at all, while those that do provide less than two hours on the topic. Training should be compulsory in order to spot early signs of eating disorders. Many participants in a 2021 Beat survey reported having a negative experience when they first sought help from a GP. There are many brilliant practitioners in the NHS delivering excellent care, but I want every doctor to complete their training with the knowledge and skills to best support people with eating disorders.

The crisis in the NHS has decimated mental health services. Staff shortages are growing. According to the National Audit Office, between 2021 and 2022, 17,000 staff left the NHS mental health workforce. The Royal College of Psychiatrists 2021 workforce census shows that since 2017 there has been a 30% increase in the number of vacant or unfilled consultant posts in England. That is not good enough. How we can encourage specialists into services is a big question that the Government need to answer.

Eating disorder psychiatry has one of the highest numbers of vacancies, with just 28 full-time consultants. We need significant investment in staff retention. The RCP’s members report high workloads and poor work-life balance. NHS trusts should be supported to meet important improvement targets for retention. I hope that the Government will keep their commitment to publish an NHS workforce plan and that they will bring that forward early, along with adequate investment.

Mental health services need proper funding. This financial year, only 13.8% of local health spending has been allocated to mental health services, although mental illness accounts for 21.3% of the total disease burden in England. The money spent on young people’s eating disorder services has not kept up with the number of young people who need treatment. I support the NHS Confederation’s call for £12 million of additional funding to be made available over the next year to get children and young people’s eating disorder services back on track.

The funding that is provided needs to reach frontline services. An inquiry by the APPG on eating disorders, which I am proud to chair, found that 90% of the additional NHS funding given to clinical commissioning groups for children’s services did not reach the services to which it was pledged. We wrote to CCGs at the time, and the answers that we received were not satisfactory. The Government must ensure that their funding pledges are not empty words and that money is getting where it is needed. A one-off boost for children’s mental health services is not enough. Soaring demand for underfunded services will lead to children missing out on care.

We are all aware that the NHS is in crisis. We hear harrowing stories about ambulance and A&E delays, but the impact on mental health services has received little attention. I hope that today’s debate will make a difference and that we will hear more about the crisis in mental health service provision.

The Liberal Democrats firmly believe that physical and mental health should be treated equally in the NHS. Eating disorders are an epidemic. The sooner we realise that, the sooner we can treat them with the attention they deserve. No one should be condemned to a life of illness, nor should anyone be dying from an eating disorder in 2023.

[Several hon. Members rose—]

[Carolyn Harris (in the Chair)]

Order. Members should be aware that I intend to begin calling the Front Benchers at 10.28 am. I call the Chair of the Women and Equalities Committee, Caroline Nokes.

09:48

[Caroline Nokes (Romsey and Southampton North) (Con)]

It is a pleasure to serve under your chairmanship, Ms Harris. I congratulate the hon. Member for Bath (Wera Hobhouse) on having secured this important debate and thank the Backbench Business Committee for having agreed to it.

I will not repeat the statistics, because the hon. Member for Bath covered them brilliantly. She highlighted the scale of the problem and the fact that it is growing more among young men; of course, Eating Disorders Awareness Week 2023 particularly highlights the challenge for young men. I will focus on some constituency cases that I have come across recently, and on some areas where we can do better to raise awareness in order to start to tackle the root causes, thereby hopefully helping future generations of young people.

I say young people, and we all know that eating disorders are most likely to impact on 17-year-old girls, but the stark reality is that they can endure into much later life. I remember meeting groups of women in this place who were well into their 40s and still suffering from eating disorders. That is not to paint too negative a picture, because we know that people can recover from eating disorders. With the right support and, crucially, early intervention, eating disorders can be tackled successfully. However, we also know that more and more people are suffering from eating disorders in this country today and that covid exacerbated that. Being locked down in our own homes, confronted with image after image on social media, undoubtedly contributed to the problem.

[Margaret Ferrier]

Social media algorithms will serve to those with eating disorders more and more content that encourages harmful and dangerous behaviours. That is particularly worrying for younger and adolescent sufferers. Does the right hon. Member agree that platforms cannot be allowed to continue to profit from that via advertisements, and that the Online Safety Bill provides the perfect opportunity to address that?

[Caroline Nokes]

That was exactly what I was going to ask the Minister: can we please make sure that the online safety legislation is used as a tool to oblige social media platforms to clean up their acts when it comes to profiting from legal but undoubtedly extremely harmful forms of advertising to people who are already suffering from very serious medical conditions? When it comes to eating disorders—specifically anorexia nervosa, which is the most lethal mental health condition there is—we have to make sure that we do not trivialising or dismiss them, regarding them as something that happens only to young girls and they get over it. The stark reality is that eating disorders kill more people than any other psychiatric illness.

We have seen from the evidence provided to all Members by the Royal College of Psychiatrists the increase in incidence, but we also know that waiting times are up hugely. I return to my initial point: early intervention is crucial. When somebody with an eating disorder asks for help, that is the time to give it to them, not 12, 24 or even more weeks later. We know there is a huge challenge with transfers from children’s to adult services. Too often, sufferers will fall through the cracks and be forced to go back to the beginning of a waiting list.

I want to highlight the case of one of my constituents— I will not give her name—who is currently suffering from a severe eating disorder and has been for years. She had been in children’s services for years but recently turned 18, which brought with it the challenge of finding her appropriate support. She is currently in an adult mental health bed in a secure ward. The stark reality is that she and two other girls in the area covered by the Southern Health NHS Foundation Trust were competing for the one bed available at Leigh House, which is the Hampshire-based specialist support unit for eating disorders. There we have it: an 18-year-old in an adult secure mental health unit, and a real challenge among clinicians to decide whether they will try to treat the physical symptoms of the eating disorder or the mental health conditions, and whether a mental health condition should take precedence over the physical problems.

I then heard from the trust that my constituent was having to be transferred every single day to be force fed with a tube because staff in the mental health unit were not able and did not want to do that. I believe that at just 18 someone is still a child. We know that with eating disorder sufferers development is often slower and young people are more childlike. Yet they are effectively forced to live in an adult mental health ward while suffering from a severe eating disorder and needing specialist help. Furthermore, training is crucial and support for staff who treat people with eating disorders is equally so. It is incredibly gruelling and, in no uncertain terms, a hideous process to have to force feed someone. We cannot imagine the impact that has on staff.

On social media content and algorithms, what does the Minister believe we can do to better protect young people? What can we do to give them the tools they need to be more resilient and to understand, when they are being pushed social media content, what is good and what is not—what is harmful and what is less harmful? I am proud to have stood repeatedly in this Chamber and called for personal, social, health and economic education to be a mandatory part of the curriculum, and proud that a Conservative Government have achieved that, but we also need to ensure that teachers are better equipped to teach PSHE, and I repeat my call for it to be mandatory up to the age of 18. It is not good enough to say that young people have to stay in education—school or college—or training until they are 18 but not to equip them with crucial life skills between 16 and 18. I get that the good colleges will do that, but many will not, so I ask the Minister to work with her colleagues in the Department for Education to ensure that the highest possible quality PSHE is delivered by teachers who feel and, indeed, are equipped to deliver it.

I want to talk briefly about stigma. I am conscious that this Eating Disorders Awareness Week we are highlighting eating disorders in boys and men. Stigma is still a huge challenge and it is undoubtedly worse for men and boys. When we look at the statistics, we see that one in five does not ever even say to anybody else that they think they might be suffering from an eating disorder. How on earth can someone get help if they cannot even talk about it?

It is incredibly difficult for young men to find their way in the world. They are under massive pressures through body dysmorphia or through the images they see, which are wholly unrealistic and unachievable. There are fitness apps on which the proponents will be taking significant amounts of steroids to achieve a physique that is, to be frank, virtually impossible for the ordinary person—the ordinary man—to achieve, and we know that over-exercising is every bit as much a part of eating disorders as not consuming calories. I am particularly aware that we need to find mechanisms to support young men, through the education system, so that they recognise the challenges around over-exercising, the dangers of steroid abuse and, frankly, the wholly unrealistic male body image that is being promoted to them.

I visited April House in Southampton, a specialist over-18 eating disorder unit, years ago now. That is to my shame: I should go back and say hello again. What was striking was that in a room of women, there was one man, and his particular problem was running. Every single day, he was running a marathon, and he could not rest mentally unless he had run those 26 miles every single day. Let us all just imagine what that was doing to his body and how incredibly weak and damaged he was by it. If we do nothing else today, let us encourage more men to speak up, encourage people to be braver, and ensure that we speak with a united voice from this Chamber. This is not a party political issue; it is absolutely a cross-party issue that we have to do more to support eating disorder sufferers.

09:57

[Patricia Gibson (North Ayrshire and Arran) (SNP)]

I am delighted to participate once again in this debate in Eating Disorders Awareness Week.

An eating disorder is a cruel and distressing illness both for those who live with the disorder and for their families, who are so often at a loss as to how best to support their loved one who is experiencing the illness. As we have heard, an eating disorder can affect anyone, regardless of gender, age, ethnicity or social background, and the impact of this serious mental illness, affecting 1.25 million people across the UK, is profound. The causes are complex, and there is no quick fix to resolve this condition. There is no doubt that, as we have heard, the gap between the onset of the illness and the start of treatment is simply too long. While family members shrink into the grip of the illness before the eyes of loved ones, families are left feeling helpless to understand what is happening and how best to provide the support that is so obviously needed.

One innovation, or new measure, that has not helped the charities and those on the frontline seeking to support people living with this condition or in danger of developing an eating disorder is calorie information on menus, which has become mandatory in England. Although we all understand the good intentions behind it, I believe it is a misguided measure. The eating disorder charity Beat is urging the Scottish Government not to follow suit on that, for very understandable reasons.

My first knowledge of the issue of eating disorders was through the story of Karen Carpenter, who died at the age of 32 in 1983 because of illness related to her eating disorder, and then Lena Zavaroni, a Scottish singer and entertainer who died in 1999 at the age of 35 because of issues surrounding her long battle with anorexia. Both those young, beautiful and very talented women spent almost all of their short lives battling with this condition, and they ultimately lost their lives to it.

Those are two very high-profile examples of deaths from eating disorder. Many people will have heard their stories and about their struggles. Sadly, it is the case that, for anyone who develops this condition, the mortality rate is frighteningly high: it is the highest mortality rate of any mental illness. As we have heard today, eating disorder does not come alone; it is accompanied by other mental health conditions such as depression, self-harm and obsessive behaviour.

[Wera Hobhouse]

Is it not also important that we look at athletes? We have heard that a lot of eating disorders are combined with over-exercising. It is important that we look at those highly successful and high-performing people, who are in danger of developing an eating disorder.

[Patricia Gibson]

Indeed. We have talked about the overlap and common ground between eating disorders and obsessive behaviour. That territory certainly includes issues such as athletes who are very conscious of body image and how to maintain it.

We have heard that eating disorders are often incorrectly, and perhaps almost exclusively, associated with young women. Stereotypes around the disorder mean that often men who are living with this condition can be deterred from seeking the help that they need. They can also have their difficulties and struggles misdiagnosed. That is why this year’s Eating Disorders Awareness Week theme is eating disorders in men. In fact, one in four people with eating disorders are men, and it is important that we raise awareness around that so that people understand this is not restricted to women.

[Mr Gregory Campbell (East Londonderry) (DUP)]

Even though men are in the minority of those affected, an important issue, and one that I too struggle with in my gender, is that many males, and young males, fail to get help, and fail to admit and acknowledge their problems. That is not the case in every other walk of life—if the car is not working, we take it to the garage; if the television is not working, we get the TV repair man—but we sometimes struggle to get males to understand that if help is needed, they should seek help and get it.

[Patricia Gibson]

Other health statistics show that men are notoriously poor at asking for the help they need, which is why they often have undiagnosed conditions. The creation of a gender stereotype around eating disorders makes it all the more difficult to break the barriers if young men develop this condition or are in danger of developing it. We need to be aware of that.

I am glad that the Scottish Government have made available support to the eating disorder charity Beat, to help to provide additional support and services across Scotland for those who are affected by this cruel illness. All medical courses in Scottish universities are discussing with Beat how to deliver, or are already providing, further training on this complex condition, of which we need to continue to develop our understanding.

Those living with the condition and their families have seen this illness tighten its grip on individuals and families who were already struggling with it during the covid pandemic. Many of those affected were left to the mercy of the awful online forums, which advise those living with the condition on how best to avoid food without family members noticing. In preparation for this debate I checked, and those online forums still exist. They are still operating and advising people how to fool their families into believing that they are eating when they are not—that is simply appalling. It is absolutely disgraceful that such sites can be hosted with apparent impunity, effectively promoting self-harm, which can and often does lead to death. When the Minister responds, I really hope she will address that.

This is a very serious condition. We work to try to remove any websites that host hate speech or incite hatred of any kind; these forums are equally dangerous, in my view, and they ought not to continue. They have been in operation, to my knowledge, for at least 20 years. There seems to have been no progress in tackling them. The takeaway for me today is that the Minister should at least tackle that element of the problem, while we all work together to try to improve treatment and diagnosis for those affected.

[Several hon. Members rose—]

[Carolyn Harris (in the Chair)]

Order. I have to impose a five-minute limit on speeches.

10:05

[Danny Kruger (Devizes) (Con)]

I thank the hon. Member for Bath (Wera Hobhouse) for securing the debate and other Members who have spoken. I also pay tribute to Members who are not with us today: the right hon. Member for Hayes and Harlington (John McDonnell), with whom I have worked on this topic, and my hon. Friend the Member for Don Valley (Nick Fletcher), who has valiantly led a campaign to recognise the need for a men’s mental health strategy. We have very much a cross-party agenda on the issue. I am pleased to work with those colleagues from the red wall, from the deep red flag of the hard left and from the deep orange of the hon. Member for Bath.

This is a totally cross-party issue, as we have heard, because this condition affects all our constituents and all our constituencies. It affects people of all ages and, of course, of both sexes. I recognise and agree with the points that have been made about unhelpful stereotypes. Some stereotypes are, of course, helpful in the sense that they point to a general truth, from which there will be many exceptions.

I spent most of my career before Parliament working in prisons, where there is a clear difference between how the two sexes express the distress that is caused by incarceration. Men tend to externalise their distress through fighting and violence against others; women internalise their distress through self-harm. Those are generalisations—there are many women who fight and men who self-harm—but they have some validity and are relevant to how we approach this particular mental condition.

There are different ways in which men and women and girls and boys express distress and mental health conditions. The fact is that the outworking of eating disorders is in many ways the same: extreme ill health and enormous distress to the sufferer or patient. I recognise the point made by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) about the distress experienced by the staff who work in eating disorder clinics. It is a very distressing condition.

As we have heard, a quarter of eating disorder sufferers are men and boys. The sources are complex—not being an expert, I do not want to stray too far into this—but it is worth acknowledging that it seems to be generally agreed that the source of eating disorders, and anorexia nervosa in particular, is a need for control. There is, of course, a perfectly healthy desire to be fit and healthy. It is appropriate that people want to control their appetites—we, not our appetites, need to be in charge—but we see that healthy desire to manage one’s health, fitness, food intake and exercise regime spilling over into a different sort of control, which itself becomes controlling. We become slave to a different sort of appetite.

I want to speak up for the men who come forward and identify themselves as suffering from eating disorders. That is a very brave thing to do. The other stereotype that we have discussed, which is entirely true, is that not enough men talk about mental health and their own mental health conditions. As we have heard, a fifth of male eating disorder sufferers have never spoken about their condition to anybody. We therefore need to raise awareness. I pay tribute to Beat, Hope Virgo and other campaigners for their commitment during this Eating Disorders Awareness Week to the cause of men’s mental health and eating disorders in men.

We know that the result of not coming forward early is that diagnosis comes later, and therefore treatment is so much harder. It is also disappointing to read in the research that the majority of men who receive treatment for eating disorders or ask for help are disappointed with the service they receive. I dare say that that is the same for women. There is obviously a fault in the provision of services.

What to do? I endorse the points that have been made about the need to raise general public awareness, which is the purpose of this debate as much as anything. People need to be able to recognise the signs and symptoms in their loved ones and friends, school friends, students and colleagues. We need more training for doctors, particularly GPs, to recognise the symptoms and signpost to good treatment. We need more services before hospital, as my right hon. Friend the Member for Romsey and Southampton North said, and we need more acute services. I pay tribute to the Cotswold House unit at the Savernake Hospital in my constituency, which is a tremendous in-patient unit. In practice, it is under-resourced, because there are not enough beds, as my right hon. Friend said.

I will end with this point: crucially, we need more support for step-down services. It is not enough just to get somebody back to the appropriate weight. It can take months and months for people to be healthy again and to be free of treatment, so we cannot just say, “You get the acute treatment, then you’re back to health, and you’re free.” We need to support people for many months more, and we need more provision in the community for that step-down service.

10:10

[Olivia Blake (Sheffield, Hallam) (Lab)]

It is a pleasure to serve under your chairship, Ms Harris. I thank the hon. Member for Bath (Wera Hobhouse) for securing the debate and for all her work on the APPG, which I am proud to be a member of.

I want to start by recognising the amazing work carried out by eating disorder specialist NHS workers and campaigners in my city and around the country, who continue to provide life-saving care and vital early intervention under increasingly difficult circumstances. Recently, I spoke to frontline workers about the situation in Sheffield, and what they reported was extremely concerning. Numbers of referrals are still up, having increased every year since 2015. The South Yorkshire Eating Disorders Association—also known as SYEDA—has a four to five-month waiting list for its services, which it fears is deterring people from seeking help.

The tsunami of eating disorders that health workers warned the Government about during the pandemic is not going away; if anything, it is getting more severe. That is because this crisis is not new. In 2017, the Parliamentary and Health Service Ombudsman for England published a damning report, which concluded that

“NHS eating disorder services are failing patients”.

Yesterday, six years later, the same ombudsman concluded that urgent action is still needed if the Government are to prevent more people from dying—a stark condemnation.

What needs to change? First, services must no longer be forced to choose between investing in early intervention and emergency support. NHS figures show that hospital admissions for people with eating disorders have risen by 84% in the last five years. Meanwhile, more than 8,000 adults are waiting to be seen for therapy—the highest figures since records began. Early intervention is the most effective form of treatment, so it is no surprise that, as it becomes harder to access, the number of critical cases is increasing. Investing in early intervention would be transformative for patients and services.

Next, we must increase training for all healthcare professionals. On average, UK undergraduate medical students receive less than two hours on eating disorders. I welcome the fact that the ombudsman is now encouraging pharmacies to take part in training programmes, as they play a crucial role in preventing more harm.

Finally, we must be consistent in having a fully funded access and waiting time standard for adults seeking help, as we now have for children. We also need a treatment pathway specifically for avoidant/restrictive food intake disorder so that people are not left undiagnosed and untreated. That needs to be commissioned through the NHS.

But we cannot stop there. To truly address the crisis, we need a root-and-branch review of eating disorder provision. We need a holistic approach, with preventive, community-based, tailored support centred around the needs of each individual patient. We need to adopt innovative forms of treatment and to launch well-funded research programmes into the most effective treatment.

This crisis could, and should, be an opportunity to rebuild our approach to how we support and treat the 1.25 million people in the UK who suffer from an eating disorder. I therefore urge the Minister to look at the transformative work groups such as SYEDA are doing to help build an alternative framework for care nationally.

I want to turn now to an issue that has been raised with me and that I have written to the Department about. I have been hearing worrying reports from eating disorder specialists, researchers, medical staff and parents of young people about the rising use of restraints on children with eating disorders in general medical wards by staff with no training in mental health. I have heard harrowing stories of staff having to close the entire ward just for one patient because the use of restraints is so disruptive and distressing. In other cases, I have heard of security guards being brought in to restrain patients because the staff were not trained to provide this sort of care.

The use of restraints and restrictive interventions can have long-term consequences for the health and wellbeing of patients, as well as a negative impact on the staff involved. I have also heard that these interventions have been used far too early and without following guidance, such as that from NICE.

Under section 6 of the Mental Health Units (Use of Force) Act 2018, medical staff are required by law to record the use of restraint in all medical settings, but the Act does not apply to patients being treated for a mental health disorder in general medical settings. I am extremely concerned that that means that we do not know how prevalent the use of restraint is for children currently stuck in a medical ward awaiting a tier 4 bed. I hope the Minister will consider applying the recording requirements that apply to the use of restraints in mental health settings to patients who are currently in non-mental health settings. Will they meet me to discuss this further?

In my city, Sheffield Children’s Hospital has recognised this as an issue and has already started recording restraint, recognising the difference between the services it provides for mental health and non-mental health conditions. That is so important. It is a national scandal waiting to happen that people are being forcibly restrained when it is not needed.

10:15

[Tim Farron (Westmorland and Lonsdale) (LD)]

It is a genuine pleasure to serve under your guidance this morning, Ms Harris. I congratulate my hon. Friend the Member for Bath (Wera Hobhouse) on securing this debate, which she has led very well. It has been a helpful debate, and I associate myself with the comments that everyone has made. I also add my thanks to Beat, Hope Virgo and all the others leading the campaign to increase awareness and improve provision for people suffering with eating disorders.

Eating disorders are, of course, a range of mental health conditions that have a physical consequence, with maybe two thirds of those suffering from them having a physical illness as a consequence of their mental health condition. It is a privilege, and deeply moving, to work alongside, support and serve sufferers and their families in my communities in Cumbria. I feel deeply affected by not just their struggle with their condition but, sometimes, their struggle to access the services they need.

As has been mentioned, covid has had an impact on the prevalence of eating disorders, with something like a 55% increase in referrals during that period, and an increase of more than 80% in the number of hospital admissions, and I want to remark on what we do in response to those admissions. In our communities in Westmorland, anybody needing tier 4 hospitalisation for an eating disorder will be placed in a bed in Manchester, Edinburgh or Darlington if they are lucky and there are sufficient beds in those places. In many cases, as the hon. Member for Sheffield, Hallam (Olivia Blake) mentioned, people—often young people—end up hospitalised on the wrong kind of wards, where they are supported by lovely, wonderful people who are just not trained to support them. Therefore, the experience not just of that person in their suffering, but of the people caring for them and the other people—often young people—on those wards, is harrowing, deeply distressing and inappropriate.

As has also been noted, it is worth mentioning that the use of BMI as a measure to decide whether someone can access services is dangerous and foolish. We would not say to a person with cancer, “Come back when you have more cancer”—we would treat them.

[Caroline Nokes]

This will be a very brief intervention. The hon. Gentleman is absolutely right about BMI—we really have to move away from it. It gives a misleading impression of wellbeing. Can we please remember that it is designed for a Caucasian male’s body type? We know that the majority of sufferers of eating disorders are women.

[Tim Farron]

I am grateful to the right hon. Lady for a helpful intervention. That is absolutely true. We would not say to a person who presented with cancer, “Come back when your tumours have spread.” If someone is presenting with an eating disorder, we need to believe them and allow them to access the right support immediately. That needs to be changed urgently.

At the other end of the spectrum, at tier 1, and particularly for young people, what are we doing to build resilience so that people do not develop eating disorders in the first place? In Cumbria, there is nearly nothing in terms of provision for adults, while we spend a grand total, through our public health, of 75p per child and young person on tier 1 resilience support, and that is for all mental health conditions, not just eating disorders. We need to prevent people from getting into these circumstances in the first place—for their sake and for everyone else’s.

Let us be positive: it is important to welcome the access waiting time standards. They are a good thing. However, they are mostly not being met. In north Cumbria, 26% of routine referrals of young people and 11% of urgent referrals of young people are not being treated in that timescale. In south Cumbria, 23% of routine referrals are not being seen within the four-week standard. While there is better news for those meeting the standards for urgent referrals, the total declared for Morecambe Bay hospitals trust is 12 individuals with an urgent eating disorder need. That is baloney. I personally know more people than that who are struggling, which tells us either that the data is faulty or that it is hard to get into the system because BMI is used as a gateway to access those services.

More generally, this speaks of a lack of parity when it comes to care, treatment and taking seriously issues relating to mental health, particularly where young people and eating disorders are concerned. If one of our young people were to break their leg on a football pitch on a Saturday afternoon, they would be straight into hospital and the healing process would begin that day. If something invisible in them breaks, it could be weeks or months before they get support, or it could never come. It may come dangerously, or even fatally, too late, and that is wrong.

What are our collective asks? We need increased awareness. It is right that we focus on men, who are less likely to come forward and yet make up a huge proportion of those in need, but help should be there for everyone, and I urge people to come forward and access it. We also need more support for families, who are massively hit by the consequences of eating disorders for their loved ones.

We mentioned the waiting time standards for young people and children—I am glad we have them, although I wish we met them—but there are no standards for adults, and it is about time that there were. Research funding needs to be increased so that we can understand the causes and cures and tackle this range of diseases head on. We need to be utterly intolerant of dangerous images and things that lead people into this dangerous area and cause such ill health.

Medical training needs to be improved so that we can refer our referred accurately. We need to tackle the BMI gateway. When tackling obesity, for example, we need to remember that there is a danger of things such as like calorie references being well-intentioned but counter- productive. We need to ensure that money allocated to integrated care boards for eating disorder support is actually spent on that. Finally, services must be commissioned adequately and close to home.

10:22

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to speak in Westminster Hall, and I thank the hon. Member for Bath (Wera Hobhouse) for securing this essential debate. She has made it her passion in the House—in Westminster Hall and the main Chamber—to highlight these issues, and I commend her for that. Her enthusiasm and energy for the subject are worth noting. This is an emotive issue and, like other hon. Members, I have recently been fighting a case for a constituent who needed in-patient care and could not be seen in Northern Ireland.

According to a report published by the Regulation and Quality Improvement Authority in its review of eating disorder services in Northern Ireland, approximately 50 to 120 people develop anorexia nervosa and 170 people develop bulimia nervosa every year in Northern Ireland. That is a significant number. Thanks to the office of former Health Minister Edwin Poots, and thanks to his energy and commitment, a young woman who was a constituent of mine at the time went to St Thomas’s across the way. He saved her life—I have no doubt about that at all. Her mum and dad were extremely concerned about her, and I was concerned because I know the family very well. Today she is a married woman with two children and she has a life like everybody else because action was taken. That is a true story and shows what can be done. In another case—I know the mother and the young girl herself well, but I will not mention any names—my constituent needs advanced help.

We want to address the issue of stigma, discrimination and shame. It is clear that eating disorders are becoming more prevalent, and there are a number of reasons why people believe that is the case. I have heard of those who blame filters on social media, which make vulnerable people believe that a flat stomach, perfect abs and enhanced proportions are real. As the hon. Member for Bath said, that mostly affects men, but some girls want that as well. Others have highlighted that eating disorder forums accessible on the internet and on social media give tips on how to eat as little as possible.

I had a parent tell me before Christmas that a school classmate pledge was the reason why her daughter dropped to 6 stone at a height of 5 feet 9 inches. The classmates decided that none of them would eat Christmas dinner and that they would weigh themselves several times a day. That is peer pressure. Again, that illustrates what the hon. Lady has said in this important debate. This parent said her daughter went to the GP and was found—at 14 years of age—to have damaged her heart and to be in danger of starvation, yet she felt the schoolyard pressure to fit in with other dieting 14-year-olds. We need to get things in place because boys and girls could destroy their health, or even kill themselves, if they do not have access to mental health services. The mental health aspect is really important.

[Mr Gregory Campbell]

My hon. Friend is outlining some harrowing cases from his constituency. Does he agree that some progress has been made in the wider context of the debate but that, as in other walks of life, we need to ensure that more progress is made to get to a better place?

[Jim Shannon]

I thank my hon. Friend and colleague for that intervention. Yes, I fully agree. As always, and I say this not because he is my friend and colleague, he brings wise words to Westminster Hall. I thank him for that.

On mental health, it is also known that early recognition and early treatment are associated with improved outcomes, so it is vital that all healthcare professionals are able to identify those at risk. There is an onus on them to do that, and patients should be able to access care quickly.

However, this is not simply a disease of young girls or indeed of young people in general. As others have said, one person in four with an eating disorder is a man, and the eating disorder charity Beat launched the United Kingdom’s biggest survey to date of men’s experience of eating disorders. Of those who took part, one in five had never spoken about their struggles—that happens—and four in five felt that raising awareness would help more men get treatment sooner. I ask the Minister, what has been done to promote awareness and to signpost available help—not simply for worried parents, but for worried brothers and sisters and for family members and friends who can see that things are not going well for their loved one?

I read an article on the National Eating Disorders Association website with the heading “Nine Truths about Eating Disorders”. I am not sure whether I have time to mention them all, but I will do my best—I will talk really fast, and nobody will be able to understand. [Laughter.] No, I am not going to do that.

The article states:

“Many people with eating disorders look healthy, yet may be extremely ill… Families are not to blame, and can be the patients’ and providers’ best allies in treatment.”

The third point, which I want to emphasise, is that an

“eating disorder diagnosis is a health crisis”—

that is what it is, and we should be under no illusion that it is anything else—

“that disrupts personal and family functioning.”

The article continues:

“Eating disorders are not choices, but serious biologically influenced illnesses… Eating disorders affect people of all genders, ages, races, ethnicities, body shapes and weights, sexual orientations, and socioeconomic statuses… Eating disorders carry an increased risk for both suicide and medical complications”

Others have mentioned that. The article goes on:

“Genes and environment play important roles in the development of eating disorders… Genes alone do not predict who will develop eating disorders.”

The ninth and last truth is:

“Full recovery from an eating disorder is possible. Early detection and intervention are important.”

I want to finish on this point. I am thankful for Eating Disorders Awareness Week, but I say with the greatest respect to the Minister—it goes without say that I greatly admire her, and we are dear friends—that we need an action plan. Will she put her shoulder to the wheel and implement what is necessary to effect change in the way we fund this area and approach this killer, because it is just that? Will she do so as a matter of urgency?

10:28

[Carol Monaghan (Glasgow North West) (SNP)]

It is pleasure to serve under your chairmanship, Ms Harris, and I pay tribute to the hon. Member for Bath (Wera Hobhouse), who has campaigned tirelessly on the issue and brought the debate to the House today.

The hon. Lady talked about the focus on men and why that focus is important—one in four of those affected by an eating disorder is a man. We have heard some statistics today, including that there has been an increase of 128% in hospital admissions of men for this issue, so it is right that we should highlight it this morning. We have also heard that men are notoriously poor at asking for help, so it is important that we have so many male MPs here this morning, speaking out and raising awareness.

I want to talk about the BMI issue, which was mentioned by the hon. Member for Westmorland and Lonsdale (Tim Farron). I remember having my BMI measured during a health screening process at my previous place of work. At the time, I was six months pregnant, but I was a slim six months pregnant.

[Jim Shannon]

You are still slim.

[Carol Monaghan]

I thank the hon. Gentleman for that comment. However, I was told that my BMI showed that I was obese. I said, “I’m not obese, I’m pregnant”, and they said, “No, you are obese. You’re showing up as obese.” And they gave me a leaflet on obesity. It seemed that I could not break through that mindset. Those carrying out and promoting these tests sometimes have absolutely no understanding of what obesity is about. I was able to speak up for myself quite capably, but there may be others for whom it is different, so I totally agree with the comments about BMI.

The hon. Gentleman talked about the importance of intervention and how it makes such a difference. He spoke about a young lady in his constituency who is alive today because of an intervention to help her. All of us have to hear those types of stories.

I am a teacher by profession, and over the years I worked with a number of young people who had eating disorders. It was interesting that most of them wanted to get better; they understood that there was an issue. It was often high-performing young people, as well; eating disorders represented an element of control for them. We saw that early intervention made such a difference for them. It was important that teaching staff and other people in a young person’s life were able to recognise the signs early on, and did not put them down to, “She’s just doing a bit of extra exercise”, or, “He’s just trying to achieve that body.”

Unrealistic expectations are put on young people. We have heard from a number of Members this morning about the impact of social media. I would add that some TV programmes also have an impact. I will name one in particular: “Love Island”. It shows beautiful young people with perfect bodies wandering about all day, scantily dressed. If young people aspire to those unrealistic standards, it is not good for anyone. The producers of such programmes need to take responsibility for their impact.

The NHS digital survey asked children and young people aged between 11 and 19 a number of questions, including, “Have you ever thought you’re fat when other people said you were thin?”, “Have you ever made yourself deliberately throw up?” and “If you eat too much, do you blame yourself?”. The responses were really worrying. Among 11 to 19-year-olds, 12.9% screened positive, meaning that they answered yes to two or more of those questions. Among 17 to 19-year-olds, the screening positive figure was 60%. If that is what young people are thinking, then we are at crisis level.

The waiting times to receive help are too long. We heard from the hon. Member for Sheffield, Hallam (Olivia Blake) about a 2017 report on eating disorders that referred to patients being failed, and how that situation really has not improved. We also heard harrowing stories about patients being restrained, which I think all of us here were quite disturbed by.

The right hon. Member for Romsey and Southampton North (Caroline Nokes), who is Chair of the Women and Equalities Committee, talked about the impact of shortages in services on those affected by eating disorders, and mentioned that it would not do young people any good to be treated in adult services. We must provide appropriate treatment in appropriate settings.

My hon. Friend the Member for North Ayrshire and Arran (Patricia Gibson) talked about two very prominent women, Karen Carpenter and Lena Zavaroni. I will talk about a colleague of mine who had an eating disorder. She was getting over it when, sadly, she had a heart attack and died. We do not talk enough about the long-term impact of eating disorders on physical health. We know that the heart is affected by them.

As time is short, I will scoot through my speech and get to the asks. First of all, we need action on social media companies that target vulnerable individuals. We also need the removal of calories from menus; their inclusion was aimed at tackling obesity, but unfortunately the message is hitting the wrong people. We need better input to mental health services, and we absolutely need signposting for families who are going through the trauma of having a family member suffer from an eating disorder.

Finally, I thank the hon. Member for Bath once again for securing this debate, and for giving us all an opportunity to speak about the issue this morning.

10:34

[Dr Rosena Allin-Khan (Tooting) (Lab)]

What a pleasure it is to close for the Opposition with you in the Chair, Ms Harris. I thank the hon. Member for Bath (Wera Hobhouse) for bringing forward this debate; I am honoured to be part of it again. It is a shame that we have to be here every year talking about this issue, but it is a testament to how seriously we take it. We will be here until we see the issue resolved.

This is normally the point at which I mention a few comments from Labour Members and say, “Didn’t they do well?”, but every single contribution and intervention was valuable. I learned new things on a topic that I thought I already knew very well. I hope that this debate will not just be filled with words about what needs to change, but that there will be something tangible—some action—at the end.

Across the UK, as many as 1.25 million people are living with an eating disorder. That is a staggering number, if we actually think about what that means. We have heard about the considerably high mortality rates; anorexia claims the most lives of any mental illness. With timely and appropriate treatment, people can go on to live healthy and fulfilling lives, so how many of those deaths are avoidable? That is the truth that we have to face.

I welcome the fact that we have opportunities in this place to mark Eating Disorders Awareness Week, but we have to do so much more all year long to challenge the stereotypes and assumptions that so many people still hold about eating disorders. It is so important to remember that eating disorders can manifest themselves in a variety of ways—through people eating too much or too little, or even restricting what they eat. To echo what has been said, we must never forget that eating disorders can affect people of any age, gender, ethnicity and socioeconomic background.

We have heard that one in four people with eating disorders is a man. It is staggering that it is still so difficult for boys and men to come forward and talk about their issues with eating. In my work in A&E, I see younger and younger people—especially boys—talking about their struggles with food and body image. They often cite social media and peer pressure as the source of those struggles.

I always like to thank the charity Beat for its incredible work. It works so hard to combat the negative stereotypes and misleading perceptions of eating disorders, which are sadly all too common. As was said eloquently today, people experiencing an eating disorder can often find themselves in mental health hospitals. To pick up on the point made by my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), about the use of restraint, I have written to the Minister on that topic. I look forward to having a meeting about it, and to seeing the end of the inappropriate use of restraint. Mental health in-patient settings must be a place of safety, where patients and their loved ones can expect to be treated with dignity and professionalism. However, that is clearly not always the case.

For the families of those with eating disorders, the situation is crippling. They have an all-encompassing fear of the unknown when it comes to what their loved one will eat that day. They are concerned that they may have to give up their job, or even not care as much for their other children because they are obsessed with what one child is eating. They know that the child could lose their life at any moment.

It has been agonising to listen to the recent reports of the death of 19 eating disorder patients in in-patient settings; serious concerns were raised about their care. Lives should not be needlessly lost because of poor care and a lack of understanding of eating disorders. My heart goes out to their friends and families. Far too many families—not just the families of those with eating disorders—have lost loved ones in mental health hospitals. How many more people will lose their life before the Government get a grip on safety in in-patient settings? We need a Government who will get serious about mental health and eating disorders. As we have said time and again, access to proper treatment can be life-changing. Prevention is important, and early intervention provides the best chance for recovery. Think of those families who have lost loved ones, knowing that it could have been prevented, and that we in this place have not yet done enough to save these lives.

Targets on accessing treatment are being routinely missed. In 2016, a clear standard was set that 95% of children and young people experiencing the most urgent eating disorder cases should receive treatment within one week. Since then, however—I accept that the Minister has not been in post that entire time—the Government have missed the target; I hope the situation will improve. Disappointingly, only 60% of urgent cases were seen within one week last year. That means that four in 10 children and young people were not seen at the point of desperation. Children and young people are being left on lengthy waiting lists, unable to access support. Meanwhile, their families are helpless, and are trying their best to support their children without vital help from mental health professionals.

[Wera Hobhouse]

Does the hon. Lady realise the mental health impact on those who see a sufferer suffering and not getting the intervention they need? Families see what is happening to their loved one. They are waiting with them, and their mental health is deteriorating at the same time.

[Dr Allin-Khan]

Without a shadow of a doubt, not investing in a person with a mental health need often has a knock-on impact on four, five or six members of the family. Ultimately, we then need to use more mental health resources to serve their needs as well. It makes no economic sense, and no moral sense either, so I thank the hon. Member for her intervention.

The strain that an eating disorder places on an entire family is immense. As I say, parents often have to stop working to care for their child around the clock. How can the Government continue to fail young people with mental health needs? This cannot go on. For how long do the Government think it is acceptable for young people to be stuck on waiting lists for mental health treatment? Eating disorder psychiatry and child and adolescent psychiatry are two of the three psychiatric sub-specialties with the highest consultant vacancy rates. Where is the Government’s workforce plan? Patients are suffering.

After more than a decade of Tory mismanagement, patients are being failed, waiting lists are soaring and services are struggling to cope. I do not like to make eating disorders a political football—they are not—but the truth has to be told: the Government have failed thus far on their commitment. If they cannot get a grip and improve services, Labour will. We stand ready with a bold plan to recruit 8,500 additional staff in order to provide mental health treatment within a month for all who need it. Labour will put prevention and early intervention at the forefront of our approach to mental health. We will place a mental health specialist in every school, and we will place an open-access mental health hub for young people in every single community. The Government can no longer continue to neglect mental health services.

10:43

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Ms Harris. I thank the hon. Member for Bath (Wera Hobhouse) for securing this important debate. Both as an MP and as chair of the all-party parliamentary group, she has long been a champion of those with eating disorders.

Improving treatment for eating disorders is a key priority for the Government and a vital part of our work to improve mental health overall. We have heard from right hon. and hon. Members from across the political divide about how urgent this issue is and how many of our constituents are affected by it. It is national Eating Disorders Awareness Week, and raising awareness is an important part of improving the outcome for those suffering with this serious and often life-threatening condition. It can affect anyone of any age, gender or background.

As has been mentioned numerous times, Beat has done tremendous work in this space. It estimates that 1.25 million people live with an eating disorder in the UK. Of those, one in four is a man. I am really pleased that this year’s national Eating Disorders Awareness Week is focusing on eating disorders in men. I think that every Member who spoke in the debate covered the fact that men are often reluctant to come forward and ask for help. There is a stigma around eating disorders, particularly for men. It is important that healthcare professionals recognise that this is also an issue for men, so that if a man or a young boy seeks help, that is taken seriously.

It is vital that we recognise that these issues affect men, so that we can break down the stereotypes and help men to speak up and get help, because having an eating disorder is devastating, and not just for the individual. As the hon. Member for Strangford (Jim Shannon) highlighted, it can also be devastating for those around them, whether family or friends. We know that recovery is possible, which is why it is so important that people come forward to ask for help and support, and get timely access to the right treatment that can save their lives. That is why, under the long-term plan for the NHS, we are investing £1 billion extra in community mental healthcare for adults with severe mental health illness, which includes treatment for eating disorders. The extra funding is being used to enhance capacity for new and improved community eating disorder teams, covering the whole of England.

Hon. Members have raised concerns about long waiting times in their communities. Integrated care boards, which were set up in July, now commission services. We will hold them to account for their timelines, but hon. Members can also hold their local commissioners to account. The funding is given to them for mental health services. We do not dictate how it is spent, because that will be different for different communities, and the prevalence of eating disorders will be different in different parts of England. We expect commissioners to commission those services and to ensure capacity and timeliness for their local population, but if Members of Parliament feel that is not being done, we are happy to meet them to discuss how we can improve things locally.

Since 2016, investment in children and young people’s community eating disorder services has risen every year; there has been an extra £53 million per year from 2021. As my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) highlighted, the pandemic continues to have an impact on the mental health and wellbeing of many people, and has caused a large increase in demand for eating disorder services. Services were almost closed, or certainly severely reduced, for nearly two years during covid, and covid itself had an impact, and there is now a tsunami of people coming forward. Data shows that the number of children and young people entering urgent treatment for an eating disorder in 2021 increased by 11% on the previous year, to over 2,600, and in the year before that it increased by 73%, from around 1,300 to close to 2,400, so there are more referrals than ever before.

A number of Members, particularly my right hon. Friend the Member for Romsey and Southampton North, mentioned online safety. I reassure colleagues that we are working with Ministers from the Department for Culture, Media and Sport on the online safety legislation, but also on other issues, because there is so much work that needs to be done to ensure that online influence is reduced where it is causing significant harm.

To return to the funding being made available, this is the first Government to really put mental health on the same footing as physical health. I am proud that we are creating parity of esteem, not just in planning services but in funding services. As part of the £500 million covid recovery plan funding for the mental health recovery action plan, we have invested an extra £79 million to expand young people’s mental health services, which has allowed 2,000 more children and young people to access eating disorder services. We have delivered this, with over 4,000 more young people entering treatment for an eating disorder than did in the previous year.

A number of Members talked about setting targets for children. We have indeed set targets for children’s eating disorders services. For adults, NHS England has consulted on setting a target for mental health services. I am particularly keen for that to be introduced as quickly as possible. I am meeting NHS England’s clinical lead for mental health services in the coming days and hope to be able to update Members on progress on that, because what gets measured gets done. While we may not be meeting the target for children yet, because of the sheer scale of demand, at least we have a target, and we know which parts of the country can and which cannot meet it, and I am keen that we do the same for adults.

The issue of BMI was raised, and I take the points made extremely seriously. Let me be clear: rejection for treatment on BMI grounds should not occur. If there are instances where that has happened, I am happy to address them; that practice is not in line with any guidance, including National Institute for Health and Care Excellence guidance, so it should not be happening. If there are examples of it happening, we are very keen to hear about them. If it is happening at a local level, I urge hon. Members to contact their local commissioners to find out why, because the guidance does not recommend that practice at all.

The hon. Member for Sheffield, Hallam (Olivia Blake) raised the issue of restraint, which I was concerned to hear about. We introduced new legislation in 2018 on restraint in mental health in-patient settings. If there are loopholes in that legislation, I am very keen to look at them. Restraint should not be happening at in-patient mental health settings, but if someone is outside of that setting and it is happening, we need to look at that. The rapid review across in-patient mental health settings is looking at the safety of those services. We will be looking at the results of that review in the coming weeks. I am clear with hon. Members that this Government sees mental health services as a priority.

[Sir George Howarth]

The Minister may recall that I intervened on the hon. Member for Bath (Wera Hobhouse) about the problem of type 1 diabetics with eating disorders. Is the Minister aware of the two trials taking place, one in London and the other in Bournemouth in the west country? Once an evaluation of the success of those integrated approaches is available and published, will she undertake to look at it, because it could have some indications as to how to treat other kinds of eating disorders as well?

[Maria Caulfield]

Absolutely; I will look out for the results of those trials. I am keen that we use evidence-based medicine, and if something has proven to be effective in clinical research, it absolutely needs to be rolled out. An hon. Member touched on the lack of research into eating disorders. The National Institute for Health and Care Research does have funding available, so I would encourage clinicians, researchers and charities that want to undertake research into eating disorders to apply for funding for those trials. We need more research into eating disorders, particularly around men and high-risk groups, such as diabetics.

[Wera Hobhouse]

Will the Minister respond to the concern raised that Government money had been made available but did not reach the frontline, as a freedom of information request by Beat showed? How do the Government intend to tackle that and ensure that money reaches frontline services?

[Maria Caulfield]

The Government have made huge amounts of funding available, for both mental health and eating disorders. More funding than ever before has gone into those services, but that funding needs to reach the frontline. That speaks to my point about local commissioners: where funding is given to a particular area, commissioners are supposed to use that money to commission services at a local level. If that is not happening in some parts of the country, then I am happy to meet with those commissioners and Members of Parliament to find out why.

We want to ensure that funding is going to the frontline to make the difference that we need it to. We are the first Government to prioritise mental health, and the first to set targets for eating disorder referrals. We are the first Government to set a standard of recruiting 27,000 additional mental health workers. We have started to roll out mental health teams in our schools, and when I spoke to the Royal College of Psychiatrists yesterday, for the first time it said that it had filled all its training posts in the last year.

We are making significant progress, but patients need to feel that. That is the next step. I am happy to work with the hon. Member for Bath and the APPG on eating disorders to make sure that is happening on the ground, because, as someone said, it is great to talk about it, but we need to see the impact for patients.

I hope that reassures right hon. and hon. Members about how seriously we take this issue. I look forward to working with everyone across the House to make eating disorders a bigger priority for clinical work. Good progress has been made, but there is a lot more to do.

10:54

[Wera Hobhouse]

It has been a real pleasure to listen to all the contributions today; I thank everyone who contributed to the debate. It was wide-ranging, reflecting the wide-ranging issues associated with eating disorders, from body image and social media to access to services, waiting times and the need for early intervention and diagnosis, as well as the need for research funding and more specialists in the field.

This is a cross-party effort to eradicate the epidemic of eating disorders. The good news is that eating disorders can be treated and full recovery is possible, but we need to do a lot more to make that happen. We need to increase our knowledge about the many different types of eating disorder. We need many more specialists and specialist services, and mental health and physical health services need to be integrated, as has been made clear today. Eating disorders are a mental health condition, as well as a physical health condition. If the two are not treated together, then we are failing patients.

Eating disorders do not discriminate; we must encourage everybody to come forward to seek help, especially boys and men. That was the main topic of the debate. Early diagnosis and treatment can make a life-saving difference. As we have heard many times, men do not like to come forward or talk about physical problems, but it is important for men of all ages to come forward and seek help.

I thank everybody who contributed, particularly those tireless campaigners, including Hope Virgo, who has been mentioned several times, and the eating disorder charity Beat. Without their tireless efforts, awareness of eating disorders and treatment would not be what it is today.

Question put and agreed to.

Resolved,

That this House has considered Eating Disorders Awareness Week.