Body Mass Index

Baroness Parminter Excerpts

Thursday 22nd April 2021 Grand Committee

[Baroness Parminter (LD) [V]]

My Lords, I thank the noble Lord, Lord Addington, for his passionate introduction to this debate.

I applaud the Women and Equalities Committee’s work highlighting the impacts of the use of BMI on eating disorders and people’s mental health by disrupting their body image. Eating disorders are not niche. The 2019 NHS health survey found that

“16% of adults … screened positive for a possible eating disorder”.

Covid has increased the pressure on eating disorder services hugely, with referrals across the country increasing by 75% on average.

There is still an overreliance on BMI by GPs when diagnosing eating disorders to determine who is unwell enough to access treatment. Hope Virgo’s “Dump the Scales” campaign has literally hundreds of people, mainly young women, sharing how damaging it was to be told that they were not thin enough for treatment. It drives them deeper into this pernicious illness, which I know about from our family’s experience. Indeed, the evidence shows that early intervention is far better and offers the best hope of recovery.

The Government and the NICE guidelines are clear: BMI should not be used on its own as an arbiter of whether to offer treatment, yet GPs are still doing this. Why? First, there is inadequate training for GPs and other health professionals about eating disorders. The issue was identified by the Parliamentary and Health Service Ombudsman in his report on eating disorder services in 2017, in the follow-up report by the Public Administration and Constitutional Affairs Committee in 2019, and in the Cambridgeshire and Peterborough coroner’s prevention of future deaths report last month, to which the Secretary of State has to respond formally by next Wednesday. Will the Government now lead a strategy to improve eating disorder education in the medical profession, including embedding it in the curriculum? For GPs already in surgeries, a screening tool should be produced to ensure that, instead of relying on BMI, they ask the right questions of patients, with clear guidance on the language to use.

Secondly, GPs are using BMI to ration access to services as demand hugely outstrips supply. I welcome the Government’s recent investments in mental health funding, but it is mainly for children and young people, and only one in six eating disorder patients is under 18. Given the rise in demand, significantly exacerbated by Covid, without ring-fenced funding BMI will continue to be used to limit access to eating-disorder services, resulting in further unnecessary deaths.