Why the UK Needs a National Strategy for Eating Disorders: Lessons from Around the World

Eating disorders remain one of the most significant and persistent treatment gaps in UK healthcare, they are also one of the areas with the greatest potential for meaningful transformation. As an Associate Non‑Executive Director at Lancashire and South Cumbria NHS Foundation Trust, and formerly a Director at the NHS Benchmarking Network for 26 years, I’ve spent much of my career supporting national policy teams to monitor and improve mental health services using data and evidence. Through this work, I have seen huge progress in UK mental health care. However, eating disorders stand out as a major exception: one of the largest treatment gaps in the NHS, and an area still lacking a national strategy to guide long‑term improvement.

Understanding the Scale of the Challenge

Access to NHS Benchmarking Network data was central to my ability to establish the case for change in UK eating disorders services. The national lifetime prevalence of eating disorders in the UK is estimated at up to three million people, yet only around 35,000 people can access specialist eating disorder services each year. It is important to note that services for children and young people have strengthened, as a direct result of the focus, investment and workforce development that was made possible by successive national strategies for CYP mental health. The most substantial element of the UK treatment gap is for adult eating disorder care which has not been subject to a national strategy and continues to face capacity limitations and high thresholds for access, leaving many without timely or appropriate care.

A Churchill Fellowship to Explore International Solutions

In 2024, I was awarded a Churchill Fellowship to learn from countries that have implemented national strategies for eating disorders. My aim was to understand how governments around the world are responding to rising demand and how the UK might adopt similar approaches. I collaborated with policymakers, providers, and lived‑experience organisations across Australia, New Zealand, and Sweden, exploring early intervention models, effective treatments, best use of resources, strategies for enhanced prevention and the process of one day finding a cure.

What Other Countries Are Doing Differently

Each country had a clear political support for a national ED strategy. Australia has a long history at state and federal government level, using a stepped‑care model, emphasising that eating disorders are ‘everyone’s business’ in healthcare, and helping improve both skills and access. In Sweden the system of prioritisation and national guidelines had succeeded in raising the profile of all eating disorders, whilst bringing a particular focus to the need to enhance care for anorexia and ARFID. Sweden takes an evidence‑led approach to healthcare strategy and planning, with national guidelines and structured care pathways, including specialist hubs and digital therapy services which provide rapid first line response and help in relapse prevention. New Zealand’s refreshed strategy focuses on improving access, expanding workforce capability beyond specialists, and ensuring services are culturally specific and inclusive.

In each country it was possible to see the demonstrable benefits that national strategies and frameworks offered in being able to illustrate a vision for eating disorders care and describing the clinical standards that were expected to be delivered.

The Role of Lived Experience

Across all three countries, the importance of lived experience is embraced in their strategy development and implementation. Carers and service users helped shape policy and offered crucial feedback on real‑world experience and impact.

Why the UK Can and Should Act Now

The UK has a strong history of delivering improvements in mental health care through clear strategies and investment. Eating disorders should be no exception. With demand rising and international evidence showing effective solutions, the opportunity for transformation is both urgent and achievable. The full Churchill Fellowship report details evidence and recommendations to guide this change.

Read the full report: Addressing the treatment gap in UK eating disorders, learning from international studies - The Churchill Fellowship 

Contact Steve: stephen.watkins@lscft.nhs.uk