Eating Disorder Patients Discharged with Dangerously Low BMI, NHS Data Reveals

The release of new data revealing that mental health units in England are discharging patients with eating disorders even when their body mass index (BMI) is dangerously low – in some cases as low as 12.5 – is raising serious concerns among clinicians and advocates. The findings, obtained through Freedom of Information requests by eating disorder campaigner Hope Virgo, underscore a growing crisis in the provision of care for these complex and often life-threatening conditions.

The data, covering discharges between January and November of last year, shows that nine NHS trusts discharged a total of 119 patients with anorexia nervosa or avoidant restrictive food intake disorder (ARFID) when their BMI was below 15. A BMI of 15 is internationally recognized as indicating severe malnutrition, according to the World Health Organization. Although discharge at this level isn’t unheard of, experts warn it significantly increases the risk of relapse, chronic illness, and even death.

The Risks of Premature Discharge

Dr. Agnes Ayton, an NHS consultant psychiatrist and vice-chair of the eating disorders faculty of the Royal College of Psychiatrists, explained the dangers. “A BMI of 15 represents severe malnutrition…Discharge at this stage carries a high risk of rapid relapse, progression to a chronic course or further physical and psychological deterioration.” The usual minimum BMI considered safe for discharge within the NHS is typically between 18.5 and 19, reflecting a healthier weight range. However, clinicians emphasize that BMI is not the sole determinant of readiness for discharge, but rather one factor among many.

Bethany Francois, a dietitian specializing in eating disorders, expressed strong concern, stating, “In my experience, no individual I’ve ever worked with has been well enough to be discharged from eating disorder treatment at a BMI of 15.” She highlighted the potential for serious physical complications at such low weights, including cardiovascular instability, hormonal disruption, compromised immune function, and bone density loss.

Underlying Pressures on NHS Services

Experts believe these early discharges are likely linked to the increasing strain on NHS mental health services. Demand for eating disorder treatment has surged, particularly since the COVID-19 pandemic, while funding has not kept pace. This creates a situation where hospitals may be forced to prioritize bed availability over optimal patient care. The Guardian reported in February 2026 that NHS eating disorder services are struggling to cope with the rise in demand.

Dr. Ashish Kumar, chair of the eating disorders faculty of the Royal College of Psychiatrists, acknowledged that discharge decisions are based on a complex assessment of clinical, psychiatric, medical, and social risk factors. He emphasized that no single BMI threshold dictates discharge readiness, but generally, a BMI of 19 is considered indicative of sufficient health for a safe return to the community.

What the NHS Says

NHS England maintains that existing discharge practices are safe. A spokesperson stated that the figures “in isolation are not unusual” and that clinical guidance, including that from the National Institute for Health and Care Excellence (NICE), is clear that BMI should not be used as the sole marker of readiness for discharge. They added that patients are only discharged by expert clinicians when they have made sufficient progress in their weight, eating patterns, and other factors, and with appropriate support plans in place for continued recovery.

The Role of Advocacy and Data Transparency

The revelations about these discharges were brought to light through the persistent advocacy of Hope Virgo, who herself experienced an eating disorder as a teenager. Virgo’s work with the All-Party Parliamentary Group on Eating Disorders has been instrumental in raising awareness of the systemic failures within the UK’s eating disorder services. Her utilize of Freedom of Information requests has forced greater transparency regarding discharge practices and highlighted the extent of the problem.

Virgo is critical of the tendency to blame patients for slow recovery, noting that clinicians sometimes attribute lack of progress to a lack of motivation. She argues that discharging individuals at dangerously low weights is not a neutral clinical decision, but a failure of care.

Looking Ahead: Systemic Change and Improved Support

The situation demands a multifaceted response. Increased funding for eating disorder services is crucial to address the growing demand and ensure that patients receive timely and appropriate care. Improved training for clinicians is also needed to ensure they are equipped to assess and manage the complex needs of individuals with these conditions. A shift in public perception is necessary to combat the stereotypes surrounding eating disorders and promote early intervention.

The BBC reported in January 2025 on the urgent need for action, stemming from a report by the All-Party Parliamentary Group on Eating Disorders. This report called for eating disorders to be treated as an “emergency” and highlighted major failures across the board.

Ongoing monitoring of discharge data, coupled with robust auditing of clinical practices, will be essential to ensure that patients are not being discharged prematurely and that their safety is prioritized. The NHS, along with advocacy groups and clinicians, must work collaboratively to develop and implement effective strategies to address this critical issue and provide the support that individuals with eating disorders deserve.

Next Steps: Ongoing Data Collection and Service Review

NHS England has indicated it will continue to monitor discharge data and review clinical practices. The Royal College of Psychiatrists is expected to update its guidance on safe discharge criteria in light of these findings. Advocacy groups, like those led by Hope Virgo, will continue to push for greater transparency and accountability within the system.