Patients with eating disorders are being discharged from UK mental health units with critically low Body Mass Index (BMI) levels, some as low as 12.5. This practice deviates significantly from standard clinical guidelines, which typically aim for a BMI of 18 or 19 before discharge.
These early discharges were highlighted by eating disorder campaigner Hope Virgo through freedom of information requests to NHS trusts in England. Experts have described the revelations as "horrifying," attributing them to services struggling with overwhelming demand. Nine trusts reported discharging 119 patients with conditions like anorexia nervosa and ARFID between January and November last year, despite BMIs below 15. A BMI of 15 is considered severe malnutrition by the World Health Organization.
Consultant psychiatrist Dr. Agnes Ayton noted that discharge at such a low BMI means a patient remains seriously unwell and requires ongoing monitoring, with increased mortality risk due to physical complications or suicide. The Royal College of Psychiatrists views a BMI of 18.5 or 19 as a healthy minimum for safe discharge.
NHS England stated that existing discharge practices are safe and that BMI is not used as a sole marker for readiness. They emphasized that patients are only discharged by expert clinicians when significant progress is made in weight, eating patterns, and other factors, with recovery support plans in place.
However, specialists like dietitian Bethany Francois expressed concern, stating that in her experience, no individual was well enough for discharge at a BMI of 15. She cited risks to cardiovascular stability, hormonal function, immune response, and bone density at such low weights.
Eating disorder campaigner Hope Virgo called the figures "dangerously low," labeling the discharges a "failure of care" that places patients at high risk of relapse, chronic illness, or premature death.