Press Release: Eating Disorder Experts and Bereaved Families Urge Parliament to Close the Anorexia Loophole

Leading clinicians, legal experts, bereaved families, and individuals with lived experience have urged MPs to amend the Assisted Dying Bill.

The Parliamentary event, ‘Is Anorexia Ever Terminal?’ was held on Wednesday 23rd April and co-sponsored by Labour MP, Naz Shah and Conservative MP, Rebecca Paul. 

All parties warned that its current wording could permit people with eating disorders — particularly anorexia nervosa — to die by assisted death when treatment is unavailable, refused, or deemed futile.

Speakers warned that the Bill could allow those with severe eating disorders to die by assisted death in a moment of acute despair—  particularly if they are unable to access timely treatment due to gaps in care in the NHS.

“There is no doubt in my mind that I would not be standing here today, fighting against the Bill as it currently stands, if it had been passed and made legal when I was ill,” said Ailidh Musgrave, who has recovered from severe anorexia. She described how her illness distorted her thinking, convincing her that death was her only escape.

Lesley and Neal Davison shared the story of their daughter Megan, who lived with Type 1 Diabetes and an Eating Disorder (T1DE) and died by suicide after years of inadequate care. Megan had applied to Dignitas shortly before her death. They fear that if the Bill passes unamended, others like Megan will be enabled to die rather than recover - undermining suicide prevention and treatment efforts.

Dr Lucy Stephenson, Consultant Psychiatrist in Eating Disorders at the Maudsley Hospital and member of the Complex Life and Death Decisions Research Group at King’s College London, spoke about key points of tension in the Bill. These include assumptions around how attempts to exclude Anorexia Nervosa using concepts such as ‘terminal’ and ‘irreversible’ are challenged in light of the ‘terminal anorexia’ debate. She also emphasised the notorious complexity around mental capacity assessment in eating disorders and how this has not been a barrier to individuals with anorexia accessing assistance in dying in other jurisdictions.

Dr Patricia Westmoreland, a psychiatrist from Colorado, shared evidence that women with anorexia have accessed assisted death in U.S. states where it is restricted to terminal illness. She highlighted how “terminal anorexia” has been used to assert women with eating disorders are terminally ill, despite a lack of clinical consensus and data showing recovery is possible, even in severe cases.

Barrister Dr Oliver Lewis pointed to legal ambiguities in the Bill. He cited the Court of Protection Case of Re BG (2022), where a 19-year-old woman with anorexia was allowed to die after clinicians presented evidence that treatment was unlikely to be effective. He cautioned that, without clarification, individuals with anorexia could meet the criteria for assisted death under the Bill — particularly when the patient is so malnourished that they have serious physical illnesses or where clinicians are not willing to offer forced feeding. He also cautioned that “it would be impossible for a clinician to ascertain whether a person was under coercive control as the person would be motivated to hide such coercion.”

Dr Ashish Kumar, Chair of the Faculty of Eating Disorders at the Royal College of Psychiatrists, warned that the Bill risks diverting attention from a deeper issue: gaps in services and limited access to evidence-based care. A recent report from the All Party Parliamentary Group on Eating Disorders highlighted over 30,000 hospitalisations for eating disorders last year, with fewer than 5% treated in specialist units. Some patients were discharged at BMIs as low as 11. Dr. Kumar noted that many services lack psychiatrists, and long waiting lists mean patients deteriorate and develop more severe and chronic illness.

Tom Freeston, speaking on behalf of Beat, the UK’s leading eating disorder charity, echoed these concerns.

“While healthcare professionals are doing their best, services remain under-resourced. Without urgent investment, waiting lists will continue to grow and individuals will become more unwell. The voices of the entire eating disorder community are clear and united — it is imperative that the proposed amendments are passed.”

Rebecca Paul MP urged Parliament to take seriously the concerns raised by families, clinicians, and people with eating disorders. “There can be no real choice,” she said, “in a system that fails to provide timely, effective care.”

All speakers strongly support Amendment 14, tabled by Naz Shah MP. This amendment would clarify that voluntarily stopping eating or drinking does not constitute a terminal illness and close the ‘anorexia loophole.’

The Assisted Dying Bill is expected to return to the House of Commons for report stage on 16 May 2024. No formal impact assessment has yet been published.