As a compassion-focused psychotherapist and specialist eating disorder dietitian, I have worked both in the NHS and the private healthcare sector. Throughout my career, I’ve witnessed the extraordinary commitment of healthcare professionals and the immense pressure they are under. Yet, despite their dedication, the system they work within is often ill-equipped to provide the timely, compassionate care that people with eating disorders urgently need. It’s not a matter of will, but of resources, training, and systemic priorities. The Dump The Scales campaign is striving to change this.

Mental Health Needs More Than Just Recognition

The UK currently spends £150 billion annually on physical health and only £15 billion on mental health. This imbalance persists even though mental health remains a major factor in overall mortality. While physical health issues dominate later in life, early-life mental health conditions, including eating disorders, depression, and substance misuse, can significantly impact long-term wellbeing within our younger generation and even fasten the onset of physical illnesses.

Healthcare systems have understandably focused on the needs of an ageing population, but this has inadvertently left younger individuals without adequate early mental health support. By delaying intervention, we allow eating disorders to become more entrenched and harder to treat, increasing the emotional and financial cost. If we can intervene early, we can support those struggling with an eating disorder to discover something better than their eating disorder. The earlier we intervene, the better the outcomes. At early stages, it’s far easier to help individuals replace the eating disorder’s perceived benefits—such as control or confidence—with healthier alternatives. Neurological research supports that early intervention prevents harmful neural patterns from becoming deeply ingrained.

Whilst this may sound strange to someone who isn’t living with an eating disorder, for someone going through it, their eating disorder becomes their life. They’re promised confidence and agency, but instead they’re left with shame, guilt, isolation and an inability to let go. For those whose condition has not yet resulted in a significantly low weight, society sees their commitment to weight loss as dedication, motivation, whilst inside they are crumbling. When this is reinforced as “okay” or “nothing to worry about” by mental health professionals, it only endures suffering and silence. Behaviours become ingrained, and neural pathways become more challenging to disrupt.

Diagnosing Beyond Weight

Weight-based criteria, particularly BMI, continue to be widely used in diagnosis and treatment eligibility for eating disorders. This outdated focus can exclude individuals who are in serious danger despite not being underweight. Those in larger bodies who are severely restricting may face equally life-threatening complications, yet often go unrecognised in clinical settings.

In my experience as a practitioner, when sending a client to A&E it has become a necessary part of my practice to write a letter for my clients to take with them regarding the blood tests I would like completing, as a result of the lack of understanding in frontline staff. This is not a slight on frontline staff, who are tirelessly working to support patients, but a demand for more resources and training so that adequate support can be provided to those in need.

The Dump The Scales Campaign

Dump The Scales is a campaign launched in 2019 by Hope Virgo, which challenges these misconceptions head-on. The campaign was launched to advocate for the implementation of evidence-based guidelines and equitable treatment, regardless of body size. Its goals include:

• Full enforcement of NICE Guideline 1.2.8, which advises against using BMI or illness duration as the sole basis for treatment decisions.
• Comprehensive training for GPs, junior doctors, and other frontline staff.
• Ending the postcode lottery that dictates access to life-saving care.

Dump The Scales is creating momentum for change where it’s needed most. So far, it has over 68,000 signatures and growing support from the public and healthcare professionals alike. You can add your signature to the petition by clicking here.

Making Improved Training a Priority

Training is improving, but it’s not yet consistent or widespread. Many clinicians still feel underprepared to treat eating disorders comprehensively. This isn’t a reflection of their commitment, but of a system that hasn’t equipped them with the tools and knowledge they need. There is still a lot of stigma that exists towards mental health conditions. This often limits the treatment or support available for those with eating disorders. Sadly, I have witnessed the lack of compassion for someone with an eating disorder in comparison to someone struggling with a physical health issue, and it is vital that this changes.

We must:

• Strengthen training at all levels of care to ensure healthcare professionals feel confident in supporting someone with an eating disorder
• Use NHS communications channels to share lived experiences and educational materials to reduce the stigma associated with eating disorders
• Encourage compassionate, non-weight-focused approaches in all patient interactions to ensure everyone struggling receives the appropriate treatment they deserve.

A Call for Collective Action

Healthcare professionals are doing their utmost under difficult circumstances. To truly support them and the people they serve, we need systemic change:

• Proper implementation of NICE guidelines.
• Funding aligned with the scale of the need.
• A cultural shift in how we understand and treat eating disorders.

By acting now, we can save lives, reduce NHS costs and ultimately improve outcomes and recovery rates for thousands.

The Dump The Scales movement offers a roadmap for change. It’s not about blame, it’s about building a future where no one is left behind because they don’t look “sick enough.” Let’s work together to create a more compassionate, effective, and inclusive healthcare system.