TODAY MPs will once again debate and vote on legislation which places vulnerable people at risk, including those who struggle with eating disorders. The faltering, inadequate, late-to-the-party attempts to plug one of many gaps in the so-called “safeguards” in Lauren Edwards’s resurrected assisted dying Bill in relation to eating disorders should be a warning for MPs, not an encouragement to support this flawed Bill a second time round.

To have an eating disorder is not a death sentence. No-one is untreatable. There is hope. 

But it is also true that eating disorders can be fatal, and can cause profound physical deterioration whilst simultaneously distorting a person’s understanding of their own health, their body and their need for treatment. While belated attempts were made to address concerns around anorexia in the previous assisted suicide Bill, there is considerable cause to doubt the ability of the Bill to protect people at risk. MPs casting their vote need to go in with their eyes wide open to the reality that this Bill remains a real threat for people with eating disorders, which are not limited to restricting food and drink, but may include purging, misuse of medication, compulsive exercise or insulin restriction, to name but a few examples.

Even before Kim Leadbeater’s Bill was introduced in the previous session, the struggles of people living with and seeking to recover from eating disorders have been a prominent feature of the assisted dying debate. Writing in the British Medical Journal before Second Reading in November 2024, experts cautioned that “the proposed Bill may enable patients with treatable eating disorders who have life-threatening malnutrition and/or feel suicidal to qualify for assisted death.” In The Times, Chelsea Roff, founder of the charity Eat Breathe Thrive, warned that, if the Bill were to become law, “scores of vulnerable young women could receive assistance from the NHS to kill themselves.” Though these warnings centre on women, eating disorders affect men too, and the risks this Bill poses apply just as much to anyone living with an eating disorder, whoever they are.

Concerns on this topic were flagged at every stage of the Bill’s parliamentary journey — in the House of Commons alone, nearly 200 references to eating disorders were made. Despite this, amendments to tackle this danger were repeatedly rebuffed at Committee Stage in the Commons by Bill supporters. On May 13, on Newsnight, Lord Falconer, who sponsored the Bill in the House of Lords, suggested that eating disorder campaigners were “wrong” regarding their concerns about the Bill.

At Report Stage in the Commons, Leadbeater claimed that her “clear, strict criteria…[would] exclude possible serious mental health disorders such as anorexia.” Imagine her surprise, then, when Lord Falconer later tabled what he called “an important amendment designed to ensure that persons with anorexia cannot, by not eating, put themselves into a position in which they qualify for an assisted death.” Clearly, this is a complex issue and past reassurances cannot be relied on. 

The reality is that tackling concerns about anorexia only scratches the surface of challenges presented by this Bill for people with eating disorders. Many people struggling with eating disorders and the physical consequences of their condition remain unprotected by the Bill; as Baroness Berger told the House of Lords, “A large population study published in 2017 found that anorexia accounted for just 8 per cent of eating disorder cases”.

Professor Gareth Owen, Professor Alex Ruck Keene KC, Professor Katherine Sleeman and Dr Lucy Stephenson, all members of the Complex Life and Death Decisions Group at King’s College London, warned bluntly that the legislation simply doesn’t “achieve its aim of excluding the impact of eating disorders behaviours from the scope of the Bill.” Lord Falconer’s response when presented with these concerns was that he would “consider” these issues, but did not want “to create any expectation that that would lead [him] to table any further amendments.”

Again, it is this same Bill, with these same unresolved issues, which Lauren Edwards is asking MPs to back today. Does the Bill do enough to protect people with eating disorders? Both Kim Leadbeater and Lord Falconer once claimed it did, before conceding it did not. Experts whose warnings were ignored and downplayed by the Bill sponsors maintain that the Bill remains deficient in this regard. Beat, the UK’s eating disorder charity, says that “significant risks for people with eating disorders still remain.” The simple fact remains that the Bill is not clear enough and therefore cannot protect adequately.

These concerns are not technicalities or nitpicking. The purpose of legislation is to establish clear boundaries within which the law operates. By picking up where Kim Leadbeater and Lord Falconer’s flawed Bill left off, Lauren Edwards has left too many questions unanswered, with too many judgements left in the hands of doctors, of whom far too much is being asked in assessing the complexities of physical consequences inflicted by poor mental health.

As is so often the case, the people most in need of protection under this Bill may be the least able to recognise that they need it. An eating disorder can tell someone that treatment is unnecessary, that their deteriorating body is somehow acceptable, or that death is preferable to recovery. Our response to a person in that position should be to make it easier for them to receive effective treatment, not to construct a legal framework in which the consequences of their illness could potentially become the basis for ending their life. If MPs are in any doubt, they must vote against the Bill at Second Reading today.

Hope Virgo is a mental health campaigner, author and founder of Dump the Scales.