This is a topic I’ve so far held off from writing about – maybe because it feels too heavy for a blog post, too big to capture in a way that does it justice.  But the more I sit with it, the more I realise that silence isn’t an option.  We HAVE to talk about this.

Before I really get into it, let me be clear: I am not fundamentally against assisted dying.  I can understand it as an important and compassionate choice for those with terminal physical illnesses (such as types of cancer, MND, etc etc ) — conditions where suffering is extreme, options have been exhausted, and assisted dying can offer some dignity in death.  But in the context of Severe and Enduring Eating Disorders (SEED) and the growing use of terms like terminal anorexia (which, for the record, I do not believe should be a recognised diagnosis), I am absolutely terrified.

I have sat in therapy rooms with clients who have been told they are never going to recover  I have heard professionals describe people as “too entrenched in their disorder to recover.”  I have friends who been denied treatment because they were considered too sick to benefit from it.  And I have experienced it myself.

At my worst, professionals told me I was – quoting directly from my medical notes here – “beyond help”.  That I would never get better.  And of course, I believed them—because surely they knew far more about anorexia than I did?  WRONG.  I was not beyond help.  I was not beyond hope.  But had I been given access to assisted dying at the time, I am pretty sure I wouldn’t be alive today.

Anorexia, by its very nature, distorts reality.  It is a condition built on hopelessness.  It tells people they are not sick enough while simultaneously telling them they are too sick to recover.  When professionals reinforce those beliefs—whether through explicit words or by withdrawing treatment—it can feel impossible to argue against.  The idea that someone in the depths of an eating disorder could then be granted assisted dying on the basis that they have an “untreatable” illness is chilling.  Who decides when someone is beyond help?  Who determines when hope is gone?

Because, let’s be clear: we do not have gold-standard, universally accessible eating disorder treatment.  The reality is that access to specialist care is deeply inequitable, often weight-dependent, and full of systemic failings.  Many people labelled with SEED have been through treatment cycles that were not fit for purpose, discharged without adequate follow-up, or left fighting for years just to access basic care.

If a person has been consistently failed by the system, consistently told they are not sick enough or too sick to help, then of course they will believe that recovery is not an option.  And that is not a failing on their part—that is a failing on ours!

And yet… instead of asking how we can make treatment better, more accessible, and more effective, we are moving towards conversations about allowing people with eating disorders to end their lives through assisted dying.  It is as though the problem isn’t the lack of care, but rather that some people are just beyond saving.  I cannot accept that.

I have seen hope return.  I have felt hope return, both for myself and for others.  I have watched people who were once told they were “too sick” go on to find recovery.  I have sat with clients who believed there was no future for them and witnessed them slowly build one.  I know, without question, that being labelled SEED does not mean someone cannot get better.

When we talk about terminal anorexia, what we are often really talking about is people who have been failed by the system.  People who have internalised the idea that recovery is not possible because they have never been given the right kind of help.  Until we have extensive research on the reality of recovery from a SEED as a thing that is not possible (which I don’t believe we will ever have!), we should not be offering assisted dying.

What we should be doing is investing in research about the needs of those not currently helped by the treatment models available (they only help around 50% of people by the way) and working towards supporting folks in ways that are meaningful to them.

But, until that happens…. What can we do right?  First, we need to be talking about this.  We need to be questioning why eating disorder services are so underfunded, why treatment is so often inaccessible, and why so many people fall through the cracks.  We need to challenge the idea that an eating disorder can ever be truly untreatable—because the evidence simply does not support that.

And we need to act.  The Assisted Dying Bill is gaining traction and we need to ensure that MPs are aware of the risks this poses for those with eating disorders.  If this worries you as much as it worries me, please consider writing to your MP and raising these concerns.  You can find guidance on how to do that [here].

No one should be written off as too sick to recover.  No one should be given an irreversible option before they have been given real, sustained opportunities to heal.  And no one should have to fight to prove they are worthy of care.

We have to do better.  And that starts with making sure this conversation isn’t ignored.