The death of a 26-year-old woman, after she was repeatedly told she was either “too thin” or “not thin enough” to qualify for eating disorder treatment, has highlighted what campaigners call a “deadly systemic failure” in care.
Charlotte Murphy, a veterinary nurse from Merseyside, battled anorexia and bulimia from the age of 11. Her family and friends state that throughout her life, she faced constant barriers to receiving specialist NHS support. According to her lifelong friend, Phoebe Campbell, Charlotte was told she was “too thin, then not thin enough, then not sick enough, and then eventually too sick for treatment.”
Her mother, Lesley Murphy, described how Charlotte’s physical health catastrophically deteriorated, leading to hospital admissions for seizures and a heart condition which she believes were linked to her eating disorder. “Every time she was in hospital, and I’d explain about her eating disorder, they never seemed to link the two together,” Ms Murphy said. Medical research indicates that severe electrolyte imbalances, such as critically low potassium levels caused by restrictive eating, can provoke seizures and cause abnormal heart rhythms.
Despite these crises, no specialist inpatient bed for her eating disorder was made available. The family resorted to paying for private psychological support. Even when seen by specialists at the Stein Centre, a mental health facility, Charlotte was reportedly told they could not treat her further due to her weight. She died of natural causes on 22 August 2023. Before her death, she left a note expressing her wish for her story to be shared to help others.
A Systemic Reliance on “The Scales”
Charlotte’s experience is echoed by a damning National Audit of Eating Disorders (NAED) report published in December 2025. It found that some NHS inpatient units and hospitals exclude patients because their Body Mass Index (BMI) is either too low or too high. This practice persists despite official guidelines from the National Institute for Health and Care Excellence (NICE) advising against using single measures like BMI to determine treatment eligibility.
Hope Virgo, founder of the Dump the Scales campaign, who was herself denied treatment for not being “thin enough,” said the fixation on weight must end. “We have got to stop people thinking that eating disorders are a weight-based illness,” she stated. The campaign calls for better GP training and full implementation of NICE guidelines, which recommend immediate referral for suspected eating disorders.
Vanessa Longley, chief executive of the eating disorder charity Beat, explained the fundamental flaw in weight-based assessment. “You can have a very serious eating disorder and yet have no change in your physical shape, or you can be in a larger body and still be at a really high risk. The criteria clinicians are using don’t often recognise that,” she said. This reliance on visible metrics contributes to a vast treatment gap, with an estimated 80% of the 1.25 million people in the UK with an eating disorder not receiving treatment.
The system is also buckling under demand and stark inequity. The NAED report found adult community teams face 89% higher demand per team than child and adolescent services. Consequently, median waiting times for adults stretch to 28 days for an assessment and 42 days for treatment, with some waits reaching 700 days. For young people, the median wait is 14 days for assessment and 4 days for treatment.
Official Responses and Ongoing Pressure
In response to Charlotte’s case, a Department of Health and Social Care spokesperson offered sympathies to her family and friends. “For too long, people with eating disorders have not been getting the support they deserve. That’s why we are working with NHS England to strengthen community-based eating disorder services,” they said. As part of the government’s 10 Year Health Plan, 8,000 additional mental health workers have been recruited since July 2024, though Beat has previously expressed disappointment at the plan’s lack of specific commitments on eating disorders.
Cheshire and Wirral Partnership NHS Foundation Trust, which provides adult eating disorder services in the region, said: “Our thoughts and condolences remain very much with the family and friends of Charlotte Murphy. However, due to patient confidentiality, we are unable to comment on matters relating to an individual person’s care.”
Charities continue to report soaring demand for their services. Beat’s helpline supported over 12,000 people in March 2021, a four-fold increase from the previous year. For anyone struggling, Beat’s helpline is available 365 days a year on 0808 801 0677. The National Centre for Eating Disorders (NCFED) also offers information and counselling on 0845 838 2040.