Chamber and committees

I am pleased to bring to the chamber this debate recognising eating disorders awareness week 2026, which runs from 23 February to 1 March. I thank members from across the chamber for adding their voices to mine on the issue, and I thank the eating disorders charity Beat for providing briefings. I welcome to the public gallery representatives from Beat and SupportED, as well as David, a father who lost his beloved daughter just last year. I pay tribute to them for bearing with us as our decision time this evening crept ever later.

This year’s theme is community, and it could not be more important. Eating disorders are profoundly isolating illnesses. They isolate the person who is struggling; the parents and carers, who are frightened and unsure where to turn; and the families, who often feel that they are navigating a complex and fragmented system alone. However, community, connection, shared understanding and peer support can be an absolute lifeline.

We know that eating disorders affect at least 1.25 million people across the United Kingdom, including around 100,000 people in Scotland. We also know that the prevalence and complexity of such disorders appear to have increased since the Covid-19 pandemic. Behind those numbers are real lives: people who are living with anorexia, bulimia, binge-eating disorder or avoidant restrictive food intake disorder—ARFID.

It is ARFID that I want to speak about personally today. In my own family, we have experienced the reality of ARFID, and I want to be honest about what that has meant. I have spoken about it before, but it bears repeating. It did not look like what many people imagine an eating disorder to be. There was no discussion about body image and no desire to lose weight. Instead, there was overwhelming anxiety around food: the texture, the smell and the appearance—fears that others might dismiss as fussiness. Meals became battlegrounds and social occasions became stressful or non-existent because they were just too traumatic. Nutrition became an urgent daily concern for us all.

When we sought help, we encountered what so many families tell us they experience: uncertainty. There was uncertainty about who was responsible for treatment; uncertainty about whether the case was “serious enough”; and uncertainty about what pathways even existed. We met dedicated professionals who wanted to help—I acknowledge that—but we also encountered gaps, a lack of consistent understanding, long waits and no clear, agreed pathway. That experience is not unique.

We continue to hear, through helplines and community organisations, that services can be hard to access and late to intervene, and that they are too often driven by crisis management rather than early support. Some people receive excellent care from general practitioners and primary care teams, but there remains significant geographical variation, with support sometimes being dependent on where people live.

Families describe struggling to get recognition for binge-eating disorder, young people with ARFID being told that they do not fit traditional criteria, and people waiting months and sometimes years for specialist input. Meanwhile, presentations are becoming ever more complex. People are navigating eating disorders alongside neurodivergence, trauma, substance use, depression and anxiety. Social media shapes how young people are thinking about food and body image. The increasing availability of glucagon-like peptide-1—GLP-1—weight-loss injections adds another layer to a fast-changing landscape. This is not a static challenge—it is ever evolving.

It is important to recognise however, that Scotland has much to be proud of in terms of its policy direction. The 2021 national review of eating disorder services set out comprehensive, thoughtful recommendations in its “Scottish Eating Disorder Services Review—Full Report”.

The 2024 “National Specification for the Care and Treatment of Eating Disorders in Scotland” provides a clear framework for improvement. Through the national eating disorders network, work is being done to improve training via the Turas online learning platform, NHS Inform and NHS 24. Health boards have been asked to audit themselves and plan implementation. That is all good work and it deserves recognition.

However, the reality that we continue to hear about from people with lived experience is that the ambition has not yet translated into consistent change on the ground everywhere. A strategy is only as strong as its delivery, and we must, collectively, strive harder, as I know we all want to do. Clinical teams are being asked to implement significant transformation within existing structures and ever-tightening budgets. Waiting time targets and expectations around self-referral require capacity, and the national network itself operates with very limited staffing. We cannot assume that publishing a review means that the problem is solved or that, because structures exist, the experience of families has improved everywhere.

That brings me back to the theme of community. Community means peer support, which amazing organisations such as Beat are expanding across the country. It means training teachers so that schools can identify concerns early; equipping GPs with the confidence to recognise ARFID and binge-eating disorder; and supporting carers, who often shoulder enormous emotional and practical burdens. I cannot put a number on the amount of time that I have spent in tears over the years.

However, community also means political will. The national specification was designed as a 10-year transformation, yet current structures are secured only until the end of the current session of Parliament. Eating disorders transcend political timeframes—they are serious mental illnesses, with among the highest mortality rates of any psychiatric condition. Sustained change requires sustained commitment beyond electoral cycles.

If we are serious about early intervention, we must invest in it. If we are serious about parity between mental and physical health, we must demonstrate it. If we are serious about reducing geographical inequality, we must measure and address it. If we are serious about community, we must listen to lived experience.

When families say that they feel dismissed, we must respond. When young people say that they are waiting too long, we need to act. When clinicians say that they need clearer pathways, we must provide them. No parent should sit at a kitchen table in tears wondering how to get help for their child; no young person should feel their illness is not the right kind to qualify for support; and no family should feel alone, as we did. Certainly no family should lose their child, as David, who is sitting in the public gallery this evening, did.

Eating disorders awareness week gives us an opportunity to talk openly, reduce stigma, share stories and build connection, but awareness must be matched by action. This week, we should not only recognise the scale of the challenge but renew our commitment to addressing it fully, consistently and compassionately. I know that the Minister for Social Care and Mental Wellbeing will set that out, because I recognise the work that the Government is doing in this space. For the 100,000 people in Scotland who are living with an eating disorder, for their families and for the communities that surround them, we need to come together on this issue.

20:18

Amendment 23 proposes the introduction of a statutory review of the implementation of the changes to the withdrawal process, which would be published three years after the provisions come into force. That represents a proportionate and workable approach. By allowing a reasonable period of time to pass before the review is undertaken, the amendment would ensure that sufficient evidence and practical experience were available to assess whether the legislation was operating as intended.

Under amendment 23, the review would also consider how religious observance had been delivered during the period in question and assess how inclusive that provision had been. That provision aims to respond to the concerns that were raised during the parliamentary process regarding the dearth of evidence about the current form and delivery of religious observance by growing the existing evidence base. That is especially important given the freedom of information responses that were published last week by the Humanist Society Scotland.

Importantly, amendment 23 would require the Scottish ministers to set out what actions they intended to take in response to the review’s findings, or to explain clearly if no further action was proposed. That would extend in particular to any actions taken to enable children to independently withdraw from religious observance.

Finally, ministers would have to lay a copy of the report before the Scottish Parliament.

I encourage members to support amendment 23.

You mentioned the shortening of supply chains. We have already heard this morning about localism, and Brian Whittle talked about food security in a local area. Can the good food nation plans start to align with initiatives such as community wealth building? If we think about food processing in a local area, is there a golden thread that could be pulled through all that?

Thank you. That is helpful.

Is there enough resource in the system to address this ever-evolving situation? How do you feel about the resource?

I have a couple of questions about food crime. When I was reading the meeting papers again, I was struck by the fact that a lot of food crime is undertaken by people who have legitimate roles in the food industry, which allows them to exploit it. How does FSS approach food crime that is facilitated by or organised within the food industry? Is that a key strand of work that you have on your radar?

Good morning. I want to speak about human rights and how we balance them with other considerations, which you have spoken about in your answers and in your opening statement. The regulations allow the suspension of visits where a provider has reasonable cause to believe that it is essential to prevent serious risk.

What specific human rights criteria will providers be expected to apply when they are determining whether the threshold is met? How will you ensure that visiting restrictions are genuinely a last resort and that they are proportionate and time limited, given the concerns that we have heard about the lack of clarity that there could be about terms, such as “reasonable cause” and “serious risk”?

My final question is about whether you could commit to ensuring that there is greater oversight, which you have already spoken about, and enhanced review mechanisms to limit the discretion of providers so that that the rights of residents are consistently maintained and they are consulted and have a voice in decisions that are being made.

Good morning. I want to spend a bit of time talking about food processing, food safety and food crime. Is there any synergy between addressing those three issues and the creation of a good food nation, or could any tensions arise as we seek to ensure that we have food safety, address food crime and have safe food processing?

Thank you. That is very helpful.

Let us stick with the issues of food safety and food processing. I was interested to read in the meeting papers that, according to the most recent lab report data that is available, the detection rates for food-borne pathogens have remained static during the past five years. Is there any information about why that is? Is it because we are getting better at detecting those pathogens, or is there still an issue with food processing that has caused the number of pathogens to remain static over the past five years?