Victoria's persistent surge in eating-disorder emergency visits challenges new strategy

Emergency presentations for eating disorders in Victoria have returned to levels seen during Covid lockdowns, prompting questions about early intervention and support efficacy amidst rising cases and persistent stigma.

Victoria is once again seeing eating-disorder emergencies at roughly the rate recorded during its harshest Covid lockdowns, with about 40 people a week presenting to hospital emergency departments, according to Eating Disorders Victoria. The figure, highlighted in Monday’s edition of ABC Radio Melbourne’s The Conversation Hour, suggests the surge first seen during the pandemic has become a persistent strain rather than a temporary shock. For clinicians, advocates and families, the argument is shifting from counting cases to asking why so many people still miss help until an illness becomes acute.

The renewed alarm comes against a backdrop of already rising demand. SBS News reported in 2024 that eating-disorder-related emergency presentations in Victoria were averaging 32 a week in May that year, up from almost 23 a week the year before. The same report said experts believed stigma was still suppressing the true prevalence of the illness, that women are twice as likely as men to have an eating disorder, and that prevalence among 10- to 19-year-olds almost doubled between 2012 and 2023, citing Deloitte Access Economics. It also noted that the federal government had released a 10-year plan for the roughly one million Australians living with an eating disorder.

That weekly figure also fits a much longer pattern in the state. A 2025 study in the Australian and New Zealand Journal of Psychiatry, based on linked health data across three states, recorded 40,972 emergency department presentations in Victoria by people with an eating-disorder diagnosis between 2010 and 2019. The researchers found that total emergency presentations in Victoria more than doubled over that decade. Most were by females, who accounted for 92 per cent, while 39 per cent involved people aged 18 to 25. The study also found that 77 per cent of presentations came from major cities, and that urgent cases made up the largest share.

The breadth of the problem is wider than the stereotyped image many people still hold. The Victorian health department says eating disorders include anorexia nervosa, bulimia nervosa and binge-eating disorders, and describes them as complex illnesses with high mortality and morbidity that can affect people of any age, gender or stage of life, as well as families and carers. In a health.vic article published on Monday, an Eating Disorders Victoria peer support worker, Heather, pushed directly against appearance-based assumptions, saying: “Eating disorders don’t have a particular look. Someone can experience an eating disorder at any weight, shape or size.”

That same tension between visibility and reality has shaped Victoria’s policy response. When the Allan government launched the Victorian Eating Disorders Strategy 2024-31 in October 2024, it said the plan had been shaped by more than 250 people, including people with lived experience, health services, clinical experts and advocacy groups. The strategy is built around prevention and early intervention, accessible evidence-based treatment, and recovery support. Ingrid Stitt, the state’s mental health minister, said at the time: “The more we can talk about eating disorders and acknowledge they are serious mental health conditions, the more we can encourage our people to come forward and seek the help they need.”

The policy was matched with money, at least on paper. The Victorian government said the strategy was backed by a $31 million investment in the 2024/25 budget, including a new day programme at Barwon Health, billed as the first of its kind in regional Victoria, and new in-home intensive early engagement and treatment programmes at Alfred Health and Austin Health. It also set aside $6.4 million for 10 dedicated early intervention professionals, spread across five metropolitan and five regional services. Eating Disorders Victoria received $5.8 million to continue wellbeing checks, telehealth and peer mentoring, while ministers said the package built on more than $39 million from the previous two budgets, including $16.9 million for Victoria’s first public residential eating-disorder treatment centre, which was then under construction. Premier Jacinta Allan said: “This will transform the way we deliver support – ensuring people get care in their own communities, close to their support networks and the people they love.”

Even so, Victoria’s own service map helps explain why early intervention remains difficult. The health department says treatment is delivered across public and private primary and community-based services, while public specialist mental health services assess and treat people with eating disorders. In theory, that creates a stepped system of care. In practice, the ABC’s discussion on Monday framed the problem as one of gaps, navigation and delayed help-seeking as much as raw prevalence. A system can exist on paper yet still be hard to enter, especially for people who are unwell, ashamed, ambivalent about treatment or simply exhausted.

That is why peer-led and person-centred care has become such a prominent part of the official language around recovery. SBS reported that Camille, who recovered from an eating disorder and now supports others through Eating Disorders Victoria, said: “Someone with eating disorder feel very isolated. It’s very hard to understand. It’s hard for family members and friends to understand what you are going through. So to have somebody that is experienced in all facets of their life, including eating disorders, is very valuable.” Heather made a similar case this week, saying: “That moment reminded me of the unique power of peer work and how important it is for people to feel genuinely understood.” Her message was blunt: “Recovery is absolutely possible. No matter the duration or severity of someone’s illness, people can build meaningful and fulfilling lives beyond an eating disorder.” With emergency presentations back at Covid-era levels, that promise of earlier, closer and more comprehensible care is now the standard by which Victoria’s strategy will be judged.