the way i see it: our system is failing youth with eating disorders

and as long as we live in a society where we continue to see eating disorders as a choice , it seems inevitable that nothing will improve.

types of eating disorders
there are four clinically recognized eating disorders in canada . these include anorexia nervosa, characterized by self-induced starvation, or similar behaviour that interferes with maintaining a healthy weight; bulimia nervosa, which involves bingeing and purging; avoidant and restrictive food intake disorder, which sees a person limit and restrict what they eat to types of food, but does not involve the body-shape “fat” fears that anorexia includes; and binge eating disorder, which involves periods of bingeing food and feeling shame afterwards.

approximately 1,000,000 canadians have been diagnosed with an eating disorder, and close to 2,000,000 have sufficient symptoms for an eating disorder diagnosis. eating disorders are mental health illnesses, with a reported 10 to 15 per cent mortality rate, the highest overall mortality rate of any mental illness. children and adolescents are increasingly at risk for eating disorders, and in canada, between 12 and 30 per cent of girls and nine and 25 per cent of boys aged 10 to 14 report restricting nutritional intake in order to lose weight. most people with eating disorders suffer from  additional, anxiety and mood disorders .

the mental health connection
wendy preskow is the founder and president of the national initiative for eating disorders (nied). she has been working tirelessly for decades to achieve awareness of eating disorders as real mental health illnesses, as well as for funding from the canadian government. some provinces, like manitoba , have pledged more funding for eating disorders programs since the pandemic began, but other provinces are lagging , according to advocates.

dollars for eating disorders
while programs like the one at sickkids are more common, funding for eating disorders research in canada is low compared to other mental illnesses. a recent study published in world psychiatry indicated that in canada, government funding for eating disorder research equals approximately cad$2.41 per affected individual, compared to cad$462.14 per individual with autism, and cad$103.31 per individual with schizophrenia. researchers have linked this to the lack of funding for programs outside of hospital settings .

for this reason, most programs that are publicly funded in canada are for children in an emergency, in-patient circumstance. those publicly-funded eating disorders programs are multidisciplinary and divided into outpatient (patient is mainly in self-care at home, with weekly hospital check-ups), day treatment (patients sleep at home but spend every day at the hospital for meals and therapy sessions), and inpatient (the patient is in hospital for constant physical monitoring and intensive therapy). but during the pandemic, most hospitals have had to made access to treatment harder because of an unprecedented uptick in admissions. not only are healthcare facilities out of beds, but they have also had to lower the criteria for what makes a patient sick enough to get treatment just to meet the needs of the patients in crisis or emergency. in the city of toronto, there are no publicly funded outpatient treatment programs for adults in recovery .

dr. leora pinhas, who has worked as an eating disorders specialist for many years in both the public and private sectors, previously told healthing about the discrepancy between the cycle of emergency or inpatient care, and the lack of education for young people who transition to adulthood without the controlled environment of hospitalization — a situation that often leads to devastating relapses. from her perspective, people living with an eating disorder should be able to access a “wrap-around service in the community” for as long as they need it.