Question Period Note: Eating disorders

N/A

• Our Government cares deeply about the mental heath of Canadians, including those living with eating disorders.
• This is why, through Budget 2017, we are providing provinces and territories with $5 billion over 10 years to improve access to mental health and addiction services, including services for those living with eating disorders.
• In addition, through the Canadian Institute of Health Research (CIHR), we have invested $5.6 million in research over the last 5 years to improve health outcomes for individuals with eating disorders living in Canada.

Dissatisfaction with one’s weight or shape and unhealthy relationships with food and physical activity can contribute to disordered eating (e.g., unhealthy eating behaviours, like binge eating, restrictive eating, meal skipping to lose weight) and eating disorders (i.e., disorders which involve a clinical diagnosis; reflects more severe or chronic disordered eating). Eating disorders, such as anorexia nervosa, are serious mental illnesses with significant morbidity and mortality. Disordered eating and eating disorders affect individuals of all body sizes.

A number of factors can contribute to the development of an eating disorder, including biology (genetic and biochemical), psychology (personality and mental health), and social factors (such as cultural norms about food and appearance). Individuals experiencing other emotional or psychological disorders such as substance use disorder, depression, or a personality disorder, are at a higher risk of developing an eating disorder.

The experience of living with an eating disorder affects each individual differently. Some individuals may feel shame stemming from their symptoms or the way they eat, and can be secretive about food and eating. Some individuals experience other mental illnesses concomitantly, such as anxiety, depression, obsessive-compulsive disorder, or post-traumatic stress disorder, together with their eating disorder. Due to stigmatization, people living with eating disorders may go to great lengths to hide their disorder.

While eating disorders are serious and can have life-threatening complications, they are also treatable illnesses.

Incidence and/or Prevalence in Canada
Although eating disorders can affect anyone, they typically begin in adolescence or young adulthood and affect women ten times more than men. Data from the Canadian Community Health Survey show that the prevalence of eating disorders among Canadians aged 15 years and over was 0.4% in 2002 and 0.5% in 2012. More recent data from the 2019 Canadian Health Survey on Children and Youth found that 0.32% of youths aged 5 to 17 years had a diagnosed eating disorder (0.45% in females; 0.19% in males).

Recent findings from a Knowledge Synthesis undertaken by the Canadian Institutes for Health Research (CIHR) show that the COVID-19 pandemic has negatively impacted individuals living with eating disorders. Through the pandemic, those with eating disorders have experienced heightened psychological distress, increases in eating disorder symptoms and behaviours, reduced motivation for recovery, and greater risk of eating disorder relapse. With the closure of eating disorder day hospitals, the most severely ill patients have had more limited access to the intensive treatment they require. Caregivers face difficulties with first-time home monitoring for children living with eating disorders, and clinicians have been challenged with providing the same level of care virtually.

Recent data from both before and during the pandemic show that the rate of hospitalizations for eating disorders was 1.6 times higher in 2020 compared with 2019 for females aged 10 to 17. Potential explanations for this increase include disruptions to daily routines, fewer physical activities, poor social supports and increased exposure to media and social media.

Eating Disorder Research and Surveillance
The Government of Canada, through CIHR, has invested $5.6 million in the past five years (2017-18 to 2021-22) in research to improve health outcomes for individuals living in Canada with eating disorders. This investment supports the work of researchers at universities and research institutes across Canada as they build the evidence base on these conditions and develop effective interventions. For example, through the Transitions in Care initiative, CIHR is supporting a project led by Dr. Gina Dimitropoulos at the University of Calgary that will seek to co-design and implement practice guidelines for transitions in care from pediatric to adult services for youth with eating disorders.

The Government of Canada also recognizes the importance of surveillance for the prevention and treatment for mental illness and is exploring options for the surveillance of eating disorders. PHAC is working with Statistics Canada, the Canadian Institute for Health Information and researchers to investigate the impacts of the pandemic on a variety of interrelated topics, including healthy eating and eating disorders.

PHAC is also working with paediatricians across the country on a surveillance study of new diagnoses of anorexia nervosa during the pandemic through the Canadian Paediatric Surveillance Program (CPSP). The CPSP is a joint project of PHAC and the Canadian Paediatric Society that conducts national surveillance and research into rare and emerging childhood diseases/conditions with disproportionate risk of disability, morbidity and economic costs to society, despite their low frequency.

Health Portfolio Activities
While the Health Portfolio does not do any direct work in the area of eating disorders, the Government of Canada provides funding to the provinces and territories for the administration and delivery of health care services, including mental health services, such as those serving individuals experiencing eating disorders. Through Budget 2017, the Government provided provinces and territories with $5 billion over 10 years to improve access to mental health and addiction services.

In Ontario, for example, federal funds were used to implement a new province-wide Eating Disorders Early Intervention Program that will use targeted prevention, mental health promotion, early identification and early intervention services to address body image, disordered eating and early-stage eating disorders in children, youth, and young adults.

Federal Initiatives in Response to COVID-19
The Wellness Together Canada portal provides 24/7 access to free and confidential evidence-based mental health and substance use tools and resources. Through Wellness Together Canada, individuals across the country can access supports ranging from self-assessment, self-guided programming and peer support, to confidential sessions with social workers, psychologists and other professionals. All services are available in both official languages, and phone counselling sessions are supported by instantaneous interpretation in more than 200 languages and dialects. Wellness Together Canada augments existing provincial and territorial services, and does not replace them [as of April 7, 2022, $270 million has been invested].

None