Madam Chair and members of the committee, thank you for helping to raise awareness of Eating Disorder Awareness Week. I know that some of you have been on social media, and we very much appreciate that.
Eating disorders are complex conditions with no one cause. Biological, psychological, and societal influences contribute to their development. With the right kind of intervention, eating disorders may be prevented, the course of the illness shortened, and full recovery achieved.
Dr. Woodside has provided this committee with information on the extent, severity, and impact of eating disorders and inadequate treatment options across the country.
In Canada, like other western nations, we have a particular cultural idea of the ideal body, which includes notions of healthy eating, healthy weights and appearance. We also share similar views towards mental health challenges. The impacts of these beliefs on eating disorders are experienced in myths, stigma, and social and economic hardships, which perpetuate the problems of prevention, identification, and treatment.
I represent the National Eating Disorder Information Centre, as was mentioned, and since I have limited time I'll refer to the organization by its acronym, NEDIC. This socio-cultural space is where we at NEDIC do our work, and through NEDIC, the situation across Canada can be explored.
NEDIC was begun in 1985 and is unique in Canada in a number of ways. We're the only community organization focused on eating disorders and related issues that works nationally. We have a national helpline and database of approximately 800 service providers for eating disorders. The vast majority of these are fee for service, and about 80% of our callers can't afford this and are looking for services that are covered by provincial health insurance.
Difficult as it is to find services in urban and peri-urban areas, remote and rural services are largely non-existent.
NEDIC provides information, support, and resources to individuals with eating disorders, family members and friends, health and education professionals, the media, and students. We are often the first port of call for frightened parents, a confused spouse, or an individual wanting reassurance with regard to her thoughts and behaviours.
To lower barriers to information and services, most of our assets are web enabled. One of the most important aspects of our work is to increase understanding among the public, professionals in health and education, and the media of what eating disorders are, who gets them, what influences their development, and what help is available.
We work hard to build partnerships. We believe in collaboration to maximize resources and impacts. For example, we create curricula for educators and youth-serving organizations to support and build critical thinking and emotional resilience in children and youth, which will help to prevent eating disorders. Examples are our “Love Yourself” badge for the Girl Guides of Canada, a fact sheet for the Canadian Centre on Substance Abuse, and our work with the Elementary Teachers' Federation of Ontario. We have developed a critical media literacy curriculum for grades 4 to 8, which fills a national gap and meets ministry expectations in all provinces and territories.
To disseminate the latest information, NEDIC is partnered with groups such as the Canadian Women's Health Network, formerly funded by the now defunct women's health contribution program. Already challenging, it's getting increasingly difficult for small organizations like NEDIC, focused on more intangible goals, such as increasing understanding, education, and prevention, to actually find partners with the capacity to support our common interests and without commercial interests. This situation leads to a lack of accessible evidence-based information on eating disorders and related issues.
NEDIC's limited budget means that we rely on pro bono services and are not able to saturate markets as needed for real traction. No other organization in Canada does this educational work. Nationally, community-focused eating disorder organizations working in education, prevention, and support come and go because of limited and insecure funding.
Individuals who have recovered from an eating disorder or parents begin many of these organizations, such as, Sheena's Place in Toronto, Hopewell in Ottawa, and the National Initiative for Eating Disorders. They are heroic in their efforts to improve access to information and treatment. For most, it's not a sustainable model.
To effect change in belief, attitudes, or behaviour, there has to be a strategic, multi-platform, sustained approach which is appropriately funded. Without this, our attempts to raise awareness of eating disorders are like whistling in the wind. We must get our message to a critical mass or to a tipping point. There is too much competing noise in the culture from the diet and appearance industries and much misinformation about healthy bodies and healthy minds.
Some public health messaging, particularly that which bleeds through from the U.S., contributes to weight stigma and body shame, and can influence the development of food and weight preoccupation in general and eating disorders in particular. Research shows that girls with poor body image are less likely to engage in academic, social, and economic opportunities, and are less likely to voice an opinion.
The stigmatization of an eating disorder is complex. The common face of an eating disorder is that of an emaciated young woman, usually white skinned. Common beliefs about individuals with eating disorders are that it's self-inflicted, it's just a phase, they should just eat and get over it, and it's just an attention grab. Research shows that both the general public and health professionals hold these myths. The fact is that one cannot tell the health of an individual based on their physical size and weight, including whether they have an eating disorder.
The actual face of an eating disorder is heterogeneous: mostly female, but also male; individuals who identify with their assigned sex and gender, and those who don't; racialized individuals; newcomers to Canada and established Canadians; individuals with physical disabilities; individuals with concurrent medical or psychological disorders, such as, diabetes, substance abuse, depression, PTSD, and so on. Individuals from all socio-economic walks of life have eating disorders.
Eating disorders have the highest mortality rate of all psychiatric illnesses and are the third most common illness among adolescent girls.
The consequence of these mythologies about eating disorders is that shame creates silence that can be deadly. Individuals ashamed of what they are going through are less likely to seek the help that they need. We need to amplify the conversation about eating disorders in Canada, mindfully, fully, respectfully.
There is simply no financial support by any level of government for an appropriately resourced, sustainable organization focused on increasing understanding of what eating disorders are, how they develop, what maintains them, what kinds of treatment are available and how to access it.
NEDIC, for example, has 2.5 permanent staff members and our sole source of annualized funding is a small budget from the Ontario Ministry of Health and Long-Term Care. The majority of our work is done by cobbling together student, volunteer, and project funding.
Working upstream, in education, mental health promotion, and prevention of eating disorders is of critical importance. Awareness and education campaigns are important because they can lead to better population health and fewer subclinical eating disorders. They can relieve shame, denial, and decrease stigmatization and discrimination against individuals with eating disorders. Education campaigns can lead to better early identification of individuals at risk. They can lead to earlier treatment which is known to have better outcomes. Earlier treatment for less entrenched eating disorders will relieve the pressure on already inadequate services for the severely ill.
Clearly, appropriate prevention, early intervention, and early identification and treatment will have social and economic benefits that are largely unquantifiable. Parents of individuals with eating disorders will not be taking time off work to care for critically ill children. Youth will remain in school, socially engaged, and will contribute more to society, enriching all of us.
There are enormous gaps across Canada in the continuum of care that should exist for eating disorders. They run the gamut from research and health promotion to prevention and treatment. Canada desperately needs a coherent national eating disorders strategy. I believe that it's critically important to invest in education at the population level as well as within segmented audiences.
Thank you for this opportunity to appear in front of you today. I'm happy to answer questions.
