Status of Women Committee on Feb. 10th, 2014

[Stella Ambler, Conservative, Mississauga South, ON]

Thank you very much.

[The Chair, NDP, Hélène LeBlanc]

You've got two minutes.

[Stella Ambler, Conservative, Mississauga South, ON]

Oh, good.

What would you say some of the most common misconceptions are that you and your daughter have come up against with regard to her eating disorder?

[Wendy Preskow]

Honestly, I think it's understanding from the majority. I think people over the years, even my close family—I hate to say that, but it's true—just aren't aware. They get fed up or they've had enough or they don't want to hear me talking about it anymore, so I just let it be. We have wonderful friends and other support systems in place.

I don't think people realize the depth of the complication and complexity, the anxiety, the social phobia, and her fears of something that you and I just take for granted or don't think is such a big issue. For somebody like Amy, it's absolutely enormous. Even for a family meal, just the other day she even said to me she's fine eating her fruit and vegetables in front of my husband and me, but for instance she can't even have an omelette in front of us because she doesn't know how to. I honestly think she's lived in such a bad way for the past six or seven years especially, that for her to relearn normal social skills is absolutely enormous.

[Stella Ambler, Conservative, Mississauga South, ON]

Thank you very much. We really appreciate your forthrightness and honesty.

[The Chair, NDP, Hélène LeBlanc]

You have one minute left if you want.

[Stella Ambler, Conservative, Mississauga South, ON]

Do I? That's great.

Last week when we got together we talked about the article in Canadian Living. I mentioned that the mother of the teenage boy in the article who had an eating disorder blamed herself and asked herself questions about the kinds of messages she imparted to her son as a youngster, telling him that he shouldn't have a second helping because he would get fat. She felt very guilty.

I'm wondering if there's any message we can give parents. I want to tell them it's not their fault. Did you have those feelings? Did you go through that stage. Is there any advice you can give to parents of children suffering from an eating disorder?

[Wendy Preskow]

Yes, initially my husband and I totally had those guilt feelings: what did we do wrong; what did we say?

I think the best advice I can give to any parent is that if your child does not want help, you need the help. This is not something the parents have done or not done. I'm not saying in all circumstances, but certainly from the knowledge that I have gained over the years, it was absolutely not something my husband and I did. Every one of them has their unique story, and my best advice for any parent is the parents themselves need to go for help.

[Stella Ambler, Conservative, Mississauga South, ON]

That's great advice. Thank you.

[The Chair, NDP, Hélène LeBlanc]

Thank you very much.

We'll move on to Ms. Ashton for seven minutes.

[Niki Ashton, NDP, Churchill, MB]

Thank you very much, Ms. Hodge and Ms. Preskow, for joining us today.

Ms. Preskow, I want to thank you for sharing your private story, your family story, your powerful testimony. We've heard from witnesses that one of the major barriers is the silence that people living with eating disorders and their families face. You are certainly breaking that silence by speaking out on behalf of so many families who normally wouldn't be able to join us in this committee.

Ms. Hodge, to follow up on your presentation, you talked quite a bit about existing research but also about gaps that exist in research with respect to this issue. I am wondering if you can elaborate on how underfunding can impact the quality of research conducted on eating disorders as well as the quality of care women receive.

[Jarrah Hodge]

There has been a real lack of any kind of research in Canada on eating disorders over the last little while. The most recent detailed calculation done by Statistics Canada of how many people we're looking at in Canada was done in 1993. That's part of the reason you see huge variations in estimates of what the needs are. You end up with a bit of a vicious cycle happening for the non-profits, the community organizations, and the health care providers that want to be able to offer programs. To offer programs they need to show hard statistics, but they need funding and the ability to do pilots to collect that data. I think there has been a really big gap.

Another issue of what research it would help to have from the government would be an analysis of the full financial impact of eating disorders on Canada. Countries like Germany have looked into that. It needs to take into account not just the cost to the health care system, but also the burden placed on caregivers, the indirect costs that are caused by people not being able to work. I think all that information would be beneficial for us to figure out how we can address the needs that are there and to show that, as they have in Germany, not addressing these issues is ethically but also financially irresponsible in the long term.

[Niki Ashton, NDP, Churchill, MB]

That's interesting.

You spoke very passionately about the need for media literacy. It's interesting, our first witness in this study, Dr. Woodside, whose long career has been committed to the issue of eating disorders, and Ms. Preskow mentioned him as well, talked about how the root causes are connected to issues that you can break down medically, whether it's mental disorders or related issues, but the trigger is often social issues. You spoke about the images girls and women are exposed to. You referred to the increased pressures, perhaps most recently—and I think we all know from our own experience; I, myself, as a young woman do—the kinds of images that my generation have been faced with, and continue to be faced with, which are also shifting images, right? We see different trends when it comes to the image of what women should look or act like.

Given the need, as you know, for media literacy initiatives, particularly in a school setting, I'm wondering what a general awareness campaign initiative could look like to actually reach out to the public in an effective way.

[Jarrah Hodge]

Yes, I think there needs to be general awareness, as well as school-based programs. Some things that this can look like is more government recognition, and supporting the activists, advocates, and non-profits working on these issues. In terms of what school-based programs or education could look like, the research shows that media literacy interventions need to be long term. They need to start early, and they need to focus on critical thinking, questioning and discussions. It's not just, like I said, delivering one-way information or showing a video.

In the U.K., a program is being run called Happy Being Me, which is a school-based program targeting kids 10 and 11 years of age. It targets both girls and boys and looks at known risk factors for negative body image. It promotes self-esteem. Researchers have assessed participants pre, post, and three months after the program. They found that girls had significant positive change in body satisfaction, appearance-related conversation and comparison, eating behaviours, and knowledge of the topics that they were talking about. Boys also showed positive outcomes from that program.

There's also a program called Go Girls! that operated in the United States and which was studied in five states. It included 12 group meetings of an hour each, either in class or after school. The evaluation also found really promising results. Girls were reducing their internalizing thin ideals, had a reduced desire to be thin, and had increased self-acceptance and empowerment.

[Niki Ashton, NDP, Churchill, MB]

Thank you very much, Ms. Hodge.

In your presentation you mentioned that you wanted to elaborate on a couple of points. I'm wondering if you'd still like to do that in the remaining minute that you have left.

[Jarrah Hodge]

Sure.

That's sort of what I was getting into with those two programs. Again, as I said, just to reinforce that successful programs aren't one-offs.... They involve discussion. The message is reinforced over time. In addition to the treatment, there are things that we desperately need to improve now and looking down the road. We need to address the education side to make things better in the future and help build up resistance to some of those social triggers.

[Niki Ashton, NDP, Churchill, MB]

Thank you.

[The Chair, NDP, Hélène LeBlanc]

Thank you very much, Ms. Hodge.

We will now go to Ms. Crockatt, who has seven minutes.

[Joan Crockatt, Conservative, Calgary Centre, AB]

I'd like to start with Jarrah, please.

Thank you both very much for being here. Every witness that we have heard provides us with more compelling testimony. Some of us might wonder why we didn't get to this beforehand, but I'm very glad we have you here today.

Jarrah, I want to talk a bit about the media image, coming from the media myself. It sounds like you've put a lot of thought and study into this, and I appreciate it.

Can you talk to us about where you think the message is best directed? Sometimes we think there's a component of this that requires us to have a lot of communication to change attitudes, etc., but for this age group, I'm wondering where you think that can be properly targeted.

[Jarrah Hodge]

Fundamentally, it needs to start in schools, but you're right: it is a big problem. That's part of the reason studies have shown that one-off interventions don't work. When you watch a short video, you're still bombarded with these messages all the time on billboards, on TV. You have the The Biggest Loser on reality TV, and things like that. You need to build up the skills starting at a younger age, of course, being age appropriate, and reinforce them over time. It's not just saying that this is bad, but it's helping kids develop the skills that help them understand advertising tactics. The way things have changed over time, like Ms. Ashton mentioned, in terms of what the beauty ideal was, say, six years ago to today shows that these ideas aren't fixed.

The other big problem with the media image is the fact that it creates even more barriers for people who aren't white. Some of the early evidence we've seen in studies that have been done on women of colour with eating disorders is that because the image of the ideal beautiful woman is presented as a white woman, it can create additional complications. There still may be susceptibility to this same issue, so we need to explore race in there as well.

[Joan Crockatt, Conservative, Calgary Centre, AB]

Perhaps we can think out of the box in terms of what influences kids. If kids as young as three....

We heard today of very negative stereotypes toward fat people. Are we looking at something where this needs to be part of parenting early on? Do we need to do cartoons for kids? How do you grapple with such an overwhelming stereotype that to be thin is sexy and desirable when it's on cereal boxes, it's seen every time you turn on the TV, it's in movies, it's in everything?

[Jarrah Hodge]

Absolutely parents have a very important role to play. If elements of that can be built into parenting programs or parent and kid programs in communities, that would be fantastic. It's something that you can't rely on happening, but it should be encouraged, absolutely.

Also, in terms of things like cereal boxes and other advertisements that kids are exposed to on a daily basis, it's worth exploring, trying to get creative, I guess. It has been suggested in Norway, England, and France, for example, that they might want to look at having warning labels on advertisements to denote when they have been Photoshopped, or at least making it easier. The American Medical Association wants to make it easier for people in the United States to have complaints addressed when the women and images are retouched to such an extent that the advertising is no longer honest.

[Joan Crockatt, Conservative, Calgary Centre, AB]

Are you familiar with the modelling company that uses normal-sized models? I'm not sure where they're from, but I think they're from Barrie, Ontario. Dove, the soap company, has used them, as well as some others. Are you familiar with them? Do you think that has an impact?

[Jarrah Hodge]

I'm not familiar with them specifically, but laboratory studies on body image often involve showing women. They evaluate women's attitudes about their bodies and then show them images and then evaluate them again afterwards. It has been reinforced that women who view so-called average-size women or plus-size models in advertisements feel less bad about their body at the end of those experiments, so I think it does have an impact.

Italy, Israel, and India have all looked at banning models who are underweight. I don't know if that would have an incredible impact because we're getting a lot of our media from the United States, but I think encouraging health and working to break down the idea that beauty is one size would be helpful.

[Joan Crockatt, Conservative, Calgary Centre, AB]

Ms. Preskow, I'm sorry I'm not going to get to you. It's not out of any desire, but I have one more question, and I think that's all the time that I have for Jarrah.

You mentioned the LGBT community. I realize you're not an expert on causality of eating disorders, but you do write a blog, and you have people who write into you. What anecdotally do you know about the risks and causality of eating disorders just from what you've heard? We know a lot of people will express themselves more openly on social media than in a lot of other places. Could you comment?