Status of Women Committee on Feb. 24th, 2014

[The Chair, NDP, Hélène LeBlanc]

You have two minutes.

[Joan Crockatt, Conservative, Calgary Centre, AB]

Okay.

I was going to ask Elizabeth Phoenix a question, but I want to share my time, so I'll turn it over to MP Leung.

[Chungsen Leung, Conservative, Willowdale, ON]

Thank you, Joan.

Thank you, Chair.

I want to address this question from a different angle, a more multicultural dimension. Canada is increasingly a country of immigrants and diversity. Is there a cultural national origin or genetic difference in this eating disorder, especially when we can identify hypertension mostly in the black population, hepatoma in East Asians, and type 2 diabetes in South Asians? In your clinical practice do you see the diversity of Canada or is it a more Canadian culturally induced environment whereby kids are eating a diet that is more dangerous and higher in sugar, salt, and fat?

In the discussion that has gone on, it appears to me that there is a lot of acute care, which is a symptom of our North American medical practice. Isn't the health care dollar better spent in a top-down, directional education process to address this broader issue? Anyone can answer.

[Dr. Wendy Spettigue]

To that second point, absolutely, that's what was so awful about the fact that our team was closed to all referrals except for those patients who needed hospitalization for the last 20 months. We were so overwhelmed by how many of them there were that nobody was treating mild, moderate, and moderately severe eating disorders. Yet the research shows that earlier intervention has a better prognosis, so for sure, we should be doing the exact opposite of what we're doing and treating the kids earlier.

[The Chair, NDP, Hélène LeBlanc]

I would ask then, to briefly address the first part of the question about the diversity of the patient, Ms. Phoenix. Could you talk about the cultural diversity of the patients you've encountered or some examples you would like to share with us, maybe for 30 seconds?

[Elizabeth Phoenix]

Our program is a newly funded program in London. We are seeing cultural diversity within our program and also very statistically matched male presentation as well within our program.

Can I answer that accurately—is it a function of being in western society that we're seeing these folks present with eating disorders at this present time? We know there are some cultures where eating disorders in country of origin are lower than they are here in North America, but they still do exist and are present. Again, we're always struggling to address the numbers and really understand the data effectively because the numbers are very inconsistent.

I don't know, Dr. Tasca might have those numbers at his fingertips.

[The Chair, NDP, Hélène LeBlanc]

Do you?

[Dr. Giorgio A. Tasca]

I don't have the particular numbers, but I know of research that has looked at cultures before Internet and TV was introduced and after Internet and TV was introduced, and the incidence of obesity and eating disorders shot up after the introduction of the media.

[The Chair, NDP, Hélène LeBlanc]

If you have some documents or links or articles that you feel could complement the answers, please send it to the clerk.

Thank you very much.

Now for five minutes, we have Ms. Duncan.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Again, Dr. Spettigue, you might want to think about writing a case study for inclusion in this report, because I think it's important.

I'm going to ask two questions this time.

Dr. Spettigue, the first one is to you and the Canadian Psychological Association might want to answer as well. It's regarding Gail McVey's work in terms of building this Ontario network in terms of training the doctors. We need to reach these young doctors before they become doctors. We should be talking about this in medical school. If you could give us that Ontario model and again, this might be a brief that's later submitted—

[Dr. Wendy Spettigue]

Meaning you want me to describe the Ontario model...?

[Kirsty Duncan, Liberal, Etobicoke North, ON]

If you could, please, so I can ask my second question.

[Dr. Wendy Spettigue]

The model is just that all of the provincial programs are part of a network where we are in constant communication. We share data and information. We meet at least once a year to have regular conferences where we share data but we also try to make our programs consistent with each other. We have monthly teleconferences where we talk about the treatments we're providing, trying to be consistent about it.

She got all the pediatric programs together in retreats to try to make sure that programs are similar. It was the same for the adult programs and advocating for program evaluation and for prevention. She advocated at the government level to get us the NPs in the programs. There was just so much.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Does the federal government kick in funding to support this or is it funded through Ontario?

[Dr. Wendy Spettigue]

It changed part way there.

Can you answer that one?

[Dr. Giorgio A. Tasca]

I think it's funded by the Ministry of Health.

[Dr. Wendy Spettigue]

It's the Ontario Ministry of Health.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

It's Ontario, okay.

Perhaps, someone could reach out—

[Dr. Wendy Spettigue]

But it's provincial.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you.

Also, in terms of training doctors....

[Dr. Wendy Spettigue]

That's a tough one, because the problem is that the doctors are all the sons and daughters of us who have grown up with the same attitudes as everybody else, so they also would see a slim, pretty girl and think she looked just fine at a BMI of 18, say. But maybe her healthy BMI is 23 and they can't then recognize the dangers—

[Kirsty Duncan, Liberal, Etobicoke North, ON]

So it's training the doctors as part of the network.

[Dr. Wendy Spettigue]

They need training on set point theory, and the dangers of being below your healthy weight, and the importance of regular periods, and things like that, which they don't know about.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

We really need a brief to this committee about what that model looks like, and the specific recommendations for implementing that—

[Dr. Wendy Spettigue]

For teaching eating disorders.... Thank you.