Thank you, Madam Chair.
Evidence of meeting #13 for Status of Women in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was patients.
A recording is available from Parliament.
Evidence of meeting #13 for Status of Women in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was patients.
A recording is available from Parliament.
February 24th, 2014 / 4:45 p.m.
Conservative
4:45 p.m.
Conservative
Stella Ambler Conservative Mississauga South, ON
Thank you to all of you for being here today.
Dr. Tasca, I'm wondering if you could tell me, from a research point of view, how much interest there is in the academic community to study eating disorders.
4:45 p.m.
Research Chair in Psychotherapy Research, University of Ottawa and the Ottawa Hospital, Canadian Psychological Association
There's actually a very active group in Canada of eating disorders researchers. The interesting thing about the group is that they're a lot like me, clinicians who are doing research within tertiary care centres. There's a group in Ottawa, our group. There's the group at CHEO. There are SickKids, Toronto General, the Douglas, and St. Paul's in Vancouver. I say it's interesting because they're all in the tertiary care centres, not in the universities.
4:45 p.m.
Research Chair in Psychotherapy Research, University of Ottawa and the Ottawa Hospital, Canadian Psychological Association
Yes. I don't know if that's as true in the U.S or if that is unique to Canada.
Do you know?
4:45 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
I think they're still connected with the centres, the programs.
4:45 p.m.
Research Chair in Psychotherapy Research, University of Ottawa and the Ottawa Hospital, Canadian Psychological Association
So it's unique, but the good thing about it is that the people doing the research are the ones who are most closely connected to the treatment programs.
4:50 p.m.
Conservative
Stella Ambler Conservative Mississauga South, ON
Right, so it's good and bad. Would you say that possibly one of the reasons you find the researchers in practice is because there just aren't that many opportunities for pure research?
4:50 p.m.
Research Chair in Psychotherapy Research, University of Ottawa and the Ottawa Hospital, Canadian Psychological Association
There's not a whole lot of funding to do research on eating disorders in Canada, period. So it's very difficult if you're a young researcher in an academic setting, trying to start a career, to do research in eating disorders. I'm not sure that I'd even recommend it because it's just too difficult.
4:50 p.m.
Conservative
Stella Ambler Conservative Mississauga South, ON
Right.
This question would be for either you or Dr. Votta-Bleeker. Among professionals, would you say there is sufficient sharing of knowledge, research data, and promising practices? If not, what could be done to increase that knowledge-sharing.
4:50 p.m.
Deputy Chief Executive Officer and Director, Science Directorate, Canadian Psychological Association
I think one of the key things, at least among the psychological research, whether it's done in an academic setting or in a clinical setting by a science practitioner, is that knowledge translation. So whether it's done via conferences, whether it's done through journals, or whether it's done through fact sheets, brochures, there's definitely an effort.
Can we be doing more? Absolutely. My argument would be that I'm not sure the knowledge translation needs to be amongst each other, but it needs to hit the different target groups. We've heard about the schools. We've heard about the students. We've heard about the media. We're good at talking to each other. We need to get a little bit better at translating our scientific knowledge to the lay person, to the parent, to whoever can best make use of that information.
4:50 p.m.
Conservative
Stella Ambler Conservative Mississauga South, ON
Thank you.
Perhaps I could switch to Dr. Spettigue. You mentioned pharmacological treatments. There was talk of two different ones. One of them was 45% effective. I know it's a big question, but what kinds of pharmacological treatments are available for those suffering from eating disorders? How are they regulated by the Food and Drugs Act? I was a little bit shocked and I wrote down that medications for depression don't work for anorexia. I didn't really know that. Maybe you could explain a little bit for me.
4:50 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
Okay. There is no medication that treats anorexia nervosa, nothing that we've discovered. As I said, there was one study at the Ottawa General Hospital in which there was an antipsychotic medication that was found to be helpful for some of the women who took it for treating anorexia nervosa.
4:50 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
Yes. I've been trying to study olanzapine for youth with anorexia nervosa since 2001. It's one of my major failures because it has taken tonnes of time and tonnes of money, and I just can't get enough subjects to agree to be in it. That's partly because if the parent says yes, the teenager says no, and if the parent says no, the teenager says yes. It's hard to get consent from everybody to be in a research study about a medication when you're not sure about the effects on your child. They just worry about their child being a guinea pig, so it's been very hard to recruit into it.
4:50 p.m.
Conservative
4:50 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
The major side effect is weight gain, which is why we're using the medication and sedation. But there's a long list. If you look up every medication in a pharmaceutical book, you get tonnes and tonnes of side effects. When parents read that, they don't want to put their child on it, so it's been hard to study. We just don't know whether it helps or not.
Do you want me to address the depression question?
4:50 p.m.
NDP
The Chair NDP Hélène LeBlanc
Not for the time being, but thank you. Perhaps we could move on to other questions.
Ms. Crockatt, you have five minutes.
4:50 p.m.
Conservative
Joan Crockatt Conservative Calgary Centre, AB
Thank you very much.
I'd like to share a bit of my time with MP Leung, so if you could let me know when I have used three minutes that would be great.
I wanted to ask a bit because I wasn't quite sure what the answer was here. It was about the recommended treatment—Dr. Spettigue, I'll come back to you, thank you—for outpatient family therapy. I'd just like you to expand a little more about why you feel that works. It sounds as if that's a more cost-effective treatment as well, compared to in-patient. Why do you think the family therapy route is the best one, in your experience?
4:50 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
For a few reasons. First of all, in the past, in many instances in psychiatry, parents were blamed, and mothers in particular. The good news is that over time that is changing, as it needed to change. Parents used to be blamed for autism, schizophrenia, eating disorders, all things that are not the fault of parents. We now know you can be a very good parent, and of course most of them are, and still have a child with a very severe eating disorder like anorexia nervosa. It's a matter of recognizing that the best support for any ill child is their parents. I work with some of the most wonderful families and parents in the world.
The other thing is, as I said before, it's really that the kids are compelled to have symptoms. A combination of a severe phobia, a delusion, an addiction, and a form of obsessive-compulsive disorder all mixed together would be how I would describe anorexia nervosa. Children can't be expected to be able to just choose to eat and gain weight when they're so terrified and so sick. So we put that into the hands of parents and make it clear that it's their responsibility. I often compare it to a child with diabetes who has a severe needle phobia but needs to get their insulin, and then it's up to the parents to figure out how they're going to do that, and they're wonderful at it.
4:55 p.m.
Conservative
Joan Crockatt Conservative Calgary Centre, AB
Thank you.
I think that's a really important clarification.
You talked about the real difficulty between the messaging of how we're in a society that talks about all the risks of obesity, and then we have kids who are responding to that in a very disastrous way. I just wanted to commend you, because I think you might have given us the solution to the marketing campaign when you said low weight is as dangerous as overweight.
4:55 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
It absolutely is.
4:55 p.m.
Conservative
Joan Crockatt Conservative Calgary Centre, AB
I can see that being a campaign slogan that might help to get that message out, so I wanted to thank you for that little nugget.
If I can just go—
4:55 p.m.
Psychiatrist, Canadian Academy of Child and Adolescent Psychiatry
If I can quickly add, they keep saying healthy weight is a BMI between 18.5 and 25, but they don't point out that not everybody can be healthy at a BMI of 18.5. It has to be the BMI that's healthy for your body, and for some of my patients it's a BMI of 23, which is perfectly healthy.