Status of Women committee  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.

Status of Women committee  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.

Status of Women committee  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.

Status of Women committee  Somebody who has an excellent answer to that question is Dr. Gail McVey. You may have already heard from her. She specializes in the prevention of eating disorders and is trying to change that environment in the school, but there are huge barriers. We need to change the curriculum so that the teachers aren't teaching about eating disorders by describing anorexia nervosa, which then causes girls to go, “Oh, that's a good idea”, which in fact the research shows that it does.

Status of Women committee  I think they're still connected with the centres, the programs.

Status of Women committee  Ontario is probably a good role model for the other provinces, in terms of Gail McVey's work on the Ontario community outreach program for eating disorders, and how she has brought all of the eating disorder programs across the province together as a network. As part of that, our team is trying to lead an initiative to have a shared database amongst the pediatric Ontario eating disorder programs, although, again, we didn't get funding for it, but anyway....

Status of Women committee  Yes, and they should be. I agree.

Status of Women committee  Do you mean there were more normal-sized models?

Status of Women committee  I agree. I think that's excellent.

Status of Women committee  I think that's a huge point. The typical model and celebrity actress has a BMI between 16 and 17, and the average healthy BMI for young females is about 21.

Status of Women committee  Are the media part of it? Yes. That's where prevention efforts really need to be targeted, at changing social.... “Weightism” is what it's called—in other words, the attitudes of our society about weight and about, as you said, what's perfect, what's beautiful. We don't want our daughters growing up aiming for an unhealthy BMI.

Status of Women committee  It definitely is an illness that can relapse, often in times of stress.... Do you know the rate of relapse? Is it about 30%?

Status of Women committee  That's an excellent question, and it certainly follows on the last one. I would describe it as a toxic atmosphere, based on the descriptions that I hear from all the teenage girls that I treat, where they talk about groups of girls that don't eat lunch, that it's just not done, often there isn't even a place to eat lunch; of the comments that boys are making about the girls; and the huge focus on appearance and weight.

Status of Women committee  Yes.

Status of Women committee  For sure I would want a centralized database. I'd want to be able to track eating disorder patients and their progress, their numbers. Separate from that, I agree we need practice guidelines. We need more study of effective treatments, and the dissemination of all of that, tracking the outcome of patients with eating disorders.