Status of Women committee  Every patient at CHEO in our eating disorder program gets family therapy. This means there is a therapist who is mostly with the parents, working very closely with them to educate them and to raise their anxiety about the severity of the illness in their child and the need for very intense intervention, and to try to empower them to take control over the child's nutrition and to not give opportunity for symptoms.

Status of Women committee  It's hard to know since I didn't have to see them, but I'm going to say about 200 or so.

Status of Women committee  Well, funding. It's tough because I know that there's not enough funding for a lot of areas in health care, but for sure there's just not enough for eating disorders.

Status of Women committee  We certainly need help at all levels. We certainly need more specialized, multidisciplinary teams like the one at CHEO. They need to be bigger and have more services, and we need more of them, but there's no doubt that we also need more services in the community. As I said, if we're only treating the most severely ill patients, then who's going to treat all the others?

Status of Women committee  Yes, but it will take me some time. That's a tough one.

Status of Women committee  Yes, in many ways. Would you like me to elaborate?

Status of Women committee  For example, in medical school and residency training, there's a definite lack of training and a lack of understanding of eating disorders. Like Ms. Phoenix said for the NPs, for the doctors there would be a mandatory lecture on the symptoms of anorexia nervosa and that kind of thing, but never enough time or depth to really understand and appreciate these patients, what they're going through, and the kind of help they need.

Status of Women committee  There's not one single specialized multidisciplinary pediatric eating disorder program in Saskatchewan, P.E.I., New Brunswick, or the Canadian north. There's one only in all of B.C., Nova Scotia, Quebec, and Newfoundland.

Status of Women committee  I think we need to have a huge campaign to change the huge anxiety around eating and nutrition and helping youth, especially young children. The increase in eating disorders in young children is coming out of the fact that there are a lot of very compliant, self-conscious, perfectionistic, anxious little girls who are trying to be very, very good, and avoiding all the bad foods.

Status of Women committee  —that are causing eating disorders.

Status of Women committee  That was nice of you, thank you. For 14 years I served as the psychiatric director of the program at CHEO. Two years ago we were faced with a one-year waiting list, which is completely unacceptable, given the severe medical and psychological complications of eating disorders in young people.

Status of Women committee  There's a difference between treatment for girls versus that for women, so for adults, yes, but for young people we recommend family-based therapy.

Status of Women committee  It depends on the severity of their illness because I wouldn't want to hospitalize a patient with a mild eating disorder, nor would I want to keep a patient out of hospital who was very severely ill and medically unstable. So it does depend on the level of intervention, and it's important that we match the level of intervention to the severity of the illness.

Status of Women committee  The components of care are that you need psychological treatment, medical treatment, and nutritional treatment, and they all need to be combined. For most patients, the recommended treatment is outpatient treatment, where they're followed for their medical issues by a medical doctor and they have nutritional input if that's available, although it's not absolutely necessary.

Status of Women committee  It would be less than 1%, I would guess, if we looked at the whole country.