Status of Women committee  The number one challenge—and again, I'm only talking about pediatric eating disorders—is that she won't seek treatment because she's terrified that it will mean that she'll have to gain weight. So no matter how much she is suffering, she will not choose to go and get help, because she's terrified.

Status of Women committee  That's a very difficult one, because I don't have enough research to answer that question. We desperately need more research into the causes of eating disorders. I might have some opinions, but I don't have facts.

Status of Women committee  Wow. There are so many gaps that it's hard to know where to begin. There's a huge lack of research. We don't understand the causes of eating disorders. We don't understand how to prevent eating disorders. We don't know how to disseminate the most effective treatments. We don't know how to treat the ones who don't respond to the family-based therapy, which is about 30% of youths.

Status of Women committee  Again, perhaps I can just clarify. There are practice guidelines for the treatment of child and adolescent eating disorders. There are American practice guidelines, which I helped to develop, and we're in the process of trying to make some Canadian guidelines.

Status of Women committee  They do not entail Canadian guidelines.

Status of Women committee  No, I definitely favour evidenced-based treatment for eating disorders, and we lack a lot of evidence. So at this point, for example, there is no evidence whatsoever that there is any medication to treat children and adolescents with anorexia nervosa. Having said that, as I pointed out there is a very high association between eating disorders, depression, and anxiety, and there are medications that are helpful for treating depression and anxiety although they don't work in low-weight patients.

Status of Women committee  That's an easy one, but I warn, I can talk a long time about it. I want you to imagine a patient with severe obsessive-compulsive disorder, who has the constant thought, “There are germs on my hands,” and the only thing that makes it better is if that patient goes and washes their hands, and then the anxiety decreases.

Status of Women committee  I should point out that those are older statistics and that they are for young adults or a study in adults. We think things are starting to get better for young people and for pediatric eating disorders because of the recognition of the need to involve families. An exciting development you will have probably have heard of is the fact that family-based therapy, also known as Maudsley family therapy, has been studied enough for us to recognize that it is effective in young people and that it is the recommended treatment for restrictive adolescent eating disorders.

Status of Women committee  Thank you for the honour of presenting to you on behalf of the Canadian Academy of Child and Adolescent Psychiatry, and on behalf of clinicians who treat eating disorders in youth. As you know, eating disorders are devastating illnesses. Research suggests that it takes between two and seven years to recover from an eating disorder, and that only 50% fully recover.