Status of Women Committee on Dec. 10th, 2013

[The Chair, NDP, Hélène LeBlanc]

Dr. Johnson, would you like to answer that question?

[Dr. Joy Johnson]

I think the question is about rates of anorexia and this notion of how we actually get good data in relation to this.

I think Marla Israel provided data from 2006. We do not have other current data in Canada. Marla Israel might be able to correct me on this, but I think we in Canada are about to collect more data in relation to child and youth health. So hopefully we will have better data in relation to this.

I think this is an important issue for us to bear in mind as we move forward, and that's why I used American data.

[Marla Israel]

The latest data available is from 2006, but there will be a report published in 2013 or 2014. I have to confirm that information. It is the next study of the Canadian Community Health Survey. There will be a chapter on mental health. Some of my statistics are just the ones that have been published, but there will be additional updated numbers available next year. I've already heard that the numbers remain the same.

[The Chair, NDP, Hélène LeBlanc]

I am curious about something. The study that Ms. Johnson mentioned also describes how this condition affects young boys and men. Does the Canadian study also look at that?

[Marla Israel]

Yes, it does. According to the 2006 report, women were more likely—

—I'll read it in English, if that's okay.

[The Chair, NDP, Hélène LeBlanc]

It's okay.

[Marla Israel]

I can't translate in real time, so I apologize for that.

Women were more likely than men were to report an eating disorder: 0.8% versus 0.2%.

More women than men met the criteria of an eating attitude problem. Among young women, 1.5% reported that they had an eating disorder. Three per cent of women will be affected by an eating disorder in their lifetime.

[The Chair, NDP, Hélène LeBlanc]

Okay.

[Marla Israel]

But binge eating affects boys more than girls.

[The Chair, NDP, Hélène LeBlanc]

Thank you for clarifying that.

We now move on to Ms. Ambler, for five minutes.

[Stella Ambler, Conservative, Mississauga South, ON]

Thank you, Madam Chair.

Thank you very much to all of you for being here today.

My question, if I might begin with you, Dr. Johnson, is with regard to your experience as a professor at the school of nursing. This is of interest to me because our witness last week was talking about the fact that at medical schools students are not taught very much, if anything, about this. I was looking for my notes, and I couldn't find them, but if I recall correctly he mentioned that they spend about two hours in total in their three years at medical school learning about eating disorders.

I'm wondering if nurses in training, student nurses, learn any more about it. I would imagine that they're front-line workers as well in diagnosing eating disorders, or at least in triaging them. I'm wondering if that's part of what you do or if you think it's important that that be part of the nursing program in Canada.

[Dr. Joy Johnson]

I think if we were to go across the country and look at nursing curricula, you'd probably see fairly similar numbers to what was reported in relation to medical curricula. We'd probably see about two hours being spent in the overall curricula. This is one of the problems: no matter what the issue is, there's limited time in the day, and it's very hard to fight for time to actually get particular issues into the curricula.

That being said, I think it is an important issue. People do need to understand the issue. Health professionals, from physicians to nurses to social workers all need to understand the importance of disordered eating.

I would say that on the ground we also need to continue to work with practitioners who are primary care providers as well as others in the system to make sure that we continue their education on the ground. There have been some really good programs that have been developed in terms of providing information about screening, providing information about prevention, etc. That's in some ways why I'm really pleased about the strategy for patient-oriented research. With this network on mental health and youth, we're hoping to actually get best evidence into practice and create a better opportunity, really, for researchers and clinicians to work together to start to change practice.

So I think undergraduate education is important, but education at the practice level is as well. Bringing researchers and practitioners together is also very important.

[Stella Ambler, Conservative, Mississauga South, ON]

In other words, it's not too late. Once they're educated and have become nurses and doctors, it's okay that they don't know everything at that point. There are ways we can train them afterwards to deal with this complicated mental health issue.

[Dr. Joy Johnson]

It's very important. I would hope that I wouldn't be practising based on what I learnt in 1981. All health professionals are responsible to continue to improve and understand current issues. The science changes, and that's a really important thing for us to bear in mind, that practice needs to change and evolve, and we need to support that.

[Stella Ambler, Conservative, Mississauga South, ON]

Thank you very much.

Dr. Hutchinson, can I ask you specifically if you, as a doctor of naturopathy, think that treatment of eating disorders by physicians in Canada is different from what it would be if a person with an eating disorder went to a doctor of naturopathic medicine? Do you know anything about that? I don't want to put you on the spot, but I thought you might—

[Dr. Hasan Hutchinson]

I really wouldn't want to venture into that, to be completely honest. I have never really practised as a naturopathic doctor because I came out and started working for the federal government. I wanted to get into public health after medical school.

[Stella Ambler, Conservative, Mississauga South, ON]

Maybe just anecdotally, do you know of any homeopathic or naturopathic treatments for eating disorders that you've come across, working at Health Canada?

[Dr. Hasan Hutchinson]

No, certainly not since I've been working at Health Canada. I wouldn't venture—

[Stella Ambler, Conservative, Mississauga South, ON]

I was just curious about that. I'm a big supporter of alternative medicine, and I was just wondering if there are different ways of doing things.

[Dr. Hasan Hutchinson]

Where I think perhaps it comes into line with what we do in the health portfolio is that level of prevention and the basic type of guidance around healthy eating patterns. Certainly that is taught through naturopathic medicine, as it is taught in a very limited way in conventional medical schools.

[Stella Ambler, Conservative, Mississauga South, ON]

Sure, it's wellness and prevention in general, of course.

[Dr. Hasan Hutchinson]

Prevention in general, yes. Certainly I do like the emphasis that is in some other practices of medicine as well, but that's something we have to make sure is consistent with what we do from a more conventional evidence base. I am also a geneticist, a molecular biologist, and I am trained as a Ph.D. as well. I do like to see that evidence base.

[Stella Ambler, Conservative, Mississauga South, ON]

Sure.

[Dr. Hasan Hutchinson]

And that's what we—

[Stella Ambler, Conservative, Mississauga South, ON]

When I say doctor, I mean it in both instances.