Status of Women Committee on Dec. 10th, 2013

[Dr. Hasan Hutchinson]

Our mandate is really to provide guidance. My unit's mandate is to provide guidance to the general population with respect to making good healthy choices. We do work very closely with CIHR.

As a matter of fact, I had talked about an awareness and education campaign that we're doing with respect to healthy weights. That's our “Eat Well” campaign. CIHR has funded a research team from Université Laval and Université de Montréal to evaluate two years of what we are doing, to make sure that we are delivering the program. They are both looking at a process evaluation and making sure we are doing things that are good for the health of Canadians as well. Now, in two years, you're not necessarily going to see any changes in health per se, but what we're hoping to see is that there are changes in intention to change behaviour with respect to healthier eating.

[Niki Ashton, NDP, Churchill, MB]

Perhaps we could see more of those connections, and perhaps we as a committee could look at recommending strengthening some of those connections between your two divisions.

[Dr. Hasan Hutchinson]

I'd add though that when we are putting together these sorts of interventions and these sorts of programs, we of course work very closely with experts across the country.

I know in your last meeting there was reference made to Dr. Leora Pinhas and Dr. Gail McVey. We have had lots and lots of discussions with them as we were developing our education awareness campaign around healthy weights. We talked extensively with them, and also with Dr. Arya Sharma, who is the director of the Canadian Obesity Network, as well as with, of course, our colleagues at CIHR. Behind a lot of our work, we talk with people who work on eating disorders to make sure we don't put forward policies or programs or interventions that are going to create more problems than they resolve.

[Niki Ashton, NDP, Churchill, MB]

Fair enough.

My colleagues and I are certainly also concerned about some of the changes that have taken place around cuts to women's research and services around women's health. In 2012 the budget slashed funding for the women's health contribution program. We believe that this choice to abolish funding dedicated to women's health has far-reaching consequences.

I'm wondering if you can explain to the committee some of the services and initiatives that fell under the umbrella of the women's health contribution program, and how they may be connected to some of the factors raised by Ms. Johnson regarding how gender and sex influence the health of women and men, and how that connects with eating disorders.

[Dr. Hasan Hutchinson]

Certainly that's beyond my particular area of expertise, but perhaps we can do a follow-up and I can make sure that we get the right information from the experts at Health Canada.

[Niki Ashton, NDP, Churchill, MB]

I think we'd really appreciate that, specifically how the work of the women's health contribution program related to work around eating disorders. I think, given your understanding of the kinds of connections and perhaps broader approach, I hope that is also applied to the work of the women's health contribution program.

Dr. Johnson, just a logistical question, or a definition question. On page 1, in the second paragraph of your presentation, you make reference to a definition of eating disorders when you say,“The spectrum of eating disorders varies very widely, ranging from mildly abnormal eating habits to life-threatening chronic disease”. We've heard some pretty specific examples, whether it's anorexia or bulimia, but you seem to propose a wider spectrum. Is this in the research community or the medical community? Who uses this wider spectrum?

[The Chair, NDP, Hélène LeBlanc]

Please respond very quickly, Dr. Johnson.

[Dr. Joy Johnson]

I think we can recognize that some disordered eating, particularly paying close attention to one's food, calorie counting, obsessiveness around calories is potentially a first symptom of disordered eating. I think you heard from the experts that early recognition of disordered eating is important, before it might move forward into more problematic diagnoses such as anorexia or bulimia. So we can think about some of these symptoms being on a continuum, and we can begin to think about prevention and how to intervene early, as these early symptoms appear.

[The Chair, NDP, Hélène LeBlanc]

Thank you very much.

Now Ms. O'Neill Gordon, you have seven minutes, please.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Thank you, Madam Chair.

First of all, I want to thank all of you for being with us today. Our committee certainly considers this a very important study as we go forward to learn more and more about it.

You have stressed that healthy eating is the most important aspect, and we certainly go along with that idea. But from my point of view, probably 10 years ago, I had a colleague whose daughter was suffering from this, but they never wanted to speak about it. Friends were baffled as to how they could help. Not only that, I also found that the other children in the family, who were very close in age, were suffering. We certainly know that the person with this disorder is suffering immensely, but at the same time their families are suffering with how to deal with it, how to help them. Is any study being done or are there new methods? What is being done now to help parents and the sisters and brothers in the families?

[Marla Israel]

Maybe I can start, if that's okay.

I think you raise really interesting points that are relevant not only to eating disorders but to other types of mental illness as well. That's why I feel it's important to look at this issue in context.

The Mental Health Commission of Canada has launched a campaign around stigma. I think these are some of the things you may be addressing: how parents are very reticent to talk about it among their neighbours, how even a young adolescent may be reluctant to share that kind of information, and they may not understand that their symptoms are being pondered by their friends. So one of the things that the Mental Health Commission of Canada has done is a stigma campaign called Opening Minds.

One of the things they've done with Opening Minds is they've tried to address the plethora of mental illnesses through reducing stigma and discrimination, and to be able to talk about these types of issues very openly, so that as a society we start to get comfortable with understanding that even though we label things as disorders or illnesses, that our mental health and well-being is no different than our physical health and well-being, and nobody should be suffering in silence.

They've approached this issue by speaking with allied health professionals, by addressing issues of stigma within the media, for example. Their interim report just came out in November, and they talk about some of the best practices involved in trying to better de-stigmatize some of these issues around mental illness and disorders.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Is that meant for the parents?

[Marla Israel]

It's for parents, for schools, for media, and it's for health professionals. They pay particular attention to youth ages 15 to 24.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

Yes.

As I watched them go through it, I felt really helpless, that there was nothing I could do. But at the same time, they never spoke about it and kept it all within the walls of their own home.

Today this girl is a nurse in the hospital and doing well, so we have seen her come a long way.

[Marla Israel]

That's great.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

You mentioned, as well, that weight preoccupation is a symptom of those suffering from anorexia.

Can you tell us the role that negative messaging about weight can play with those suffering from eating disorders? What are some of the negative messages that we are sending out there?

[Marla Israel]

I'll start, and maybe Dr. Johnson can continue.

I think there is no doubt.... One of things that I addressed was psychosocial, social, environmental, and developmental issues affecting weight. Clearly messaging and how it's perceived, how it's shared, and how it's communicated amongst teenagers has the potential to negatively affect people's sense of body image, how they perceive themselves.

One of the things we're looking at in the agency, and that we undertake every four years, is a study with Queen's University called Health Behaviour in School-Aged Children. The latest report focuses on mental health. We have a chapter on eating disorders. You understand the way people communicate, especially young people, and how they perceive themselves as either too thin or too fat. These are people whose BMIs are just right, but their own perception of themselves is not probably where it should be. This is where the concerted effort of society comes into play.

I don't know if Dr. Johnson has something to add.

[Dr. Joy Johnson]

I think it's a great point, and Marla has addressed it. I think it's really important. You pick up any magazine or watch any movie on television, and young women are getting very specific messages about what their bodies should look like. We also hear in the popular imagination a lot of concern about obesity. Really, there's very little doubt about some of these messages and how they are affecting young girls.

I think it's an important thing for us to bear in mind. We could do everything we might want to do, as parents, as teachers, but there are these other social pressures being brought to bear. They are, as I said, highly gendered, and we need to be thinking about how to prepare girls to counteract, to think about the messages and to realize they are not healthy for them.

That's why I also appreciated what my colleague at Health Canada said, that they're very careful around their healthy eating to not get into this calorie counting thing. Again, that reinforces these notions about weight and shape and how one is to behave in relation to one's food. There can be negative consequences from very well-intended programs.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

How much time do I have?

[The Chair, NDP, Hélène LeBlanc]

You have 27 seconds.

[Tilly O'Neill-Gordon, Conservative, Miramichi, NB]

That's okay. Thank you.

[The Chair, NDP, Hélène LeBlanc]

That was very helpful. Thank you both.

Ms. Duncan, for seven minutes.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thank you, Madam Chair.

Thank you to everyone for coming.

I want to begin by saying that I strongly support this study, but I think it's being done in the wrong committee and I'm concerned about it. We've heard very clearly today about complex multi-faceted health disorders, serious mental health disorders, life-threatening disorders. We also hear that it's increasing in boys—7%, in one study.

I just want to make sure this is not going to be sidelined—this is a really serious health issue—and that real recommendations come out of this report.

My questions are going to focus on recommendations.

We know the human costs of eating disorders are incalculable. I'm wondering, can anyone tell me what the economic costs of eating disorders are in Canada each year, please?

[Dr. Joy Johnson]

That's such a good question, and I don't have the numbers at my fingertips. I do want to say that there have been some studies looking at how much money, for example, the diet industry is making in terms of benefiting from marketing weight-loss products, different types of diets, exercise machines, etc. This is a multi-million dollar industry in North America, and clearly somebody is paying for that.

That's just one type of economic cost. I don't have other details at my fingertips, but I think it's a great question, and it's something we need to think more about.

[Kirsty Duncan, Liberal, Etobicoke North, ON]

Thanks, Dr. Johnson.

I'm wondering if someone can table those numbers in the committee for us. It is a really important issue.