Status of Women committee  I hope you invite Dr. Leora Pinhas to address your committee. She'll explain it to you in great detail. She is a biostatistician. In brief, and you'll get her to explain it in more detail, her read on the epidemiology is that rates of disordered eating among children are twice as high as rates of obesity, and obesity is the epidemic and disordered eating is ignored.

Status of Women committee  I'm not pro-obesity; don't get me wrong. I am anti-dieting, because I don't think dieting helps anything, not even obesity for that matter. There is a risk for things like programs in the school, where kids' BMIs are measured and they have fingers wagged at them if they're too heavy.

Status of Women committee  Sure. We are doing two things. We are world leaders in this. We're doing something called deep brain stimulation for chronic, severe, intractable anorexia, for people who are going to die. We've done 14 cases and we have six people lined up. It's the same type of treatment done for Parkinson's disease, where electrodes are implanted in the brain and hooked up to a stimulator that is turned on permanently.

Status of Women committee  Transcranial magnetic stimulation alters the function of specific brain circuits, mostly brain circuits related to the regulation of emotion. People who get a good response say that they feel more normal inside, that they feel like they have a better, more consistent experience of their internal emotional life.

Status of Women committee  Yes, in my population, I treat the sickest of the sick with anorexia nervosa on the in-patient service. Sixty per cent of my patients have a history of physical or sexual abuse.

Status of Women committee  Thank you, Madam Chair. I wish you the best of luck with your study.

Status of Women committee  For people who live in rural areas who need intensive treatment, they have to travel. My catchment area in Ontario covers, for example, most of northern Ontario. People come from many hundreds of miles away to attend my program. That is not ideal. It would be better if they could be treated closer to home.

Status of Women committee  In any province where there is an advocacy group, those groups have made representations to the provincial government. Most of those groups have professionals as advisory panels, so they will help out. Usually it's family members who are doing the advocacy. That's where it comes from right now.

Status of Women committee  That's public awareness and lobbying, right? That's why, for example, this national public advocacy group will be so important, if it's established and sustained. I think the federal government has a role to play as well in terms of public information.

Status of Women committee  I think there's primarily ignorance in the health care profession. In my experience, the average family doctor, in their entire career, may see only two or three patients who are very sick with anorexia. They get very interested when they have such a person. They call me on the phone and they want to learn all about it.

Status of Women committee  I'm not sure if that answers your question.

Status of Women committee  Absolutely. We work in multidisciplinary teams. We have many disciplines on my team. I would probably challenge what you said. This sort of work is equivalent to what happens, let's say, in an organ transplant unit where people are monitored for many years regarding rejection levels of their organs.

Status of Women committee  I'll just pick two or three out of the air as examples. One would be to recognize that appropriate treatment for anorexia nervosa of even moderate severity involves an intensive treatment program that starts with hospitalization and needs to be delivered by experts who are trained in the field.

Status of Women committee  There are eating disorder-specific skills, and then there are other skills that will differ depending on a person's precise situation. Just to be clear, somebody who comes in with a BMI of 14 would be attached to our in-patient service for about five or five and a half months, and would then transfer to our day hospital service for two months.

Status of Women committee  A very exciting event occurred a month or so ago in Toronto when representatives from advocacy groups from across the country got together with the intention of forming and launching a national advocacy group for eating disorders. It may well be that you will invite some of those principals to come and testify before the committee a bit later on as well.