At any given time in Canada, as many as 600,000 to 990,000 Canadians may meet the diagnostic criteria for an eating disorder, primarily anorexia nervosa, bulimia nervosa, or binge eating disorder.[1] Approximately 80% of individuals with eating disorders are girls or women. Eating disorders are a serious form of mental illness, “characterized by a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.”[2] The devastating symptoms of an eating disorder lead to serious consequences: an individual’s mental and physical health are compromised, personal relationships may suffer, current and future education and employment opportunities may be jeopardized, financial security is put at risk, and overall quality of life deteriorates.

Furthermore, these disorders can be deadly. Individuals with eating disorders can develop life-threatening medical complications and often have debilitating concurrent disorders, such as depression. In particular, anorexia nervosa has the highest overall mortality rate of any mental illness, estimated at between 10% and 15% of individuals with the illness; and the mortality rate for individuals with bulimia nervosa is about 5%. Combined, these two disorders kill an estimated 1,000 to 1,500 Canadians per year, with this number likely higher as death certificates often fail to record eating disorders as the cause of death.[3]

In the report Eating Disorders Among Girls and Women in Canada, the House of Commons Standing Committee on the Status of Women (“the Committee”) examines this potentially deadly mental illness, the factors contributing to eating disorders, and the obstacles in addressing them and seeking treatment. The Committee was disturbed to learn that despite the suffering and high mortality rates among individuals with eating disorders, it was difficult for these individuals to acknowledge their disorder, to seek the support of family and friends, as well as the greater community, to receive an official diagnosis from a medical professional, and to gain access to treatment and follow-up support services.

As outlined in the report, the obstacles to addressing eating disorders among Canadians are numerous. They include a lack of awareness of eating disorders; a need for greater community-based supports; entrenched stereotypes and stigma associated with eating disorders; bias in the health care field against patients with these disorders; financial roadblocks; the challenges of concurrent disorders; difficulties in producing research and tracking information; and particular challenges faced by marginalized populations.

As discussed in the report, there are also many challenges to accessing treatment for individuals with eating disorders. These barriers include health care providers with inadequate training in the field of eating disorders; lack of treatment programs; inappropriate treatment programs; lengthy wait times; and insufficient research into potential treatments. The report also examines promising treatment practices, such as Cognitive Behavioural Therapy and Family-Based Therapy (the Maudsley Approach).

The report’s findings are based on testimony from the Committee’s study on eating disorders among girls and women in Canada, which began in November 2013. The study commenced with briefings from officials from Status of Women Canada, Health Canada, the Public Health Agency of Canada and the Canadian Institutes of Health Research. Testimony was provided by 27 witnesses – 4 appearing as individuals and the remainder representing 20 organizations – over a total of 9 meetings held from November 2013 to March 2014.

The Committee recognizes the important contributions of the witnesses who appeared, many of whom shared their personal experiences of struggling with their own eating disorder or helping a loved one to cope with the disorder. One witness shared the words of her daughter, who is living with an eating disorder:

You keep saying this time last year I was dying, and although I'm not in the same immediate danger, my head is as ever, if not more, in the deepest darkest rabbit hole. I feel impending doom, the same impending doom I felt when I was alone at my lowest weight and bingeing purging 24/7. It's the sense of profound fear that I'm not going to make it out of this eating disorder. I'm not going to be the one-third that recovers. I may even be in the 20% that die [sic]….

There is nowhere to go in the emergency. There are so few who understand. I still wake up dreading the day. How will I get through it? What will I eat or not eat? How will I control myself from eating trigger foods? I can't focus on anything. I can barely read, or write, or find joy in anything because I'm constantly paralyzed with fear and anxiety, consumed with indecision and yearning to be numb.[4]

Furthermore, the Committee acknowledges that while this report examines eating disorders from the perspective of girls and women, as approximately 80% of individuals with eating disorders are female, many boys and men also suffer from these disorders, and they also face challenges in receiving both diagnosis and treatment.

Lastly, members of the Committee and witnesses would like to highlight the importance of this study, as it shines a spotlight on an often marginalized and misunderstood mental health disorder that affects hundreds of thousands of Canadians, as well as their families. As one witness explained, “the establishment of [the Committee’s study] has given me so much hope that we can work together in partnership to save lives from this horrible and lethal illness.”[5] Another witness noted:

As many leaders have now said in public in the last few years… there is no health without mental health, and that breaking the silence and opening a dialogue is critical when living with a mental illness – more specifically, an eating disorder….[6]

The Committee hopes that its report will play a role in breaking this silence, opening a crucial dialogue and leading to substantive improvement in the awareness and treatment of eating disorders in Canada.