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Eating disorders on the rise in
Canada, as sufferers wait for
treatment
CTVNews.ca Staff
Published Sunday, February 10, 2013 10:03PM EST
Last Updated Sunday, February 10, 2013 10:56PM EST
Eating disorders are seeing a dramatic increase in Canada, and the troubling trend has
physicians and advocacy groups concerned about a lack of treatment available to those
who find the courage to seek help.
Hospitals and clinics specializing in eating disorders say there is a rise in the numbers of
adults, teens and children, some as young as five, seeking help for eating disorders.
Most are women.
Sufferers of eating disorders either don’t eat enough, or overeat only to purge the food in
a desperate bid to maintain what they believe is an ideal body image. Such conditions
can ruin lives, bodies and, in some cases, can prove to be fatal.
It’s difficult to put an exact figure on the amount of people affected by eating disorders,
as numbers vary between 150,000 to more than 600,000 across Canada.
About three per cent of women are affected by an eating disorder over their lifetime.
Doctors say there are two-to-three times more cases than a generation ago.
According to the National Initiative for Eating Disorders (NIED), the rate of obesity is nine
per cent in girls, while the rate of eating disorders sits at 18 per cent. Incidence of
restrictive eating disorders in children aged five to 12 is twice the incident rate of type II
diabetes in all children, from newborn to 18 years.
Eating disorders have the highest mortality rate of any mental disorder, according to the
NIED.
The non-profit organization says it knows people are struggling to find treatment in
Canada, which is why it is aiming to increase the profile of eating disorders across the
country.
Patients who are referred to specialists and qualify for treatment often wait months on
end due to a lack of resources, Wendy Preskow, founder and president of the NIED, told
a Toronto press conference earlier this month.
Lakeridge Health, in Oshawa, Ont., expanded to meet the growing demand of people
seeking help.
Fifteen months later, the clinic’s Eating Disorders Program can’t keep up with referrals -about 75 people are still on a waiting list. The clinic provides nutritional counselling,
therapy and group programs.
Like other eating disorder centres, Lakeridge is seeing an increase in teen patients in
particular. Last year they were treating 12, this year, 35.
Lakeridge’s Dr. Skevoulia Xinaris said in some cases, treating an eating disorder is also
a battle against the clock.
“The concern that we have is that we’re dealing not just with a mental health issue, but
with a physical health issue as well,” Xinaris said. “People die, and that’s what’s scary.”
Joanne Cooper, who is a patient at Lakeridge, said a delay in medical-assisted recovery
can prove dangerous. Cooper reached out to doctors a decade ago for help to control
her bulimia.
“It took so much courage to reach out and finally admit that I had an eating disorder,”
Cooper said. “And it took so much for me to ask for help and then for there to be really
not any help … made me feel more lonely and more isolated and more hopeless.”
Lakeridge patient Audrey Alward, who suffered from anorexia, said she was completely
consumed about thoughts of food and exercise. “I would plan my day around not eating,”
she said, until things got “so bad” she had to seek medical help. She went first to her
family doctor, and then emergency.
When someone afflicted with an eating disorder acknowledges that they need help, they
need support immediately, Cooper said. The longer the wait, the greater the chance the
person may become un-motivated and see symptoms re-emerge.
Dr. Blake Woodside, co-director of the Eating Disorders Program at Toronto General
Hospital, said there are some parts of Canada with no specialized treatment programs,
even though eating disorders often have a 15 per cent death rate.
Doctors at London Health Sciences Centre in London, Ont., are also seeing younger
patients suffering from eating disorders, particularly anorexia, said Dr. Sandra Fisman, a
child and adolescent psychiatrist.
She said a rise in eating disorders is in part due to a more acute awareness of the
dangers of anorexia and bulimia, which in turn is creating a culture obsessed with
weight.
“One of the unintended side effects of talking about an obesity epidemic is to create an
eating disorders epidemic ,” said Fisman, medical director at London Health Sciences.
“So we have to be very careful about how we talk about weight and eating and healthy
lifestyle.”
Fisman said physicians must also seek out innovative ways to treat the root problems.
“We have to find good solutions that are different than the solutions that we had in the
past that include transforming the way we provide mental health care,” she said.
Alward said while she still struggles, she’s come to accept that her life is far better now
than it was before she was admitted to Lakeridge in 2009.
“I still worry about my weight, but it's more of an acceptance that this is where I have to
be to be healthy," Alward told CTV News.
Today, Cooper is getting the help she sought at Lakeridge, with positive results.
“The payoff, I can’t even describe it, it is so worth it,” she said.
With a report from CTV’s medical specialist Avis Favaro and producer Elizabeth St.
Philip
Anorexia hitting
men increasingly
hard: One in three
cases in new study
is male
Sharon Kirkey, Postmedia News | 21/01/13 |
Last Updated: 21/01/13 10:45 AM ET
More from Postmedia News
Canadian men face epidemic of eating disorders, Ontario study finds
Bulimia, anorexia nervosa and other eating disorders, long thought to be serious problems for many women,
are showing up among surprisingly large numbers of men, some of whom are starving themselves or
exercising obsessively to look like the pictures in men’s magazines.
Yet neither men themselves, nor most doctors, think of males as being at risk for these illnesses, experts
say.
Community-based studies suggest one case in three of anorexia nervosa is a male, said Dr. Blake
Woodside, director of the program for eating disorders at Toronto General Hospital. For bulimia, it is about
one in four.
Breaking through stigma in the battle for better eating disorders care in
Canada
For eight years, Debbie Gordon’s daughter suffered from anorexia. It began at the age of 15 and went on
well into adulthood. Over the years, Gordon’s daughter was constantly checked in and out of eating disorder
programs offered by the Toronto General and Credit Valley hospitals. At most, she was out of the program
for six months before having to be readmitted.
“It is the No. 1 mental health killer in young people,” Gordon says. “There’s just so many people with the
disease and so little beds.”
Indeed, in the Greater Toronto Area, there are only two eating disorder programs available.
“It saddens me,” Gordon says. “There needs to be more government funding.”
“And that’s a dramatic finding, because in clinical samples (based on people in treatment) it’s more like one
in 15, or one in 20,” Woodside said.
The stigma, isolation and confusion around suffering from what has long been perceived as a “girl’s
problem” can make men so reluctant to come forward that many arrive in treatment sicker than women. “For
men there is still such a stigma attached to the idea of having an eating disorder and reaching out for help,”
said Joanna Anderson, clinical director at Sheena’s Place in Toronto. “If you go for treatment and you’re in a
group with 10 or 12 women and you’re the only man, it’s very difficult to feel like you’re not different.”
Men develop eating disorders for the same reasons women do, doctors say
Yet men develop eating disorders for the same reasons women do, doctors say. Most have an underlying
genetic vulnerability to the disease that can be triggered by a stressful life event, such as undiagnosed
psychiatric conditions, sexual or physical abuse, trouble in school, job loss – “the enormous range of things
that make people feel bad,” Woodside said.
For boys, it can start with bullying or teasing, or something as simple as puberty. An eating disorder can
become a coping mechanism, a desperate grasp for control at a time when it feels as if their lives are
unravelling.
But there can be a strong cultural component as well. Men, like women, are under pressure to conform to
the “ideal” body type, and for men, that body tends to be linked to perceptions of success, control and
power, said Merryl Bear of the National Eating Disorder Information Centre, which has launched a poster
campaign to raise awareness of eating disorders in men.
‘There has been a much stronger link between advertising and a particular glorification of the male physique
in recent years’
“There has been a much stronger link between advertising and a particular glorification of the male physique
in recent years,” Bear said. “The social ideal of the male body has become much more tightly linked to
personal success.”
Media images can make men feel vulnerable about “who they are and how they present (themselves) in the
world,” Bear said.
“And they’re told they can manage that by controlling their bodies.”
The ideal body shape for men traditionally has been the inverted triangle, Woodside said – broad shoulders
tapering to a narrow waist.
Super-skinny male models have also become increasingly popular in men’s fashion magazines
But super-skinny male models have also become increasingly popular in men’s fashion magazines, “a kind
of ‘geek-thin’ thing that is a potential route into dieting behaviours for some guys,” Woodside said.
Both sexes experience the illness in the same isolating, “very painful, very difficult ways,” Woodside said.
The difference with men is that when they tell family or friends they have anorexia or bulimia, people initially
don’t believe them. “They say, ‘that’s an illness of girls.’”
Families are also far less likely to think “eating disorder” in a boy who suddenly begins to lose weight.
Tom Wooldridge, assistant professor of psychology at Golden Gate University in San Francisco, knows of
cases where parents didn’t realize the seriousness of the situation until their son’s hair began falling out.
Men often feel a sense of shame and embarrassment, he said. “It’s really common for men to feel very
alienated,” Wooldridge told the Canadian Medical Association Journal in one of two articles published on
eating disorders in males last week.
Woodside said greater public awareness is needed to recognize that men are at risk, “and that people
shouldn’t ignore unexplained weight loss in a 20-year-old man, or failure to grow in a 14-year-old boy, or
evidence of binging and purging.
“Those are not normal behaviours for men any more than they’re normal behaviours for women,” he said.
Teen eating disorders
Here's how to recognize the signs that your teen might be suffering from an eating
disorder such as anorexia or bulimia.
By Christine Langlois
Helping a teen with an eating disorder is among the most difficult challenges that a
family can face. Parents should know that, fortunately, there are specialists who can help
them help their child, that treatment for eating disorders is available. As with many
disorders, there's a better chance of recovery if you recognize the problem and treat it in
the early stages.
Research is ongoing into the causes of eating disorders, and the results are a subject of
debate. Most experts believe that an eating disorder is a strategy that young people use to
cope with problems too painful to talk about. They use their bodies as vehicles to play out
the issues they face, usually issues of control, sexuality, separation, and self-esteem.
Of the people with eating disorders, 90 to 95 per cent are female. People with eating
disorders may have suffered a trauma such as psychological, physical, or sexual abuse,
or be part of a family in which the caregivers are addicted to alcohol or drugs. However,
many people with eating disorders have not experienced such traumas. An eating disorder
may have no single cause. In someone who is vulnerable, a disorder can be triggered by
an event she doesn't know how to handle, which can be as common as being teased or as
devastating as rape or incest. An eating disorder often begins when the person is dealing
with a difficult transition: puberty, a new school, the breakup of a relationship. Every
person's experience is unique, but often the teen who develops an eating disorder feels
shame, disgust, and anger about her body. Some feel a need to purify or even punish their
bodies. They feet powerless to change anything else in their lives.
There are two main types of eating disorders: anorexia nervosa and bulimia nervosa. Both
are characterized by excessive concern about one's weight and shape and a negative,
distorted body image. Although a teen may weigh only 32 kg (70 lb.), when she looks in
a mirror, she sees herself as obese. She thinks that others also consider her mammoth in
size, even if you think she looks skeletal when you see her thin arms and legs.
Anorexia Nervosa
Of the women in Canada between the ages of fourteen and twenty-five, an estimated 2
per cent suffer from anorexia, a condition defined as a drastic weight loss caused by selfinduced starvation. It can, however, begin earlier. The child may begin by eliminating
desserts from her meals. Then she may also exclude bread. She could go on to deny
herself more and more food until she's eating only celery sticks and water. Eventually she
may try to exist on water alone. The anorexic may go to the extreme of counting the
calories she consumes from the glue after licking a postage stamp.
Behind this potentially fatal illness is a girl's strong desire to control everything and to
become thin. Some may already be painfully thin in their parents' eyes; others become
anorexic because they were overweight children, were either ostracized or encouraged to
diet, and were praised when they lost pounds. Anorexics believe their only problem is
being too fat. They have a distorted body image and dorA recognize how underweight
they are, which makes it difficult for them to recognize that they need treatment.
Typically the anorexic makes up excuses to miss meals. Most adolescents have voracious
appetites, but if your daughter often says that she had a huge lunch and doesn't want
dinner, you might well be alert to other indicators of anorexia.
The British Columbia Ministry of Health includes the following as signs of anorexia:
• She develops obsessions about food and recipes. An anorexic may eat vicariously by
grocery shopping, by watching cooking shows,or by cooking food for others.
• She develops unusual eating habits. She may cut her food into tiny pieces or eat only
the crumbs that others leave behind.
• She always feels cold.
• She shows a noticeable weight loss.
• She involves herself in excessive exercise. As a way of burning
calories, an anorexic may spend hours in the gym or go on day-long walks.
Bulimia Nervosa
Of the women between the ages of fourteen and twenty-five, an estimated I per cent have
bulimia nervosa. This disorder is characterized by cycles of binge eating followed by
purging or other inappropriate compensatory behaviour to rid the body of calories.
Because young girls don't know about or can't execute the methods of purging, this
disorder doesn't usually begin until the mid-teens.
For a bulimic, a binge is eating boxes of cookies or litres of ice cream in a short period or
time. Methods of purging themselves include selfinduced vomiting or using diuretics,
diet pills, or laxatives. Teenagers with bulimia use stimulant laxatives such as Correctol
or Ex-Lax most frequently because these cause diarrhea soon after eating. This leads to
the loss of fluid, which may give a false sensation that she has lost weight. The
abdominal pain, which is a common side effect, serves to make the teen's emotional pain
real. The misuse of laxatives has serious complications, including dehydration and
electrolyte imbalance. Many anorexics also suffer constipation from a combination of
inadequate intake of food bulk and excessive vomiting, as well as the laxative habit, and
may go days without having a bowel movement. Seek medical advice for your teen as
soon as you become aware of the problem.
To induce vomiting, some teens use syrup of ipecac, an over-the-counter drug intended to
induce vomiting in someone who has accidentally swallowed a poison. If used
repeatedly, the drug becomes toxic to the muscles and can destroy heart tissue
irreversibly, weakening the heart. If your child is using ipecac, she needs immediate
medical attention. Unlike anorexics, bulimics know they have a problem. However, they
don't want to admit to what they consider shameful and disgusting behaviour.
The British Columbia Ministry of Health includes the following as signs of bulimia:
• She eats large amounts of food, but shows little weight gain.
• She becomes excessively sensitive, secretive, and irritable about food and eating.
• She goes to the bathroom after meals and vomits In secret.
• She has a chronic sore throat and hoarse voice.
• She leaves evidence of vomiting or laxative abuse.
How to Help
Parents may feel helpless watching a child struggle with an eating disorder. Because of
their worry, they may vacillate between being too involved or not involved enough. In an
attempt to gain control of the situation, some parents revert to parenting techniques they
used when their teen was a young child. Trying to force or tempt a child into eating may
perpetuate the eating disorder. You may simply want to have your daughter spend more
time at home so that you can make sure she's eating regular meals and nutritious food.
But if you no longer allow your teen to hang out with her friends or go to the mall, her
symptoms may escalate. Support her by letting her continue to spend time with her
friends, to do the things other teens her age are doing.
You can help best by maintaining good communication with her, by showing your
interest in her activities and her feelings. She needs to know that she's not alone and that
you care about her. Talk about things other than food and weight. Let her know that
you're concerned about her health and seek help from your family doctor or from an
eating disorder clinic that can offera multidisciplinary approach.
Your role is that of a parent or a concerned friend, not a therapist. If your child refuses
help, negotiate with her, but don't demand. Offer to go with her to the doctor's. Promise a
shopping trip after the appointment. Say "I know you don't think you have an eating
disorder, but unless a doctor confirms that, we'll never know for sure." If she's adamant
about not seeing a doctor, maybe she'll talk with a school counsellor or a therapist who
can help her recognize that she does need medical help. The National Eating Disorder
Information Centre in Toronto keeps a national registry of therapists and programs.
Excerpted from Understanding Your Teen: Ages 13 to 19 by Christine Langlois.
Copyright 1999 by Telemedia Communications Inc. Excerpted, with permission by
Ballantine Books. All rights reserved. No part of this excerpt may be reproduced or
reprinted without permission in writing from the publisher.