Eating disorders (EDs) are serious and complex illnesses, as anyone who has struggled with them will tell you. But problems within the health care system complicate the situation even more.
By Melodie McCullough
“Suicides are due to a sense of hopelessness, because they can’t get treatment due to huge wait lists.”
EDs have the highest death rate of any mental illness (and higher than the general population) due to a combination of medical complications and suicide.
Ten per cent of people with anorexia nervosa will die from starvation or medical complications within 10 years and 1% of those with bulimia will die within 10 years.
Research suggests that it takes between two and seven years to recover from an eating disorder, and that only 50% fully recover.
“The high mortality rate is due to the the toll it takes on the body from starvation and purging behaviours. It causes damage. The body can only withstand so much,” Emily Tam, a client support worker with the National Eating Disorder Information Centre (NEDIC) in Toronto, Ontario, told JOURNEY Magazine.
“Suicides are due to a sense of hopelessness, because they can’t get treatment due to huge wait lists. Private treatment clinics, whose centres are not covered by provincial health plans, have fees that are out of reach for most people,” she said.
“For pretty much any of the OHIP-covered programs or any government-funded programs across Canada, there are lengthy waiting lists. People are having difficulties, running into barriers to finding care they can afford in their community without having to travel long distances,” she continued.
“I think it is also worth highlighting that there are no specialized government-funded services in the Territories, and no specialized government-funded in-patient services for adults in the Atlantic provinces,” Tam said. “This means that those with severe eating disorders living in these parts of Canada must seek treatment outside their home province or territory, which can be a very difficult process.”
She said the illness robs people of so much of their life. They become isolated from family and friends. Often they stop work. It’s takes a psychological toll.
“They feel there is no option. With the existence they have now, there’s so little hope for them,” Tam said.
“Suicides are due to a sense of hopelessness, because they can’t get treatment due to huge wait lists,” she said. “There is not much funding towards finding treatment that can really help people recover, partly because it’s just not seen as a priority compared to other mental illnesses, like depression.”
And according to a Globe and Mail newspaper report, of the nearly 4,800 licensed psychiatrists in Canada, only slightly more than a dozen specialize in eating disorders.
As well, a national registry for eating disorders is also needed in Canada, because there is no data on the number of eating disorder sufferers, the average wait times for treatment, or the percentage of patients who get treatment, psychiatrist Dr. Wendy Spettigue told a parliamentary Status of Women committee in 2014.
On the subject of media and its role in, Emily Tam said it is important for people in media to be mindful, not only about the potential harms of perpetuating messages that certain body types (lean, toned) are the most attractive, but also of perpetuating messages that people with these body types are necessarily the healthiest.
Research shows that people can be “overweight” or “obese” as per their body mass index, and not have any more markers of ill health than people of “normal” weight, she said.
“And yet we are surrounded by messaging that we must do whatever we can to avoid being ‘overweight’. Media messages that equate thinness with good health can then contribute to people engaging in potentially risky weight control behaviours motivated, not by an appearance goal, but by a desire to be healthier,” Tam continued. “Moreover, the labelling of foods as ‘good’, ‘bad’, ‘clean, ‘poison’, and so on can instill in people anxiety and fear around eating, which can in turn lead to increasingly restrictive eating behaviours.”
In Peterborough, Ontario, Shannon Moloney is a nurse practitioner with the outpatient pediatric (18 and under) and adult (18 and over) eating disorder programs at Peterborough (Ontario) Regional Health Centre (PRHC); Robyn Stone is a social worker with the outpatient adult eating disorder program at PRHC. They are part of a multi-disciplinary team at the hospital which treats patients with eating disorders, as the regional centre for four counties: Kawartha Lakes, Haliburton, Peterborough and Northumberland.
“You cannot tell by looking at someone they have an eating disorder. Sometimes they don’t even know themselves,” said Moloney, in an interview.
She said there is definitely a stigma, especially among adults. “People will come into the centre and say, ‘I’ve never talked to anyone about this. I know I should be eating better, but I can’t’.”
“. . .the path to the best outcome is getting a quick diagnosis and treatment as soon as possible.”