In-Depth, Information, Links & Resources   

Canadian Research on Eating Disorders

Prepared by the Ontario Community Outreach Program for Eating Disorders (2011) 

Updated by the National Initiative for Eating Disorders (2017)

> Download a PDF of Canadian Research on Eating Disorders here.

Eating Disorders

Research indicates that the prevalence rate of eating disorders is between 2% and 3%. Based on Statistics Canada population data (Statistics Canada 2016), an estimated 725,800 to 1,088,700 Canadians will meet the diagnostic criteria for an eating disorder.

An Ontario community-based study of 8,116 individuals aged 15 to 65 years across 42 health units revealed:

Lifetime prevalence of bulimia nervosa (BN) was found to be 1.1% for females (1.22 % when including respondents who lacked frequency criterion) and 0.1% for males (0.38% (when including respondents who lacked frequency criterion) (Garfinkel et al., 1995; 1996).

Among the female respondents, 2.0% were classified as meeting full or partial-syndrome criteria for anorexia nervosa (AN).

0.56% met criteria for lifetime full-syndrome AN and 1.4% for partial syndrome AN.

Of the latter group, 1.0% of the sample lacked only the amenorrhea criterion.

An Ontario study of 9,953 (aged 15-65) drawn from a community epidemiologic survey – mental health supplement to the Ontario health survey (face-to-face interviews) revealed:

Lifetime prevalence of AN was found to be 0.16% for males and females 0.66% (Woodside et al., 2001).

Lifetime prevalence of BN was found to be 0.13% for males and females 1.46%.

Prevalence of full or partial ED was 2.0% for males compared to 4.8% for females (Full syndrome ED: 0.3% men, 2.1% women)

A Quebec study of 1,310 women aged 20-40 years – recruited using random-digit dialling to participate in a 20-min telephone – between November 2002 and May 2003 revealed:

0.2% met criteria for BN (purge subtype) and 0.4% for BN (non-purge subtype) based on point prevalence data (Gauvin et al., 2009).

A total of 0.6% met criteria for BN.

The prevalence of binging at clinical levels was 4.1%.

A Canada-wide surveillance study of 2453 pediatricians (a 95% participation rate) during a 2-year period (March 1, 2003, and February 28, 2005) Pinhas, 2011) revealed:

The incidence of early-onset restrictive EDs in children aged 5 to 12 years seen by pediatricians was 2.6 cases per 100 000 person years. (161 children younger than 13 years – the ratio of girls to boys was 6:1 (138 girls and 22 boys) with 1 case not specifying sex.

The incidence of EDs in this 5 to 12 year age range of children is 2-4 times greater than that of Type 2 Diabetes in children and youth across all ages up to the age of 18 years.

Of those who were identified as having an ED, 62.1% of children met criteria for Anorexia Nervosa.

Although children with anorexia nervosa were more likely to be medically compromised, some children who did not meet criteria for anorexia nervosa were equally medically unstable.

The highest incidence was 9.4 cases per 100 000 person years, observed in girls aged 10 to 12 years.

The incidence in boys aged 10 to 12 years was 1.3 cases per 100 000 person-years.

Disordered Eating

A Southern Ontario study with a community (non-clinical) sample of 1,739 teens revealed:

Significant symptoms of eating disorders, reflected in EAT-26 scores of above 20 and bingeing or purging, or both, were reported by 27% of girls aged 12–18 years (Jones et al., 2001).

Respondents who were currently on a diet were 3.3 times more likely to report binge eating than girls who were not dieting and were 5.7 times more likely to report purging.

Only 1.6% of the total sample reported having ever received an evaluation or treatment, or both, for disordered eating attitudes or behaviours, or both.

Furthermore, only 4% of the girls who reported current binge eating and 6% of girls who were purging had ever received any assessment or treatment for these problems.

Restrictive Dieting (Dieting to Lose Weight)

A Southern Ontario series of studies with a community sample of approximately 2,000 students revealed:

30% of females and 25% of males between the ages of 10 and 14 years of age reported dieting to lose weight (McVey et al., 2004; 2005). The majority of the sample was within a healthy weight range according to body mass index (BMI).

A  Manitoba community-based study of 565 boys and girls (10-11 years of age) revealed:

• 12% of both boys and girls reported dieting in the past year to lose weight (Bernier et al., 2010). Of the children who reported dieting, 35% said they had done so for a few months or longer in the past year, and 32% described their dieting as somewhat to extremely strict. Girls more often reported that their friends had changed their diet in the past year to lose weight (15% versus 7%, p=0.001).

• Approximately 25% of children 10-11 years of age reported receiving frequent weight-related advice (Bernier et al., 2010). Girls did not report this more often than did boys. Children in the lowest BMI percentile desired the greatest change in body shape and had the highest Restraint Scale scores.

• About 30% of the children reported they had been teased about being too heavy, while 14% reported they had been teased about being too thin.

A Halifax, Nova Scotia community-based sample of 247 girls and boys in grades 6, 7 and 8 revealed:

Current attempts to lose weight were highest in grade 8 girls (41% of girls and 9% of boys) compared with grade 6 (14% of girls and 24% of boys) and grade 7 (21% of girls and 13% of boys) children. (Gusella et al., 2008).

Of those trying to lose weight, 71.4% were in the average range for weight and height, 12.2% were overweight and 16.3% were obese.

As females progress through grades 6 to 8, there is a significant drop in self-esteem scores compared with male youths (P<0.05).

8.5% of the children fell in the high-risk group for disordered eating (ChEAT score 20 or higher) – 19 were girls and two were boys (P<0.01).

Those in the high-risk group were significantly more likely to fear being overweight (90%), to have tried to lose weight in the past (81%), to be currently trying to lose weight (76%), and to have engaged in binge eating (38%) and self-induced vomiting (24%).

High-risk group were more likely to have lower self-esteem than youth in the low-risk group (P<0.01)

A survey of 29,440 adolescent students in 50 school districts across British Columbia (McCreary Society Centre; Smith et al, 2009) revealed:

By the age of 18 years, 80% of girls of normal height and weight reported that they would like to weigh less.

Dieting among females dropped from 49% in 2003 to 46% in 2008.

The proportion of youth reporting binge eating decreased from 1998 to 2003 (from 23% to 18% for males and from 41% to 36% for females), but in 2008 remained much the same as 2003.

Males reporting vomiting on purpose after eating (dropped from 5% in 1998 to 3% in 2003 and 2008).

Rates of vomiting on purpose after eating did not change among females.

Morbidity and Mortality Studies

• As described by Pinhas et al., (2011), very little quantitative information exists on the outcomes or co-morbid diagnoses of Canadian ED patients.

• The large Ontario Mental Health Survey (Garfinkel et al., 1995; Woodside et al., 1996) provided information on co-morbidity in eating disorders where 34% of women and 15% of men with an eating disorder had a lifetime diagnosis of major depression; 37% of men and 51% of women had a lifetime diagnosis of anxiety disorders and 45% of men and 21% of women had a lifetime diagnosis of alcohol dependence.

• In a cohort study of cases from the only adult tertiary care ED program in British Columbia (954 consecutive patients referred to the only adult tertiary care eating disorders program), the standardized mortality ratio for AN was 10.5 (Birmingham et al., 2005) with a life expectancy reduction of 20-25 yrs (Harbottle et al., 2008).

Eating Disorder Training in Canadian Medical Schools

• 70% of doctors receive 5 hours or less of eating disorder-specific training while in medical school (Girz, Lafrance Robsinson, & Tessier, 2014).

• In 2004, only 6.3% of psychiatry residents felt they had spent enough time with ED patients to work effectively with them in clinical practice (Williams & Leichner, 2006).

The Cost of Treating Eating Disorders

While financial data is not available in Canada on a national scale, a study conducted in British Columbia in 2003 reported the provincial costs of those with anorexia nervosa on long-term disability may be as high as $101.7 million/year, up to 30 times the cost of all tertiary care services for eating disorder treatment in the province (Su & Birmingham, 2003).

There are hidden costs associated with eating disorders, including lost earnings of sufferers and carers (Pricewaterhouse Coopers, 2015).


Birmingham, C.L., Su, J., Hlynsky, J.A., Goldner, E.M. & Gao, M. (2005). The mortality rate from anorexia nervosa. International Journal of Eating Disorders, 38(2), 143-6.

Colton, P.A., Olmsted, M.P. & Rodin, G.M. (2007). Eating disturbances in a school population of preteen girls: assessment and screening. International Journal of Eating Disorders, 40(5), 435-40.

Gauvin, L., Steiger, H. & Brodeur, J.M. (2009). Eating-disorder symptoms and syndromes in a sample of urban-dwelling Canadian women: contributions toward a population health perspective. International Journal of Eating Disorders, 42(2), 158-65.

Garfinkel, P.E., Lin, E., Goering, P., Spegg, C., Goldbloom, D.S., Kennedy, S., et al. (1996). Purging and nonpurging forms of bulimia nervosa in a community sample. International Journal of Eating Disorders, 20(3), 231-8.

Girz, L., Lafrance Robinson, A. & Tessier, C. (2014). Is the next generation of physicians adequately prepared to diagnose and treat eating disorders in children and adolescents? Eating Disorders: Journal of Treatment & Prevention, 22(5), 375-85.

Gusella, J., Goodwin, J., van Roosmalen, E. (2008). ‘I want to lose weight’: Early risk for disordered eating? Paediatric Child Health, 13(2), 105-110.

Harbottle, E.J., Birmingham, C.L., Sayani, F. (2008). Anorexia nervosa: A survival analysis. Eating and Weight Disorders, 13(2), e32-4.

Jones, J.M., Bennett, S., Olmsted, M.P., Lawson, M.L., Rodin, G. (2001). Disordered eating attitudes and behaviours in teenage girls: a school-based study. CMAJ Canadian Medical Association Journal, 165(5), 547-52.

McVey, G., Tweed, S. & Blackmore, E. (2004). Dieting among preadolescent and young adolescent females. CMAJ Canadian Medical Association Journal, 170(10), 1559-61.

McVey, G.L., Tweed, S., & Blackmore, E. (2005). Correlates of dieting and muscle gaining behaviors in 10-14 year-old males and females. Preventive Medicine, 40(1), 1-9.

Pinhas, L., Morris, A, Crosby, R.D., & Katzman, D.K. (2011). Incidence and age-specific presentation of restrictive eating disorders in children. A Canadian paediatric surveillance program study. Archives of Pediatric and Adolescent Medicine, 165(10), 895-899.

Piran, N. & Gadalla, T. (2007). Eating disorders and substance abuse in Canadian women: a national study. Addiction, 102(1),105-13.

Pricewaterhouse Coopers (2015). The costs of eating disorders Social, health and economic impacts.

Su, J.C. & Birmingham, C.L. (2003). Anorexia nervosa: The cost of long-term disability. Eating and Weight Disorders, 8(1), 76-9.

Williams, M. & Leichner, P. (2006). More training needed in eating disorders: A time cohort comparison Canadian psychiatry residents. Eating Disorders: Journal of Treatment & Prevention, 14(4), 323-34.

Woodside, D.B., Garfinkel, P.E., Lin, E., Goering, P., Kaplan, A.S., Goldbloom, D.S., et al. (2001). Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community. American Journal of Psychiatry, 158(4), 570-4.

Eating Disorder Booklet to Download

Download NIED’s special booklet Understanding Starts Here that includes sections on Eating Disorder Recovery, Approaching Someone with an Eating Disorder, Tips for Parents, Families, Spouses & Significant Others and Resources.

Colour PDF Black & White PDF

Eating Disorders & Mental Health Information, Treatment & Support

The following organizations have comprehensive Eating Disorders information to share, including up-to-date databases on Treatment Centres, Support Groups and individual Therapists, Nutritionists and Registered Dietitians.


National Eating Disorders Information Centre (NEDIC). National information, resources and links. 1-866-NEDIC-20 (1-866-633-4220)

MedicAlert ID. NIED and the Canadian MedicAlert Foundation encourage individuals with an Eating Disorder to wear a customized MedicAlert ID that can “speak for you” should the need arise. The MedicAlert ID is engraved with critical health information, a hotline number and a personalized code number. In the event of an emergency, first responders can access your medical information 24/7 via the hotline – even if you are outside of Canada.

For more information, contact the Canadian MedicAlert Foundation, 1-866-679-3217. Or email:

Public Health Agency of Canada (PHAC). PHAC has a comprehensive Mental Illness information site where you can learn about mental illness, its risk factors, symptoms and treatment. Visit the site


ConnexOntario. Health Services Information. Provides free and confidential health services for people experiencing problems with mental health, gambling, alcohol or drugs. Mental Health Helpline: 1-866-531-2600


Theravive. A comprehensive mental health resource organization linking a network of independent counselors and clinics throughout North America. They are ready to help connect people to therapists, workshops, support groups, seminars or training programs covering every mental health issue, including Eating Disorders. Theravive, P.O. Box 18 Lynden, WA 98264, USA 360-350-8627 (US) or 604-626-1329 (Canada)

Surveys Requesting Your Participation

National online “Caregivers Needs Assessment Survey”. In recognition of the Canadian Mental Health Association’s (CMHA) #getloud campaign, during Mental Health Week (May 7 to 13, 2018), the National Initiative for Eating Disorders (NIED) will shine a light on caregivers of individuals suffering from Eating Disorders. NIED initiated and collaborated with the Eating Disorders Association of Canada (EDAC), the Eating Disorders Foundation of Canada (EDFC) and the National Eating Disorders Information Centre (NEDIC).

Please visit to complete the 2018 Caregivers Needs Assessment Survey.

Professionals & Caregivers

Parental Involvement and Child and Adolescent Eating Disorders: Perspectives from Residents in Psychiatry, Pediatrics, and Family Medicine. This study investigated medical residents’ perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. Read the study Related emotional-focused family therapy links:

Strategizing for Change: A review of the 2016 EDAC 2016 Conference. Read Andrea LaMarre’s Science of Eating Disorders post on the 2016 conference held in Winnipeg, Manitoba September 28, 29 & 30. Read the review

Blogs / Advocacy

International Eating Disorder Action.  A coalition of parents, carers, survivors, sufferers and others, established so that members can take ACTION on issues relating to Eating Disorders. The group has members in over 15 countries and address Eating Disorder issues globally.

Articles, Videos

Tribute & Inspirational Links

A story of an Eating Disorder, loss and hope.

Must-See Articles and Videos

Eating Disorders video is part of CAMH’s Mental Health is Health campaign. The Centre for Addiction and Mental Health (CAMH) is calling for a change in the way we think about mental health in its latest awareness campaign. View CAMH Lisa, the powerful and personal Eating Disorder video segment produced by (CAMH) for their Mental Health is Health campaign for Mental Health Week 2018. Watch the video

 Anorexia has the highest death rate of all psychiatric illness. Why isn’t treatment funded properly? Read the Australian Broadcast Corporation (ABC) article on the Butterfly Foundation’s efforts to get the Australian government to fully fund Eating Disorders through their Medicare program. Read the article

Informative Binge Eating Disorder (BED) Video. Watch the video

Eating Disorder sufferer creates brutally honest illustrations of her disease. Read the Buzz Feed article on Christie Begnell’s visual representation of her Eating Disorder. Read the article

“I saw food as the enemy”: Article in the Ottawa Citizen on radio host Katherine Dines. Read how Katherine Dines is now speaking out publicly about the Eating Disorder she his for years. Read the article

Eating Disorders research gets a new direction. Read the National Eating Disorders Association (NEDA) post about the UK National Institute for Health Research-supported initiative to set a 10-point agenda for Eating Disorders research. Read the article

Strategizing for Change: A review of the 2016 EDAC 2016 Conference. Read Andrea LaMarre’s Science of Eating Disorders post on the 2016 conference held in Winnipeg, Manitoba September 28, 29 & 30. Read the review

UK teenagers with Eating Disorders must be seen by a specialist doctor within a month. Read about former British Prime Minister David Cameron’s initiative to trigger a revolution in mental health treatment in the UK. Read article

UK group invests £320,000 (over CAD$660,000!) for a new eating disorders service for young people aged eight to 18. Read how the enlightened Hull and East Riding Clinical Commissioning Groups are investing in a new service launched after a sudden spike in the number of young people admitted to hospital. Read article

How Monitoring Your Child’s Growth Chart Could Help Prevent an Eating Disorder. Read Lauren Muhlheim’s informative article on warning signs and early intervention. Read article

Could the Microbiome cure Eating Disorders? Read Carrie Arnold’s fascinating article on research into gut microbes and their possible impact on Eating Disorders.

Why aren’t more doctors treating eating disorders? The Globe and Mail’s Wency Leung probes the causes and effects of our society’s discrimination against Eating Disorders.

When the impulse to be thin never grows old. A powerful article by National Post Health reporter Sharon Kirkey explores Eating Disorders among middle-aged women. Includes moving “lived experience” stories and imbedded videos.

How are colleges and universities helping students with eating disorders? Watch this informative Evidence Exchange Network (EENet) webinar that looked at how to best support a student who may have an Eating Disorder. The presenters are Debbie Berlin-Romalis, BSW, MSW, RSW, Social Worker/Psychotherapist, Executive Director, Sheena’s Place.  Lauren Drouillard, MSW, RSW, Social Worker, Program Manager, Sheena’s Place. Coti Maclaughlin-Grant, 2nd Year student, Child and Youth Work Program. Created on January 28, 2015, the webinar is part of EENet’s “Ask the Experts” series. Link to the webinar here

How to Talk to Your Daughter About her Body. Read Sarah Koppelkam’s thoughtful Huff Post Parents blog.

Children’s Hospital of Eastern Ontario Steps Up Efforts to Treat Eating Disorders. Read the Ottawa Sun article that includes a picture of NIED founder Wendy Preskow with Dr. Mark Norris.

No treatment for eating disorder sufferers in Ireland. Read this telling article from The Irish Examiner. Seems like we in Canada are not alone.

Statement in support of Eating Disorders Awareness Week in the B.C. Legislature. Watch B.C. MLA, Jane Thornthwaite (North Vancouver-Seymour) present a statement in the B.C. Legislature during Eating Disorders Awareness Week, February 2015.

Eating Disorders and Parenting in 2015. Read Joe Kelly’s excellent article on responding to a child with an Eating Disorder. Worth sharing!

Eating Disorders are a scourge in need of a strategy. Read André Picard’s powerful article, published in The Globe And Mail on December 2, 2014.

Two-part online report on Canada’s Eating Disroder crisis. Global News National ran a two-part TV and online report on the Eating Disorders crisis in Canada. View Parliamentary Correspondent Vassey Kapelos’s powerful reports here: Part One Part Two

The need for a national Eating Disorder strategy. Read the compelling iPolitics article by MP (Etobicoke North) Kirsty Duncan Ph.D., (now the Hon. Kirsty Duncan, Minister of Science) on the need for a national strategy for Eating Disorders in Canada.

More compelling reading and watching:

Read about the opening of a new 12-bed Eating Disorders Unit at Ontario Shores Centre for Mental Health Sciences in Whitby, Ontario. The first-of-its-kind program in Ontario.

Read the Huffington Post Canada blog on Eating Disorders in Canada written by MP (Etobicoke North) Kirsty Duncan Ph.D. (now the Hon. Kirsty Duncan, Minister of Science). 

Read about a Newfoundland and Labrador Eating Disorder sufferer’s experience in Emergency.

Read about an Eating Disorder sufferer’s Crowdsourcing campaign online.

Desperate Ontario family turns to Crowdsourcing to fund Eating Disorder treatment for their critically ill daughter.

Exposing Canada’s ugly mental-health secret. Article in The Globe and Mail, October 13, 2013.

Dr Blake Woodside on CTV talking about the launch of the new National Eating Disorders Foundation on Friday, October 4, 2013.

Eating Disorders: What you “NIED” to know. Article in Healthy Living magazine by Dr. Heather Wheeler, member of the NIED Team.

XX in Health – Canadian Women Changing Health Wendy Preskow, founder of NIED, included in the first annual list of Canadian Women Changing Healthcare that spotlights women who are changing the face of healthcare.

Online science-based articles related to binge-eating disorder.

Anorexia Awareness Video – dedicated to all those suffering from an Eating Disorder.

Toronto Star article on Deep Brain Stimulation.

Global Saskatoon interview with Treena Wynes, food addiction councilor, on Eating Disorders in men. – interviews/video

Eating Disorders from the Inside Out: Dr. Laura Hill at TEDxColumbus.;search%3ADr%20laura%20hill

BBC News – MSP whose daughter died of eating disorder leads debate.

What NOT to Say to a Friend With an Eating Disorder.

16:9 Boys and Men: Dying to be thin.

Israeli government launches new anorexia laws.

A Parent’s Guide to Defeating Eating Disorders. Webinar.

Australia’s shock Eating Disorder statistics

Manitoba’s Progressive Conservatives say Eating Disorders patients face “unacceptable” wait times.

Books & Workbooks


Centre for Clinical Interventions This Australian resource provides accessible and useful information on issues related to Eating Disorders and its online workbook includes two specific Eating Disorder modules.


Journey of Embodiment at the Intersection of Body and Culture. The Developmental Theory of Embodiment. Dr. Niva Piran, Ph.D., is Professor, Department of Applied Psychology and Human Development at OISE/University of Toronto. Her book provides a new perspective on the interactions between the social environment of girls and women of different social locations and their embodied experience of engagement with the world around them. View Flyer

Shell. One Woman’s Final Year After a Lifelong Struggle with Anorexia and Bulimia. Michelle Stewart, author of Michelle’s Voice blog, passed on in 2014. Shell is a compilation of her blogs that put a compelling and intimate face to the disease. Click on the link to watch Kirk Mason and Karen Flello talk to Global News about Michelle Stewart’s story and her poetic memoir about experiencing a terminal illness. Watch the video

The Body Image Survival Guide for Parents. Kids as young as five are dying to be “perfect” and fit in. Parents are feeling powerless. This book helps them both. By Marci Warhaft-Nadler

Brave Girl Eating. A Family’s Struggle with Anorexia. By Harriett Brown.

Crave. Why you binge eat and how to stop. By Cynthia M. Bulik  Ph.D

Gürze Books

A Parent’s Guide to Defeating Eating Disorders.   By Karin Jasper, Ph.D and Dr. Ahmed Boachie.