Eating Disorders in Canada
Approximately, 1 million1 Canadians have a diagnosis of an Eating Disorder, such as Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED), Avoidance Restrictive Food Intake Disorder (ARFID)2 and Otherwise Specified Feeding and Eating Disorder (OSFED)3.
Eating Disorders are serious but treatable mental illnesses that can affect anyone regardless of gender, age, racial and ethnic identity, sexual orientation or socio-economic background4. Too many people with an Eating Disorder are never diagnosed but suffer significant personal and family distress. The social and economic costs of untreated Eating Disorders are similar to those of depression and anxiety, with debilitating physical and mental health effects comparable to psychosis and schizophrenia5.
While it is well documented that mental illnesses are a leading cause of premature death in Canada6, it is less known that Eating Disorders have the highest overall mortality rate of any mental illness, with estimates between 10-15%7. Suicide is the second leading cause of death (after cardiac disease) among those with AN8; 20% of people with AN and 25-35% of people with BN may attempt suicide in their lifetime9. For females aged 15-24 years old, the mortality rate associated with AN is 12 times greater than that ALL other causes of death combined.10
Younger Canadians are also increasingly11 engaging in dieting behaviour which may put them at risk of developing an Eating Disorder and other health-compromising conditions12. In Canada, between 12% and 30% of girls and 9% and 25% of boys aged 10-14 report dieting to lose weight13. Moreover, the incidence of Eating Disorders in Canadian children is estimated to be 2 to 4 times greater than Type 2 Diabetes.14
1 Statistics Canada, 2016.
3 In the United States, it is estimated that 30 million Americans live with an Eating Disorder and that only 1 in 10 people living with an eating disorder receive treatment. In 2012, it was estimated that there were 913,986 people with an eating disorder in Australia.
4 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; 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.
5 The Butterfly Foundation. (2012). Paying the price: The economic and social impacts of eating disorders in Australia.
6 Statistics Canada, Table 13-10-0801-01 (formerly CANSIM 102-0564).
7 Arcelus, J., Mitchell, A.J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68, 724-731.
8 Berkman, N.D., Lohr, K.N., & Bulik, C.M. (2007). Outcomes of eating disorders: A systematic review of the literature. International Journal of Eating Disorders, 40, 293-309.
9 Arcelus, J., Mitchell, A.J., Wales, J., & Nielsen, S. (2011). Mortality rates in patients with anorexia nervosa and other eating disorders: A meta-analysis of 36 studies. Archives of General Psychiatry, 68, 724-731.
10 Smink, F.E., van Hoeken, D., & Hoek, H.W. (2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports 14 (40, 406-414).
11 See, notably, Roberts, K.C. “Overweight and obesity in children and adolescents: results from the 2009 to 2011 Canadian Health Measures Survey,” Health Rep. 2012 Sep;23(3):37-41; and Lillico, H.G. et al. “The prevalence of eating behaviors among Canadian youth using cross-sectional school-based surveys” BMC Public Health. 2014; 14: 323; See also, Luongo, N.M., “Disappearing in plain sight: An exploratory study of co-occurring eating and substance abuse disorders among homeless youth in Vancouver, Canada,” Women’s Studies International Forum, Volume 67, March–April 2018, Pages 38-44, https://doi.org/10.1016/j.wsif.2018.01.003; and Godin, K.M., Patte, K.A. and Leatherdale, S. T . “Examining Predictors of Breakfast Skipping and Breakfast Program Use Among Secondary School Students in the COMPASS Study” Journal of School Health, Volume88, Issue2, February 2018, Pages 150-158, https://doi.org/10.1111/josh.12590
12 Raffoul, A., Leatherdale, S.T. & Kirkpatrick, S.I. “Dieting predicts engagement in multiple risky behaviours among adolescent Canadian girls: a longitudinal analysis.” Can J Public Health (2018) 109: 61. https://doi.org/10.17269/s41997-018-0025-x
13 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; Bernier, C.D., Kozyrskyj, A., Benoit, C., Becker, A.B. & Machessault, G. (2010). Body image and dieting attitudes among preadolescents. Canadian Journal of Dietetic Practice and Research, 71(3), e34-e40; and 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.
14 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 Pediatrics and Adolescent Medicine. 165, 895-899a.