More than 1.4 million Canadian youth have an eating disorder – but better data and early interventions are fighting back

A researcher at CHEO, a pediatric health care and research centre in Ottawa, is leading efforts to transform the care of young people with eating disorders in Canada.

As head of the Eating Disorders Lab at the CHEO Research Institute, Dr. Nicole Obeid has been involved in research on eating disorders for more than two decades. Dr. Obeid and her team are working to better understand the risk factors for these illnesses and find more effective treatments.

Eating disorders are serious but treatable mental illnesses. Anorexia nervosa, bulimia nervosa, binge eating disorder, and other types of eating disorders affect an estimated 1.4 million youth in Canada – and only 25 percent receive appropriate treatment.

There was a surge of eating disorders during the COVID-19 pandemic with unprecedented numbers of young people landing in hospital emergency rooms with symptoms of eating disorders. The dramatic increase prompted Dr. Obeid and her colleagues to conduct the first ever study of the social and economic impacts of eating disorders in Canada in partnership with Deloitte Economic Access.

"We can't manage what we can't measure," says Dr. Obeid, who noted that the study, which focused on the impact of the pandemic on eating disorders among youth, was done to provide critical data to identify challenges and advocate for changes to strengthen the eating disorder care system. 

The findings were startling. In the first two years of the pandemic, from 2020 to 2022, there was a 126 percent increase in emergency room visits for young people with an eating disorder, and a 60 percent increase in hospital admissions. The total cost of the services provided was a whopping $39.5 million.

"The cost is just the tip of the iceberg," says Dr. Obeid, who added that the figure is a vast underestimate since it doesn't include other vital services such as hospital day and outpatient programs, community-based services, private psychotherapy, medication, and nutritional counselling. 

With the study in hand, Dr. Obeid and her partners have mobilized a pan-Canadian consortium that is advocating for a national surveillance strategy, which will help guide innovation in eating disorder care, focus research efforts, and support new investments in health services and programs.

At the same time, Dr. Obeid and her team aim to fill a critical gap in eating disorder care in Canada by studying the implementation of an early intervention model for eating disorders known as FREED (First Episode Rapid Early Intervention for Eating Disorders). Developed in the United Kingdom for community settings, the model has been successfully scaled up across the UK and internationally.

Dr. Obeid and her team have collaborated with researchers, clinicians, community service organizations, and youth and families with lived expertise to co-adapt the program for community-based treatment settings that serve youth in Canada.

The Canadian version, FREEDcan, will aim to improve early access to care, reduce wait times, and facilitate integration across the continuum of care for young people, aged 8 to 25.

"By detecting eating disorders early and encouraging youth to seek support," says Dr. Obeid, "we can better promote their full recovery and keep young people from getting to the point where they are forced to seek treatment in hospital."