When Sally Chaster in Victoria suffered a relapse with anorexia nervosa in April 2021, she knew she wasn’t going to get through it alone. She was losing a lot of weight and was very weak. “During that time, I was in the worst relapse of my life,” said Chaster, who was an executive director in the civil service before going on long-term disability due to anorexia. Sally Chaster has battled anorexia nervosa for decades and waited eight months last year to access hospital services in Vancouver. (Submitted by Sally Chaster) She joined a nutrition group and worked with a case manager every month while she waited to be admitted to St. Paul’s of Vancouver. He was admitted in December and spent six weeks in hospital. “I waited eight months and seriously thought I was going to die,” she said. “It’s a long time to wait, especially when you’re getting sicker and sicker.” Wait times for treatment for eating disorders in Canada have increased during the COVID-19 pandemic. Psychologists, pediatricians, counselors and others across the country said they have seen a jump in referrals throughout the pandemic for eating disorders. In many areas, this increase has resulted in longer waiting times for publicly funded treatment. In some provinces, wait times for community-based and outpatient programs can be anywhere from six months to 18 months or more. Experts say early treatment is important to prevent eating disorder behaviors from becoming entrenched. “When you look at disordered eating and the behaviors associated with it, they can intensify and get worse. And certainly the pandemic has contributed to that. So it’s really concerning when we look at these wait times,” said Julia Klassen, a nutrition consultant disorders with the community-based Provincial Eating Disorders Prevention and Recovery Program (PEDPRP) in Winnipeg. Access to these services is not uniform across the country. The territories and some Atlantic provinces do not have publicly funded inpatient or residential services for eating disorders. “Access to publicly funded health care specializing in eating disorders in Canada is severely limited,” said Aryel Maharaj, outreach and education coordinator at the Toronto-based National Eating Disorders Information Center (NEDIC).

What changed during the pandemic?

Waiting times vary by country and vary by treatment options, such as hospitalization or outpatient services Dr. Kathryn Trottier, a clinical psychologist and clinical program lead in the Eating Disorders Program with University Health Network in Toronto, said the average wait time for their inpatient beds is about two to three months. But the wait for their outpatient program is now at 18 months, “whereas before the pandemic, access to this treatment was quite early,” he said. WATCHES | The pandemic doubled the number of serious eating disorders:

The pandemic doubled the number of serious eating disorders

Dr. Holly Agostino, medical director of the eating disorders program at the Montreal Children’s Hospital, explains why. The waiting list for the community-based PEDPRP in Winnipeg has also grown.
“Usually we were looking at a six to 12 month wait to get into our program, now we’re looking at 18 months or more,” Klassen said. In Nova Scotia, referrals and wait times have doubled, according to a statement from Nova Scotia Health officials. Wait times for the three inpatient beds in the province average one to two months and four to six months to access the eating disorder clinic at the QEII Health Sciences Center in Halifax. Dr. Ayisha Kurji, one of the few pediatricians in Saskatchewan who treats youth with eating disorders, said the number of referrals to her clinic has at least doubled in the past two years. Dr. Ayisha Kurji, a Saskatoon pediatrician and assistant professor at the University of Saskatchewan, says the number of people with eating disorders she sees has increased during the pandemic. (Submitted by Ayisha Kurji) He said part of the reason demand for eating disorder treatment has increased is because many have had their routines disrupted by the pandemic. “Now, instead of having to get up and go to school and have breakfast, there’s lunch time … that’s gone. And that’s been a big difference for a lot of kids,” Kurji said, adding more time to check in during of the pandemic. Social media has also been a trigger for many of her patients. Data released this year by the Canadian Institute for Health Information (CIHI) show that hospitalizations for girls aged 10 to 17 with eating disorders increased by more than 50 percent since March 2020. The data shows that there was an increase of about 52 hospitalizations per 100,000 people in 2019–2020 to 82 hospitalizations per 100,000 people in 2020–2021. The increased demand continues as many of the nation’s hospitals face staff shortages, emergency department demand and another wave of COVID-19. WATCHES | Staff shortages causing closures, long wait times in ERs:

Staff shortages causing closures, long wait times in ERs

Patients are feeling the impact of increasing pressure on Canada’s health care system as staff shortages force some hospitals and emergency departments to close their doors. Experts warn it’s a problem that could get even worse with another wave of COVID-19. Dr. Lara Ostolosky, psychiatrist and medical director for the Eating Disorders program at the University of Alberta in Edmonton, said she recently had to wait to see a new patient because there was a shortage of nursing staff. “If we don’t have enough staff, we can’t safely admit it,” he said. While there are private options available in many provinces and territories, that’s not an option for everyone seeking help, Maharaj said. Healthcare professionals stressed the importance of helping people with eating disorders as soon as they seek help for a variety of reasons. “We really want to catch people when they’re reaching out, when they’re probably most motivated and ready to get care,” Trottier said. Data released this year by the Canadian Institute for Health Information (CIHI) shows that hospitalizations for girls aged 10 to 17 with eating disorders have increased by more than 50 per cent since March 2020 (Submitted by Michelle Perry) Ostolosky added that the best treatment is in the first year or two of a person’s illness, because the brain’s neuroplasticity “is still there,” meaning the brain can still be wired to work differently, and for younger patients, the neural pathways that affect eating are still developing. “We grow them back in the right direction with refeeding and that sort of thing. But the longer it goes on, the more entrenched and harder it is to get out, which will require longer hospitalizations later. And so people wait 18 months, that’s a long time to be sick , to get worse,” he said.

Access varies

Access to publicly funded treatment for eating disorders varies across Canada, and services differ depending on whether a person is an adult or a minor. According to data collected by NEDIC in 2019, there were approximately 250 inpatient, day and residential settings in Canada, not including outpatient services. Nunavut, New Brunswick, PEI, the Northwest Territories and the Yukon have no publicly funded inpatient, day or residential options, according to NEDIC data. LISTEN | Eating disorders on the rise in Canada’s north: Pano North7:06 Increase in eating disorders in young children It is an alarming trend and is affecting the lives of young children and teenagers across the country, including the North East. During the pandemic, more and more children are being treated for eating disorders, tripling the overall wait time for treatment. Health Sciences North’s regional eating disorders program reports that referrals to the program for under-18s have increased by 94 percent since 2018. To find out more, Sam Juric spoke to Anne-Marie Baker Devost from HSN. “When I think about the pillars of the Canada Health Act, I think I can really say clearly that we don’t have equitable services for people with eating disorders and we don’t have equitable mental health care coverage in Canada from a universal level,” Maharaj said. .

What’s needed

In addition to increased funding to offer more services, many of those who work with people with eating disorders who spoke to the CBC said access to care needs to improve. Marlo Docherty, who lives in PEI, had to travel out of province to Ontario to get help for an eating disorder. (Submitted by Marlo Docherty) Marlo Docherty, who lives in PEI, has struggled with an eating disorder for more than 30 years. He has been out of province to Ontario for treatment, most recently from December to February of this year. Although he said the treatment was “excellent” and funded by the PEI government, it can be difficult to return home without publicly funded medical support. “It’s frustrating because it’s like you’re right back into old behaviors,” he said. “It’s something we really need to change.” Ostolosky said the quality of treatment approaches in Canada could also be improved. “What I see happening in eating disorder programs across Canada … is once the person is referred and at a normal weight, they’re sent to a very limited day program,” he said, adding that people should be kept in immediate care. longer duration settings so they can be better supported. A Health Canada spokesperson said in a lengthy statement that research on eating disorders and the development of mental health standards is ongoing and that the federal government remains “committed to working with provinces, territories and other partners to promote access to high-quality mental health and substance use services for Canadians with a range of needs.” Maharaj said that Canada…