Eating disorders cost $39.5M during first two years of pandemic, but researchers say it’s the ‘tip of the iceberg’


Eating disorders in children and youth during COVID-19 cost the Canadian health system at least $39.5 million over two years.

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The unprecedented rise in eating disorders in children and youth during COVID-19 cost the Canadian health system at least $39.5 million over the first two years of the pandemic, according to research led by the CHEO Research Institute.

But the study’s authors admit that number is a “vast underestimate” of the true cost of the psychiatric illnesses to society and individuals.

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In fact, Nicole Obeid, scientist and lead of the Eating Disorders Research Lab at the CHEO Research Institute said she and other researchers involved with the study were surprised the amount was not higher, given the spike in demand for treatment being seen across the country.

“We were shocked. When we thought about how much of an increase we were seeing, we felt like the numbers should have been higher,” she said. “It is really just the tip of the iceberg.”

She said the fact that available data doesn’t fully reflect the extent of the crisis in Canada means it is not fully understood, which hampers innovation and improvement in treatment.

“We can’t manage what we can’t measure,” she said.

That is something 17-year-old Bailey Curtin, who was first treated at CHEO for anorexia when she was just 11, echoes.

Curtin, who is now part of CHEO’s youth forum, said she is concerned that the lack of data reflects the lack of research into eating disorders.

“If science is apathetic towards (people with eating disorders), then the world will be apathetic toward us too. I do think it starts with science. If we are not seeing that the research is important then we are not seeing that anything else is important – like the treatment,” Curtin said.

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“Science has to catch up.”

The number of people – especially children and youth — seeking treatment for eating disorders spiked dramatically during the COVID-19 pandemic. It was a period of increased financial stress, isolation and anxiety – all of which are known to contribute to the mental health disorders, say authors of the study.

Between 2020 and 2022, there was a 126 per cent increase in emergency department presentations for eating disorders across Canada and a 60 per cent increase in related hospitalizations, compared to one year before COVID-19.

CHEO was among pediatric health institutions that saw large jumps in the number of children and youth needing treatment and sometimes lengthy hospital stays for eating disorders.

The Deloitte Access Economics report on the cost of eating disorders, led by CHEO Research Institute and healthcare and academic partners across the country, is the first of its kind to shine a light on the costs of eating disorders to the Canadian health system during the pandemic.

But because of a lack of data on eating disorders, not all components of the cost of care were included in that report. Among missing pieces are the cost of standard eating disorder treatment programs such as day hospital programs and community services. Demand for those community services more than doubled during the first two years of the pandemic.

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The Deloitte report vastly underestimates the societal cost of eating disorders, Obeid noted. The lack of data reflects an inability of researchers and health officials to fully understand the impact of eating disorders and make health system changes to better address them.

There is an urgent need to develop a robust surveillance system for eating disorders in Canada “to ensure we are adequately capturing shifting needs in services and costs so that we can better manage eating disorder care,” she said.

That will be a focus of a meeting in Ottawa on Thursday. Research and health leaders, policy makers and individuals with lived experience will review the report and work on a national surveillance strategy.

An expert from Australia will talk about how better surveillance and data, among other things, enabled the country to transform the way it treats and approaches eating disorders, said Obeid.

“They have made massive shifts in their system for eating disorders,” she said.

That includes building up the workforce and adding training as well as more accessible eating disorder care in the community.

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“If we don’t have the numbers, we don’t even have a leg forward to say this many Canadians are struggling with eating disorders or are in treatment, “ said Obeid.

A recent international study found that among young people about one in five have some level of disordered eating.

With high mortality and co-morbidity (related diseases) rates, the burden of eating disorders can be compared to the opioid crisis, said Obeid.

“We think a lot of young people are struggling. Eating disorders are highly prevalent, have a high mortality rate and lots of co-morbidity and are difficult to treat if you don’t catch them early,” she said.

“We have a lot of work to do in the field.”

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