FEWO Committee Report

UNDERSTANDING EATING DISORDERS

The Committee learned that eating disorders are a form of mental illness “characterized by a persistent disturbance of eating or eating-related behaviour that results in the altered consumption or absorption of food and that significantly impairs physical health or psychosocial functioning.”[3]

Witnesses spoke of three specific eating disorders:[4]

• Anorexia nervosa, which is characterized by distorted body image and severe dietary restriction that lead to significantly low body weight in the context of age, sex, development and physical health, accompanied by an intense fear of gaining weight.
• Bulimia nervosa, which is characterized by recurrent episodes of eating an excessive amount of food and losing control during that episode, which is called a binge, followed by purging behaviours, such as self-induced vomiting or misuse of laxatives, in order to avoid weight gain.
• Binge eating disorder is characterized by recurrent episodes of consuming an excessive amount of food in a short period of time, without purging behaviour, and is accompanied by feelings of embarrassment, self-disgust, loss of control and distress.

The Committee was provided with statistics on the number of individuals with eating disorders, as highlighted in the section below, and was also told about the immeasurable toll taken on individuals with the disorder and on their families.[5] Witnesses stated that research indicates it takes between two and seven years to “recover” from an eating disorder, but that only 50% of individuals will fully recover.[6] As Joanna Anderson, Executive Director of Sheena’s Place, an eating disorder support and resource centre in Toronto, told the Committee, eating disorders involve “relentless pain, self-loathing, isolation, sadness, hunger, disgust, and self-contempt,” and the eating disorder is “the first thing [those with the disorder] think about when they wake up in the morning and the last thing they think about before they go to bed.”[7]

Psychiatrist Dr. Wendy Spettigue, of the Canadian Academy of Child and Adolescent Psychiatry (CACAP), described the experience of some of her young patients who have anorexia nervosa:

I want you to imagine a patient with severe obsessive-compulsive disorder, who has the constant thought, “There are germs on my hands,” and the only thing that makes it better is if that patient goes and washes their hands, and then the anxiety decreases. But that patient sits down and the thoughts appear again, “There are still hidden germs on your hands. You didn't get them all. They're going to get inside you. They're going to make you sick. They're going to make you die.” You can't stand the agitation, and the only thing that makes it better is washing your hands. Individual treatment would be like trying to get the person to choose not to wash their hands. Even if they're motivated to do that, they probably can't tolerate the severe urges.

Anorexia nervosa in youth is the exact same kind of illness where they can't tolerate the severe anxiety and agitation that goes with the thoughts that have taken over their minds that constantly say, “You're eating too much. You're gaining too much weight.” They feel compelled to restrict or purge, or whatever, to get rid of that. You can't just talk them into not doing it. First of all, they're not motivated because they're afraid of gaining weight.[8]

While witnesses spoke of the difficulties of living with an eating disorder, the Committee was impressed by the strength of witnesses in the face of such a debilitating condition. Patricia Lemoine spoke of her personal battle with an eating disorder:

My diagnosis with a mental illness did not define me. Eating disorders have the highest mortality rate of any psychiatric diagnosis. I am alive in front of you today. I am 32 years old and I am recovered.[9]