FEWO Committee Report

LIBERAL PARTY OF CANADA DISSENTING REPORT:

EATING DISORDERS AMONG GIRLS AND WOMEN IN CANADA

Kirsty Duncan, Member of Parliament for Etobicoke North

INTRODUCTION

This dissenting report first thanks all the witnesses who had appeared before the Committee. Some of them were living or had lived with an eating disorder, and many of them were providing care. Many also shared often difficult information about their personal lives to contribute to a better quality of life for other Canadians. The report recognises their compassion, courage and deep desire for real change.

This report also thanks the many healthcare workers and organizations who appeared on behalf of the people they treat and work with to fight for more help for Canadians living with eating disorders.

It is regrettable that, from the very beginning, this study was a political exercise meant to appease a constituency – an effort meant to look like action was being taken. Canadians should ask why eating disorders were sidelined by the Government, which has the majority on the Standing Committee on the Status of Women. Eating disorders are serious mental health disorders, and they should have been studied at the Standing Committee on Health. The reality is that anorexia nervosa has the highest mortality rate of all mental health disorders. Women with anorexia are 12 times more likely to die than women of the same age without the condition.

Canadians should also know that, while young women are at high risk and tend to be more affected by eating disorders, an increasing number of boys and men also experience these conditions. In fact, one large American study of children aged nine to 14 years found that 13.4 percent of girls and 7.1 percent of boys showed disordered eating behaviours.

While the text accurately reflects witnesses’ testimony, it is profoundly frustrating that the key recommendations that witnesses asked for remain absent from the main report, namely: (1) that the federal government should work with the provinces, territories and stakeholders to establish a pan-Canadian strategy to address eating disorders, including early diagnosis and access to the full range of necessary care, (2) that a national registry be established, and (3) that a robust research program be launched.

Moreover, this report might be better labelled a “consider, encourage, and recognize” report. Eight of twenty-five recommendations call on the Government to “consider”; and another six call on the Government to either “encourage” or “recognize”. That is, 14 of 25 – 56 percent – of all recommendations call on the Government to undertake no action at all. This simply is not reflective of witnesses’ testimony, which urgently called for real change.

Recommendation 4 is simply redundant, as it calls for the Government to do something of which officials were already cognizant. Recommendation 7 is also redundant, as I had informed the Committee that I personally called the Mental Health Commission of Canada (MHCC) this past summer, when I was informed that those with eating disorders were not included in consultative processes. The MHCC promised it would reach out to those organizations advocating on behalf of people with eating disorders, and did, in fact, follow up with calls. Recommendation 9 is purely political, as it recognizes merely one advocacy group. More disturbing still, the recommendation does not acknowledge that advocacy groups require funding, which we heard repeatedly.

This Government always uses the excuse of jurisdictional barriers not to act on matters of health, despite its ability to convene and bring the provinces and territories together for a discussion to act. And yet, it wants to: (1) encourage academic institutions to promote media literacy for young children, where it does not have jurisdiction (recommendation 2); (2) ensure that sufficient materials are incorporated into medical curricula (recommendation 8), where, again, it has no jurisdiction; and (3) improve understanding of eating disorders in the healthcare field (recommendation 11).

It is more than disappointing that recommendations 13, 23, and 25, each of which could really help those with eating disorders and their families, were weakened to do nothing more than “encourage”, “examine”, and “encourage…to consider,” respectively.

That is, the report protects the status quo and fails to take up the recommendations made by witnesses. Hence, this dissenting report is necessary.

If, according to the Government, the status quo is acceptable and is working, why was such a lengthy study and report required? Why did I spend my summer addressing life-threatening eating disorder cases brought to me by advocacy organizations and parents who were desperate for help?

This report could have been so much more impactful if real recommendations had been made to address eating disorders – not merely “weasel words” that do not actually call for desperately needed action.

As it stands, a mere 6 of 25 recommendations (15, 16, 17, 19, 20, and 22) have the potential to move us past the status quo and trigger real change.

WHAT WITNESSES ASKED FOR

Canadians with eating disorders and health practitioners asked that the federal government work with the provinces, territories and stakeholders to develop a centralized database of treatment programs. They asked also that the government work with its counterparts to address challenges in treating eating disorders, such as an inadequate number and uneven distribution of programs across the country, excessive wait times, and the absence of pan-Canadian, evidence-based treatment standards.

Canadians living with eating disorders and their families asked for navigators to help steer them through the confusing and overwhelming world in which they are embroiled. Families and health practitioners asked for multidisciplinary care teams, and solutions to overcoming the steep financial costs for treatment.

Health practitioners and researchers asked for a pan-Canadian registry for eating disorders, and to close the gaps in data collection and analysis in order to ensure a comprehensive picture of the incidence and prevalence of these serious mental health disorders.

Families want an education campaign for healthcare professionals and other stakeholder-identified groups to promote awareness. Their goal is a better understanding of eating disorders and their challenges and conditions, and a reduction of associated stereotypes and stigma. Parents across Canada not only worry about their children’s health, but also about their loss of employment and even their homes.

And all stakeholders called for a health and wellness education campaign, to foster a positive sense of self in order to protect against eating disorders, and media literacy to counteract unrealistic images of beauty and thinness.

Health practitioners and researchers also asked that the government consider putting in place a national research chair in the field eating disorders, and to increase funding for eating-disorders research.

In February, the Government of Ontario announced the first, long-term, publicly-funded residential treatment program in the Province--offering, at the moment, 12 beds for children and adolescents. This means at least some Ontarians with eating disorders may no longer be forced to go abroad for private health care, and return with little follow-up care. But, what about, for example, the Atlantic and Prairie Provinces?

OUTSTANDING QUESTIONS

Canadians should ask why the overwhelming human and economic costs of eating disorders (and how they compare to the meagre investment in research) are not included in the report. This includes the weekly uninsured costs of appointments to psychologists, nutritionists, and the cost of being unable to work or house oneself. What are the costs of eating disorders to the healthcare system?

Canadians should also ask why, of Canada's 4,100 psychiatrists, only 12 specialize in eating disorders. And why does each Canadian province not offer the full range of care for eating disorders -- from daily to long-term residential care?

CONCLUSION

Sadly, little has changed in the past twenty-five years. Canadians with eating disorders and their families still struggle. Boys and girls, young men and women are still told they have a choice and should ”just eat”. Parents continue to be blamed, and families still complain: where are the educational programs that allow frontline health practitioners to recognize eating disorders, the early intervention, and the access to care?

It is unconscionable that, today, families must still ask where the help is, when we know that early diagnosis and access to care will significantly enhance recovery. If eating disorders are not identified or treated in their early stages, they become chronic, debilitating, and even life-threatening conditions.

For these reasons, Canadians with eating disorders and their families eagerly awaited the Status of Women Committee report on eating disorders. They want to know that their pleas had actually been heard, and that there would be real recommendations to help struggling families — because the status quo is unacceptable.

Real progress on eating disorders requires the political will to act. Sadly, this report lacks the substantive recommendations to provide the Government with meaningful direction.