Alarming spike in eating disorders leads to new new hope for virtual treatments

Toronto – It's being called a "shadow epidemic" as recent reports cite an alarming increase in young people being admitted to hospital and outpatient treatment for eating disorders in the last year.The National Eating Disorder Information Centre (NEDIC) says the volume of inquiries to its helpline has increased 100% during the pandemic. Meanwhile, Toronto’s Hospital for Sick Children expects to report a 30% increase in admittance for eating disorders for its fiscal year-end March 31, and 240 outpatient referrals, compared to last year’s 150. Doctors in other parts of the country and at other hospitals report similar increases."Over the last six months, maybe even longer, there's been a huge surge in new cases, and also, we're noticing sicker patients," said Dr. Jennifer Couturier, co-director of the eating disorders program at McMaster Children's Hospital in Hamilton, Ont., in an interview with the Medical Post."Without structure in the early phases of the pandemic, a lot of children became focused on wanting to get healthy. And they were also hearing messages in the media and social media that people were gaining weight in quarantine. So they became worried about that and started to exercise excessively. Without the structure of school and sports programs, they were exercising throughout the day. So there were a lot of new cases and there was hesitancy, I think, for some families to come to the hospital due to fear of COVID," said Dr. Couturier.In addition, she said, access to services has been more challenging because psychiatric services are overwhelmed. "So our waitlist has grown," she said. "People are waiting longer, and it's a vicious cycle."Dr. Couturier is the principal investigator for the Canadian Consensus Panel for Eating Disorders. In May, the panel, which consists of clinicians, policymakers, parents and youth, received a $50,000 federal grant to determine how best to treat eating disorders during a pandemic, particularly in children and young adults under 25.The panel's recommendations, which are about to be published in the International Journal of Eating Disorders, are intended to help doctors determine what kinds of treatments they should and should not be delivered virtually.Online family-based treatmentMeanwhile, Dr. Couturier received $200,000 for a project that is allowing her team to train clinicians in various locations in Ontario on a virtual adaptation of Family-Based Treatment (FBT), a highly specialized and evidence-based treatment for children and adolescents with eating disorders.The project, going on now, studies the virtual implementation of FBT in Ontario, in four community locations: Thunder Bay, Kitchener, North York and Newmarket."We wanted to study what clinicians think about the treatment and what families think about the virtual adaptation. The study looks at, how are we maintaining the important elements of the treatment? Are we being true to the model by delivering it virtually? How do patients do, in terms of weight and any bingeing and purging? What are the patient outcomes?"Dr. Couturier said that, while pediatric psychiatry adapts well to the virtual model, with eating disorders there are extra considerations."There are tricky parts to the virtual adaptation," she said. "One of them is, the therapist (normally) would be in-person, weighing the patient in the clinic. So the virtual adaptation is that the patient needs to weigh themselves at home, with the therapist online. We used to tell them never to weigh themselves at home, so that is an adaptation."Another part of FBT is a therapist observing a family meal in a clinical setting, which now needs to be done at the patient's home, with the therapist attending virtually. Also, said Dr. Couturier, some patients are self-conscious about how they look on-screen."The therapist has a little less control over the environment, and there are factors that make (virtual) tricky, but there are definitely benefits," she said.

Alarming spike in eating disorders leads to new new hope for virtual treatments

Register for free access or login.

Related Topics