A new pan-Canadian analysis on the cost of eating disorders in children and youth before and during the COVID-19 pandemic shows a sharp increase that the researchers say is only the tip of the iceberg. The study authors are calling for better surveillance of what research indicates is a rapidly growing issue in Canada.
Led by the CHEO Research Institute, Ottawa, in collaboration with University of Calgary Faculty of Social Work researcher Dr. Gina Dimitropoulos, PhD, and other health-care and academic partners across Canada, the Deloitte Access Economics report is the first of its kind and shines a light on the significant costs of eating disorders to the Canadian health-care system during the pandemic.
Between 2020 and 2022, there was a 126 per cent increase in emergency department presentations and a 60 per cent increase in inpatient hospitalizations compared to one year pre-COVID.
The report indicates the incremental cost impact of children and youth with eating disorders reached $39.5 million over the course of the pandemic (from 2020 to 2022), representing a 21 per cent increase based on the limited data available. The report's experts say these figures are only a fraction of the true cost of eating disorders in Canada.
Gina Dimitropoulos // Photo Credit: Kloie Picot, for the Faculty of Social Work
Due to a lack of surveillance data on eating disorders, not all components of the cost of care, including the cost of standard eating disorder treatment programs such as day hospital programs, and support-based community eating disorder services (which rose by 118 per cent during the first two years of the pandemic), were accounted for in the report.
"We can't manage what we can't measure. Understanding the impacts and costs associated with eating disorders, especially in children and youth, is imperative to drive much-needed health-system transformation planning," says Dr. Nicole Obeid, scientist and lead of the Eating Disorders Research Lab at the CHEO Research Institute, and associate professor in the Department of Psychiatry, University of Ottawa.
"As thorough as this Deloitte report is, it is a vast underestimate of the cost of eating disorders in Canada. This research highlights the 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."
Study authors are calling for more investments in data-informed system transformation in eating disorders in Canada.
"There were a lot of children and youth with eating disorders that went undiagnosed during COVID19, and for some their disorder worsened," says Dimitropoulos, the research lead of the Calgary Eating Disorder Program, Alberta Health Services.
"There was a dramatic rise of children and youth in the emergency department with acute cases because we didn't have adequate community supports in place. Some parents had to miss work to stay home and support their child. That loss of income is not captured anywhere, nor the negative impact on quality of life."
On May 2, 2024, the study group is hosting a pan-Canadian meeting in Ottawa with international experts in eating disorder system transformation, Canadian research and health-care leaders, individuals with lived experience, and policy-makers to review in detail the report findings and identify an action plan.
There is an opportunity for eating disorder experts and decision-makers to work together on a national surveillance strategy to propel much-needed, data-informed, system transformation efforts to improve eating disorder care for youth, families and clinicians.
The impact of COVID-19 on eating disorders among Canadian youth project was a pan-Canadian collaboration of more than 40 partners from across the country, led by the following working group:
- Dr. Nicole Obeid, Eating Disorders Research Lab, CHEO Research Institute, Department of Psychiatry, University of Ottawa
- Dr. Linda Booij, Eating Disorders Continuum, Douglas Mental Health University Institute, Department of Psychiatry, McGill University
- Dr. Jennifer Coelho, investigator, B.C. Children's Hospital Research Institute, Department of Psychiatry, University of British Columbia
- Dr. Debra Katzman, Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Research Institute
- Patricia Silva-Roy, Eating Disorders Research Lab, CHEO Research Institute
Funding for this report and corresponding studies was provided in majority part by a Canadian Institutes of Health Research operating grant: Understanding and Mitigating the Impacts of the COVID-19 Pandemic on Children, Youth and Families in Canada.
Gina Dimitropoulos is an associate professor in the Faculty of Social Work and departments of Psychiatry and Paediatrics at the Cumming School of Medicine (CSM). She is a member of the Alberta Children's Hospital Research Institute, the Owerko Centre, the Hotchkiss Brain Institute, The Mathison Centre for Mental Health Research & Education, and the O'Brien Institute for Public Health at the CSM.
