In the shadow of a pandemic, demand soars for eating disorder treatment

Three months into the pandemic, 12-year-old Emma was not herself: she was reclusive, cold all the time, controlling food and dropping weight.

Everything her mother, Clare, read online said these were the symptoms of anorexia and it was vital she get Emma help quickly. Ten per cent of people with the eating disorder will die because of health problems or suicide, according to the Canadian Mental Health Association. 

Seven months later, despite months of barely eating anything and losing about one-third of her body weight, Emma is still waiting to be admitted into one of B.C.'s specialized eating disorder programs.

Advocates and other parents who've been through it say wait times to get treatment were long before the pandemic — and now they're worse.

The CBC has decided not to use any real names in this story to protect Emma's privacy. 

Experts say eating disorders are not just about food. They are often a way to cope with problems or regain a sense of control. Since March, their prevalence and severity has been on the rise.

The National Eating Disorder Information Centre, which runs a toll-free helpline, says the number of people reaching out for support has doubled from November 2019 to November this year.

In B.C., the Looking Glass Foundation, a charitable support organization in Vancouver, says participation in their online peer support group has more than doubled since March. 

"COVID has made it worse on many, many fronts," said executive director Susan Climie. "[But it was] already a huge issue before COVID." 

Climie says there are not enough treatment spaces. 

"It's just devastating what people hear," she said. "There are no beds. You are too young, too old, you don't have the money for the private treatment, you are too sick, you're not sick enough. People literally can die waiting for help."

Dr. Blake Woodside, the medical director emeritus at the Program for Eating Disorders for Toronto General Hospital, says months of waiting for an assessment and treatment are "an eternity" for a 12-year-old like Emma. He believes the long waits and treatment shortage is a case of discrimination since anorexia is a mental illness that disproportionately affects women and girls. 

"If this was a disease that affected middle-age men, there would be protests on the streets," Woodside said. 

Alone in a crisis

At its worst, Clare was not sleeping, force-feeding her daughter, and said it was like having a toddler who would throw their food. As hard as it was for her, she knew it was harder for Emma. 

"She would go through a fit and a rage and then she would cry and she would look at me and say, 'Mommy, please, please fix me,'" said Clare. 

"I constantly worried, am I doing the right thing or am I making it worse for her? Because I'm not an expert. I never had to deal with anorexia before." 

Counsellors emphasise even though parents often feel blame and guilt, eating disorders are not a choice and they require specialized care.  

Emma's family doctor referred her to the Fraser Health Eating Disorders Program. In November, Emma had an intake appointment but was told she'd still have some months to wait before she could begin treatment. 

Fraser Health confirmed that wait times to be assessed have increased from one to two months before the pandemic to two to five months now. Treatment will begin some time after that, depending on the severity of the case. The program has hired new staff to help manage the increased number of referrals it is receiving.

The in-patient program at the B.C. Children's Hospital says it had to cut the number of beds from 11-14 pre-COVID to eight because of physical distancing. 

In a statement, the Ministry of Health said there is need for more services outside large urban centres and the province is currently developing eating disorder clinics in the Interior Health region. 

The ministry said wait times for specialized care vary across B.C. based on the services a patient needs and the location of their referral. 

For Clare, it has been frustrating. 

"I feel that my daughter's life was rated less than anyone else who potentially may have gotten COVID because we're so focused on one illness," said Clare. 

'We're not going to wait. We're just going to do this'

After a summer and early fall spending every waking moment trying to get Emma to eat, Clare managed to reach a nutritionist at B.C. Children's Hospital right before Halloween who agreed to squeeze Emma in when she heard how underweight she had become. It was the first person with expertise in eating disorders they had seen.

Shortly after, Emma was staying at her dad's — her parents are divorced — and called to ask Clare to come over. 

"She basically said, Mom, 'I've had enough of this, I want to be better. What do I do?' " said Clare.

Clare and Emma's father told her she needed to eat and it would be hard, but promised to stick with her.  

"I was so proud of her," said Clare.  "We're not going to wait. We're just going to do this."

So they took three weeks off from school. Clare and Emma got on a "calorific" eating schedule: a big hot chocolate with a meal supplement drink, eggs, omelettes, two snacks in the morning, two in the afternoon, burgers for lunch, and chocolate. 

Now Emma is still underweight, but gaining every week. 

As British Columbians enter this dark, winter phase of the pandemic, Clare worries about her daughter and other kids struggling with their mental health. 

"We can't neglect everything else. These kids are dying everyday a little bit more. And they deserve better."

Tap below to listen to CBC's Jodie Martinson discuss the rising demand for eating-disorder treatment programs in B.C. on The Early Edition: 

If you need help with an eating disorder, go to LookingGlassBC.com

Or call the B.C. crisis line: 310-6789 (no area code needed)

If you are experiencing symptoms of an eating disorder, please reach out for help. Find online, in-person, app, phone services and other resources from the province of B.C. here.