New guidelines aimed at catching eating disorders faster

With eating disorders on the rise, officials want to catch cases earlier.

The Canadian Paediatric Society released new guidelines urging primary-care providers to screen all adolescent patients during routine checkups.

"The sooner you identify an eating disorder and put interventions in place, the better the outcomes are," said Dr. Holly Agostino, who co-authored the new guidelines.

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Agostino is an adolescent medicine specialist and the eating disorder program director at the Montreal Children's Hospital.

"It's really about just asking one or two questions around body image. Trying to identify if there's been any change in their weight and why that might be the case. Any behaviours around food or exercise that have changed," said Agostino.

The guidelines are welcome news for Eating Disorders Nova Scotia, which offers peer support programs, workshops, and clinical services.

"Through my own experience with an eating disorder, if my family doctor had been able to kind of look at me and ask me some questions much earlier on, I know that my own recovery path would have been a lot shorter," said Shaleen Jones, Eating Disorders Nova Scotia's executive director.

Jones is also the founder of Body Peace Canada, which is a free online resource for anyone over the age of 14 who's dealing with an eating disorder or has concerns about their relationship with food, exercise, or their body.

Cases skyrocketed during the pandemic, as did referrals to the IWK Health Eating Disorders Clinic. One of the most common diagnoses at that clinic is anorexia nervosa.

"The gold standard of treatment for that condition in youth especially is something called 'FBT' or family-based treatment, which is psychotherapy, kind of talk-based therapy treatment that involves regular meetings," said Dr. Chelcie Soroka, IWK Health Eating Disorders Clinic psychiatry lead.

Soroka said the initial goal is weight restoration and nutritional rehabilitation, and then eventually normalizing the relationship the young person has with food. The majority of patients the clinic sees are people between the ages of 13 to 17, though there are younger ones too.

"Often, one of the common concerns we have from parents when we are completing assessments for young people is that they didn't know or they didn't realize," said Soroka.

"They thought it made sense their young person wanted to focus on eating healthy, or getting healthier, being more fit and active. I think all of that is great and good, but in moderation."

The Canadian Paediatric Society said parents should seek medical assistance if their teen:

• has a significant and unexplained weight change
• fails to reach an expected height or weight on their growth curves
• is showing delays in puberty
• has serious body image concerns, including a strong desire for weight loss or fear of weight gain
• has restrictive eating patterns
• exercises obsessively

"We're certainly seeing younger folks diagnosed with an eating disorder. More boys, more folks from the trans and non-binary community being diagnosed with an eating disorder, so it really impacts across all backgrounds," said Jones.

The hope with these new guidelines is youth will get the help they need sooner.

"Family practitioners, nurse practitioners, community paediatricians, they have such a great alliance with these families already, so they're really well-positioned to build that rapport, build that trust with the families, and get the ball rolling already," said Agostino.