Referrals for eating disorder treatment for teens tripled during the pandemic

Social isolation and a loss of structure during the pandemic has left adolescents more vulnerable to developing eating disorders and exacerbated already existing ones, a Winnipeg psychiatrist says.

Dr. Jonathan Boman, a psychiatrist and staff chief at the child and adolescent eating disorders service at the Health Sciences Centre, said he has seen referral rates for teens seeking treatment triple in the last year and a half. 

"I think it's been a surprise, not just in Winnipeg, but nationwide in Canada, that for some reason this has been a population of youth who have been particularly vulnerable to the effects of the pandemic," said Boman.

Since restrictions began over a year and a half ago, "services across the country saw an explosion of referrals," he said.

• Eating disorders among teens and adults surge during pandemic

Jessica Cuddy, now a recovered adult, empathizes with teens struggling with eating disorders and body image after her own 10-year battle.

Isolation was part of what enabled her binging and purging behaviour for both anorexia and bulimia, she said.

"To hear of that kind of increase is shocking, but we can say it is a collective trauma and there has been a lot of instability, uncertainty and isolation. An increase in those factors, I think for sure, would contribute to a rise in eating disorders," said Cuddy. 

There is a secretive nature to the behaviours associated with eating disorders, which she always practised in private, she said.

Imposed isolation during the pandemic makes it easier to hide, she said. 

"So if you are more isolated, that is going to fuel those behaviours, especially if is something you are already struggling with," said Cuddy. 

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Loss of structure during the pandemic also had a part to play in escalating numbers, Boman said.

"I suspect many of the youth that we're seeing were probably kind of protected by the structures that were built into their lives around, you know, daily routines, routines of mealtimes, snack times, and I think healthy activities that were probably buffering for them," said Boman. 

With months of lockdowns and imposed isolation, some of those routines were lost with students remote learning, parents working from home, family stress and uncertainty over how long the pandemic would last.

While he doesn't have any specific data, Boman has noticed some changes in his own work, including seeing younger teens relative to pre-pandemic rates.

"And I think, somewhat surprisingly, we're seeing people at increased severity of presentation," he said.

• COVID-19 creates 'perfect storm' for people with eating disorders

Cuddy suspects there is another culprit fuelling the increase: social media.

"It was certainly part of my eating disorder. In recovery circles, they talk about compare and despair. Being stuck at home, social media is the perfect environment to be presented with a lot of opportunities to compare yourself to other people's bodies. That can be definitely be a factor as well. It was for me for sure," she said. 

Cuddy credits Westwind Counselling and Eating Disorder Centre in Brandon, a privately run facility with structure and routine, for creating a safe environment for therapy and group support for her recovery.

"Seeking treatment and talking about it can be really scary, but it is so important. There is no shame. Let the shame go. This is something so many people deal with. Find some support. Reach out for help," she said.

Boman said while the waiting list for help has jumped from three months to seven to nine, there is the possibility to fast-track based on severity of symptoms.

"You can get there, to that place of intuitive eating and body acceptance. I still deal with those things, but I have been able to come to a place of trusting myself and learning to love myself," said Cuddy.