Eating Disorder Awareness: Types, Treatment & Support in Canada

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Eating disorders are serious, life-threatening mental health conditions characterized by atypical eating behaviours that significantly endanger physical and emotional well-being. These conditions are often accompanied by disrupted thoughts and emotions about eating, such as excessive worry about food, body image, and weight. Moreover, these behaviours are frequently linked to deeper emotional roots, self-image, and coping mechanisms for dealing with overwhelming feelings. Eating Disorder Awareness Week (EDAW) in Canada is observed annually in February, dedicated to raising awareness about the prevalence, dangers, and resources available to help those struggling with these illnesses.

What is an Eating Disorder (FED)?

An Eating Disorder, now clinically termed Feeding and Eating Disorder (FED), is a serious life-threatening illness that involves a group of atypical eating habits and behaviours that greatly endanger health. These atypical and harmful eating habits are accompanied by disrupted thoughts and emotions about eating, such as excessively worrying about food, body image, and weight. Furthermore, the disrupted eating behaviours are related to deeper emotional roots, self-image, and coping mechanisms to deal with overwhelming feelings. Understanding the underlying psychological drivers is a critical step in effective treatment and long-term recovery.

How Common are Eating Disorders in Canada?

According to the National Initiative for Eating Disorders (NIED), approximately one million Canadians have a diagnosis of a FED, such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Avoidant/Restrictive Food Intake Disorder, and Otherwise Specified Feeding and Eating Disorder. In addition, many other people have never been diagnosed and suffer from family and personal distress as a consequence. FEDs have the highest overall mortality rate of any mental illness in Canada, with estimates between 10-15% according to NIED. These disorders can affect males and females, at any age, from any race, and from any social and cultural background.

Types of Eating Disorders

There are different types of FEDs according to their specific characteristics. As per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5):

• Anorexia Nervosa is characterized by distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat.
• Bulimia Nervosa is characterized by frequent episodes of binge eating followed by inappropriate behaviours such as self-induced vomiting to avoid weight gain.
• Binge Eating Disorder is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.
• Pica is a rare eating disorder marked by persistent craving for unnatural, non-nutritive substances, such as plaster, paint, hair, starch, or dirt.
• Rumination is the voluntary regurgitation, in the absence of gastrointestinal distress (e.g., nausea, acid reflux), of food from the stomach to the mouth, where it is masticated and tasted a second time or ejected.
• Avoidant/Restrictive Food Intake Disorder (ARFID) includes a broad set of eating behaviours that involve the limitation or restriction of food or a certain type of food. In this case, it’s important to note that there is no body image concern associated with it.
• Other Specified Feeding or Eating Disorder (OSFED) is characterized by distressful and impairing symptoms of an eating disorder, but not meeting the complete criteria for one of the other FEDs.
• Unspecified Feeding or Eating Disorder has the same characteristics as OSFED, with the difference that there’s no specific reason stated as to why it doesn’t meet the criteria, perhaps due to lack of information.

How are Eating Disorders Treated?

Regardless of the type, a FED can be a fatal illness. However, there is treatment that can help; a combination of medical and psychological treatment is ideal. People suffering from a FED need to be treated for the FED symptoms, its medical consequences, and the psychological factors that contribute to the maintenance of the disorder. For the psychological component, several psychotherapy approaches are considered evidence-based, as defined by the American Psychological Association (APA):

Psychotherapy Approaches for Eating Disorders

• Cognitive Behavioral Therapy (CBT): A form of psychotherapy that integrates theories of cognition and learning with treatment techniques derived from cognitive therapy and behavior therapy. CBT assumes that cognitive, emotional, and behavioral variables are functionally interrelated. Treatment is aimed at identifying and modifying the client’s maladaptive thought processes and problematic behaviours through cognitive restructuring and behavioral techniques to achieve change.
• Dialectical Behavior Therapy (DBT): A flexible, stage-based therapy that combines principles of behavior therapy, cognitive behavior therapy, and mindfulness. It establishes a “dialectic” between helping individuals accept the reality of their lives and their own behaviours on the one hand, and helping them learn to change their lives, including dysfunctional behaviours, on the other. Its underlying emphasis is on helping individuals learn both to regulate and to tolerate their emotions.
• Acceptance and Commitment Therapy (ACT): A form of cognitive behavior therapy based on the premise that ineffective verbal strategies to control one’s thoughts and feelings actually lead to problem behaviours. It helps clients abandon these restrictive strategies and instead experience and accept their difficult thoughts and feelings as a necessary part of a worthy life. Clients then clarify their personal values and life goals, learning to make life-enhancing behavioural changes accordingly.
• Psychodynamic Psychotherapy: Views individuals as reacting to unconscious forces (e.g., motivation, drive), focusing on processes of change and development, and placing a premium on self-understanding and making meaning of what is unconscious. Most psychodynamic therapies share certain features, such as emphasis on dealing with the unconscious in treatment and on analyzing transference.
• Interpersonal Psychotherapy (IPT): A time-limited form of psychotherapy, originally based on the interpersonal theory of Harry Stack Sullivan, positing that relations with others constitute the primary force motivating human behavior. A central feature of IPT is the clarification of the client’s interpersonal interactions with significant others, including the therapist.

Seeking Help for Eating Disorders in Ontario

FED is a serious illness that is often overlooked and belittled due to a lack of information. If you are struggling with an eating disorder, there is treatment that can help you get healthy and stay healthy. You don’t have to go through it alone. At Bayridge Counselling Centres in Ontario, our regulated health professionals—including Registered Psychotherapists (RP), Registered Social Workers (RSW), and Psychologists (C.Psych)—provide specialized psychotherapy for eating disorders and related concerns. Building self-awareness and understanding the stages of change are fundamental parts of the therapeutic journey. Reach out for help today.