The Canadian Paediatric Society (CPS) is recommending community-based healthcare providers and families identify early signs and have appropriate approaches for eating disorders in teenagers.
The society said in its June 7 announcement there has been a remarkable increase in eating disorders rate (EDs) in recent years.
According to a Canadian Paediatric Surveillance Program study, the complexity and severity of cases significantly increased during the middle of the COVID-19 pandemic.
Nataly Georgieva, a registered dietitian with JM Nutrition which has offices in Ontario, Nova Scotia and B.C., who specializes in eating disorders and disordered eating support, said disorders are increasing among folks of all ages, but especially among adolescents.
An eating disorder is a mental illness related to eating behaviours and body weight. Disordered eating includes symptoms that occur when one regularly experiences eating patterns that do not follow the cultural norm.
The new CPS guidelines aim to help community healthcare providers in the early identification and treatment of eating disorders.
Eating disorders can be diagnosed by weight changes, altered food behaviours, abdominal pain, fatigue, or irregular menstrual cycles. Routine health appointments offer a chance to screen for these issues.
CPS recommends screening all adolescents for EDs during annual health check-ups to ensure early recognition and diagnosis of EDs.
Nicholas Kriss, a North York, Ont., office worker who has successfully recovered from an eating disorder, said mood swings are one of the most noticeable symptoms of this issue.
“My attitude completely changed. I used to be more happy-go-lucky and in a good mood. But when I started eating less and less, my mood became snappier and pissier,” he said.
Georgieva said food fear development, hypervigilance around food, drastic changes in eating behaviours, noticeable weight loss or gain that happened in a short period, or irregularities with a woman’s menstrual cycle are common signs of EDs.
“There could also be other signs like thin hair, brittle nails, changes in low blood pressure, and coldness in the extremities,” she said.
Kriss said his symptoms started at the beginning of university when he didn’t like his appearance and decided to make a change.
“I started eating only one meal a day and playing sports,” he said.
“After a few years of that and no change in weight, I reflected on what I had put myself through. All I had accomplished was to make myself feel more irritable.”
Dr. Holly Agostino, an adolescent medicine specialist from Montreal Children’s Hospital and co-author of the new CPS eating disorder guidelines, said in the announcement that anorexia has the highest mortality rate among psychiatric disorders, but symptoms can often be missed or delayed.
According to CPS, eating disorder conditions can lead to serious medical and psychosocial issues and usually begin during the teenage years.
Kriss said eating disorders affect his daily life sharply, specifically his self-confidence issues.
Georgieva said recognizing any symptoms in a person’s behaviour is the most effective preventive measure for reducing the risk and recovering from eating disorders.
“The sooner that any treatment is sought, the better the outcome and the shorter the duration of treatment,” she said.
Georgieva said the new recommendations are great for helping adolescents identify some red flags as early as possible to get appropriate treatments.
“Many clients have told me that they were brushed off or given very vague generic advice from the doctors; some of them just didn’t have the education around assessing things for eating disorders,” she said.
Agostino said families may need personal support and should seek help to face EDs.
Georgieva said eating disorders should ideally have weekly or biweekly treatments with a dietitian, therapist, or doctor, while more severe cases might require hospital-based or outpatient daytime programs.
CPS recommends parents should seek medical help if their teen shows significant and unexplained weight changes, fails to reach expected growth milestones, experiences puberty delays, has serious body image concerns, practices restrictive eating, or exercises obsessively.