National study on the social and economic costs of eating disorders in children and youth during COVID-19 a “vast underestimate”

A new pan-Canadian analysis on the cost of eating disorders in children and youth before and during the COVID-19 pandemic shows a sharp increase, with a price tag that is estimated to be only the tip of the iceberg, raising calls for better surveillance of the growing issue across Canada.

Led by the CHEO Research Institute in collaboration with health-care and academic partners across Canada, the Deloitte Access Economics report is the first of its kind in Canada and shines a light on the significant costs of eating disorders to the Canadian healthcare system during the pandemic. Between 2020 and 2022, there was a 126 per cent increase in emergency department presentations and a 60 per cent increase in inpatient hospitalizations compared to one-year pre-COVID.

The report indicates the incremental cost impact of children and youth with eating disorders reached $39.5 million over the course of the pandemic (from 2020 to 2022), representing a 21 per cent increase based on the limited data available. The report’s experts say these figures are only a fraction of the true cost of eating disorders in Canada.

Due to a lack of surveillance data on eating disorders, not all components of the cost of care, including the cost of standard eating disorder treatment programs such as day hospital programs, and support-based community eating disorder services (which rose by 118 per cent during the first two years of the pandemic), were accounted for in the report.

“Eating disorders programs across Canada have long recognized the compelling need for a comprehensive examination of the social and economic impact of eating disorders in Canada. The product of our two-year collaboration with Deloitte Access Economics, marks a major step forward toward a better understanding of the devastating costs associated with paediatric eating disorders,” says Dr. Debra Katzman, Staff Physician in the Division of Adolescent Medicine at The Hospital for Sick Children (SickKids).

Study authors are calling for more investments in data-informed system transformation in eating disorders in Canada.

“This report provides only a fraction of the true costs of paediatric eating disorders in Canada. Our research underscores the urgent need to develop a robust surveillance system to ensure we are adequately capturing the shifting needs in services and costs so that we can improve early identification and access to evidence-based treatment,” adds Dr. Katzman, Senior Associate Scientist in the Child Health Evaluative Sciences at SickKids Research Institute.

On May 2, 2024, the study group is hosting a pan-Canadian meeting in Ottawa with international experts in eating disorder system transformation, Canadian research and healthcare leaders, individuals with lived experience, and policy makers to review in detail the report findings and identify an action plan.

There is an opportunity for eating disorder experts and decision-makers to work together on a national surveillance strategy to propel much-needed, data-informed, system transformation efforts to improve eating disorder care for youth, families and clinicians.

“We can’t manage what we can’t measure. Understanding the impacts and costs associated with eating disorders, especially in children and youth, is imperative to drive much-needed health system transformation planning. As thorough as this Deloitte report is, it is a vast underestimate of the cost of eating disorders in Canada. This research highlights the urgent need to develop a robust surveillance system for eating disorders in Canada to ensure we are adequately capturing shifting needs in services and costs so that we can better manage eating disorder care,” says Dr. Nicole Obeid, Scientist and Lead of the Eating Disorders Research Lab at the CHEO Research Institute, and Associate Professor in the Department of Psychiatry, University of Ottawa.

The impact of COVID-19 on eating disorders among Canadian youth project was a pan-Canadian collaboration of more than 40 partners from across the country, led by the following working group:

• Nicole Obeid, Eating Disorders Research Lab, CHEO Research Institute, Department of Psychiatry, University of Ottawa.
• Linda Booij, Eating Disorders Continuum, Douglas Mental Health University Institute, Department of Psychiatry, McGill University
• Jennifer Coelho, Investigator, BC Children's Hospital Research Institute, Department of Psychiatry, University of British Columbia
• Georgina (Gina) Dimitropoulos, associate professor, Faculty of Social Work, and Cumming School of Medicine, University of Calgary & Research lead, Calgary Eating Disorder Program, Alberta Health Services
• Debra Katzman, Division of Adolescent Medicine, Department of Pediatrics, The Hospital for Sick Children (SickKids), University of Toronto, Research Institute
• Patricia Silva-Roy, Eating Disorders Research Lab, CHEO Research Institute

Funding for this report, and corresponding studies was provided in majority part by a Canadian Institutes of Health Research operating grant: Understanding and mitigating the impacts of the COVID-19 pandemic on children, youth and families in Canada.