Eating disorders are very complex illnesses and can have very serious and harmful effects on young people and their families. Many things contribute to their development.
We assess and treat children and adolescents who are diagnosed with severe eating disorders including anorexia nervosa and bulimia nervosa.
There are two types of anorexia nervosa:
The first is a “restricting” type of anorexia nervosa. Symptoms may include the following:
- The child or adolescent is below normal weight and usually has ongoing weight loss due to food restriction and / or over-exercise.
- Intense fear of gaining weight.
- Preoccupation with food and thinking constantly about eating and calories.
- Rituals around food and eating such as cutting food into tiny pieces or taking a long time to eat.
- Body image disturbance including feeling fat even when very thin.
The second type of anorexia nervosa is the “binge eating and/or purging” type. This may include some of the symptoms above; however, the key difference is recurrent episodes of binge eating and/or purging behaviours including self-induced vomiting or the misuse of laxatives, diuretics or enemas.
The main symptom of this eating disorder is recurrent episodes of binge eating followed by efforts to prevent possible weight gain by engaging in purging behaviours. A person with bulimia nervosa:
- Feels a loss of control over eating and fears she / he won’t be able to stop.
- May attempt to avoid weight gain through purging behaviours such as vigorous exercise or fasting.
- Is usually within an average weight range, although weight may fluctuate widely.
Other specified feeding or eating disorders including avoidant restrictive food intake disorders may also be assessed for treatment options at the provincial specialized program.
The Provincial Specialized Eating Disorder Program at BC Children’s Hospital is a comprehensive, interdisciplinary, specialized program to assess and treat children and adolescents with eating disorders. The program emphasizes the involvement of parents / caregivers in the delivery of care. The Program has outpatient, day treatment and inpatient services.
Any child or adolescent (up to age 18) who, in the opinion of a community care provider, is struggling with an eating disorder may be referred for assessment at the provincial program.
The program encourages consultations and referrals to promote the early identification of an eating disorder, since early treatment is consistent with improved outcomes.
Access to the program is by referral only and requires the following:
- A recent physical exam
- Before- and after-care support by a health care provider
- Parent / caregiver involvement
- Education / family support
The interdisciplinary team is comprised of psychiatrists, pediatricians, nurses, psychiatric nurses, dietitians, psychologists, social workers, youth and family clinical resource educator, youth and family counsellors, recreational therapist, and teachers. Families are strongly encouraged to partner with the care team in the treatment process.
The Eating Disorders Program has active research, evaluation, and quality improvement components. The treatment offered in the Program is informed by best practices in the field, and follows evidence-based approaches from the scientific literature. To ensure that we are offering quality care, we are evaluating the effectiveness of Outpatient, Day Treatment, and Inpatient services for children and youth with eating disorders. We aim to provide patient- and family-centered care, and to target optimal treatment approaches for youth and their families. To help us achieve this aim, we examine predictors of treatment outcome in patients who attend the program. We also have projects examining both physical and psychological factors associated with eating disorders, to identify the mechanisms that may play a role in eating disorder development, maintenance, and recovery. Several of the clinical team members have appointments at the University of British Columbia and Simon Fraser University, and are actively involved in national and international research collaborations in the field of eating disorders. All research is performed following informed consent, and protocols have been reviewed and approved by the University of British Columbia Research Ethics Boards and Hospital Ethics Committees.
Student placements and training opportunities are provided to students at all levels and from multiple disciplines including nursing, child and youth care work, social work, psychology, occupational therapy, dietetics, medicine and psychiatry. The program also offers clinicians some education and training opportunities in Family-Based Therapy and Multi-Family Group Therapy periodically.