McMaster Children’s Hospital reports ‘unprecedented’ spike in eating disorders
A year into the COVID-19 pandemic, McMaster Children's Hospital's program for eating disorders has about 300 kids on its active patient list - about double what it might typically have.
We're just seeing unprecedented numbers of new diagnoses of young people who are sicker than they normally would be," said Dr. Rosheen Grady, pediatrician and adolescent medicine specialist at McMaster Children's Hospital.
Pediatrics departments across the country are reporting significant increases in both volume and severity of eating disorders since the beginning of the pandemic.
Hamilton Health Sciences, which operates the hospital, is reporting a 90 per cent increase in the number of new referrals to its eating disorders program. From September to December of last year, the program received nearly twice the number of new referrals as the year before - 117 in 2020 compared to 67 in 2019.
In the same four-month period, the program saw a 30 per cent increase to inpatient admissions - a trend consistent with the projected annual admission rate of 33 per cent.
We are admitting far more patients," Grady said. Our unit has always been full, but we typically hadn't had such overflow."
Between September and December 2020, the department off-serviced" 30 patients - young people with an eating disorder admitted to a general pediatric ward, as an example - because there was no room in the dedicated six-bed unit. That was 20 more than the previous year.
These aren't the only concerning statistics.
The same release shows that the number of cases admitted to hospital with substance abuse disorder, in particular opioid-use disorder, has doubled. The number of cases with predominant symptoms of psychosis," the majority related to substance use, has also doubled.
In the four month period from October to January, hospitalizations following a suicide attempt more than tripled. In that period in 2020-21, 26 were admitted to hospitalization for intervention and stabilization following a suicide attempt compared to seven youth in the same period the previous year.
A large number of these youth have reported COVID-related issues such as lack of social interaction, increased conflict at home, and the inability to rely on friends as main contributors," the release reads.
Not only has volume increased, but patients are staying in hospital longer due to more serious attempts." Similarly, eating disorders are more acute, meaning their conditions are more severe, and more eating disorder patients coming through the emergency room.
Cheryl Webb, clinical specialist and social worker at the hospital, said that before the pandemic, a typical patient might have lost approximately 20 per cent of their weight, which is already really significant." Now, they are seeing kids that might have lost 30 or 40 per cent of their weight more frequently.
They're very emaciated-looking children that are cold and shivering, they're losing their hair, they have very low blood pressures, often dizzy," she said. Their whole body is being compromised by the eating disorder."
Webb said what doesn't appear to have changed is the profile of kids with eating disorders. The group of kids they see is highly diverse and reflective of our community," she said, adding that this includes all ethnic and racial groups, as well as genders and parental income groups.
McMaster Children's Hospital treats a number of eating disorders, including anorexia, bulimia and avoidant/restrictive food intake disorder (ARFID) - kids we used to call picky eaters" - in school-aged children ages seven to 18.
It definitely covers the full range," Webb said. We start seeing kids at seven, and those kids primarily have the ARFID diagnosis. They're picky eaters, selective eaters and kids that have fallen off their growth curves or have kind of lost their appetite cues and are having some fear of food, feel like they might be choking or have an aversion to eating."
Webb and her colleagues estimate about 75 per cent of patients are new-onset referrals - kids who have never been diagnosed with an eating disorder before. Relapses are also common.
I guess the numbers surprised us, but in retrospect, really, they shouldn't," Webb said. The kids were really challenged by legitimate worries about the world, legitimate worries about themselves, they're experiencing stressors from school."
Hamilton Health Sciences says the reasons for the increase are unclear." But, anecdotally, social isolation as a result of school closures and cancelled playdates, appears to a leading factor. Lack of structure, limited access to family doctors and lack of activities where changes in health may be noticed by coaches and teachers" are among other potential factors.
It's kind of the perfect storm, I think, for kids that are at risk of developing eating disorders," Webb said.
Kate McCullough is a Hamilton-based reporter covering education at The Spectator. Her work is funded by the Canadian government through its Local Journalism Initiative. Reach her via email: kmccullough@thespec.com