Food for thought: A dissonance between healthcare utilization costs and research funding for eating disorders in Canada

Abstract

In this commentary, we present the premise that, in Canada, mental illness research specific to eating disorders is predominantly underfunded, and many Canadians are suffering the consequences of it. We highlight three main drivers underlying this issue: 1) the increasingly common yet potentially life-threatening nature of eating disorders, with an onset usually during adolescence; 2) the challenges and costs to treating eating disorders, with a discussion of current hospital-related costs across Canada; and 3) the glaring discrepancy between the money spent on eating disorder diagnoses/treatment and the funding dollars granted for eating disorder research in Canada (i.e. only $0.70 per affected Canadian in 2018). Research funding per affected individual for other psychiatric and neurodevelopmental conditions are used as comparisons (e.g. $50.17 per affected Canadian with schizophrenia). We suggest that it is time to revolutionize treatment for individuals with eating disorders and use our resources in a more efficient and effective manner, using current neuroimaging and neuromodulation methods as promising examples. We conclude by emphasizing the need for increased research funding in the field of eating disorders in Canada, as the current research-related investments hinder progress in developing neuroscientifically-sound treatments for these populations.

The economic impact of eating disorders in children and youth in Canada: a call to action to improve youth eating disorder research and care

“…The economic costing study brings together ED experts from all Canadian provinces, including clinician scientists, decision-makers, individuals with lived experience, and all four national Canadian ED organizations. This effort represents a first step in revolutionizing treatment for EDs in Canada, and includes all members of key stakeholder research groups proposed by Stone and colleagues [ 13 ] as a path to use resources more effectively and efficiently. It provides a venue to unify these experts’ voices in efforts to forge change together.…”

An Evolutionary Perspective on the Genetics of Anorexia Nervosa

“…Yet, a third of individual with AN will still be ill after 20 years, and a large proportion will live with psychiatric symptoms for a significant part of their lives, even after remission from their ED (14,16). 4 Understanding the genetic underpinnings of AN could provide an opportunity to identify biological mechanisms at play -which could eventually become targets for improving interventions. Yet, studying the genetic origins of AN is challenging, in part due to its early age at onset and sexes imbalance, but perhaps also because people with AN often do not seek help for their condition (4,15), adding to the difficulty of obtaining sufficient sample sizes for genome-wide analyses (GWAS).…”

“…Symptoms of AN typically include severe restriction of energy intake, intense fear of gaining weight, and disturbed body image (2). Notably, research on AN and other eating disorders (ED) has lagged significantly behind that of other major psychiatric disorders (2,4), particularly with regard to the biological mechanisms involved in their development. Yet, AN has one of the highest mortality and morbidity rates of all psychiatric disorders – with a standardized mortality ratio of 5.9 (5).…”

“…4 Understanding the genetic underpinnings of AN could provide an opportunity to identify biological mechanisms at play -which could eventually become targets for improving interventions. Yet, studying the genetic origins of AN is challenging, in part due to its early age at onset and sexes imbalance, but perhaps also because people with AN often do not seek help for their condition (4,15), adding to the difficulty of obtaining sufficient sample sizes for genome-wide analyses (GWAS). A recent AN GWAS identified eight risk loci and displayed significant pleiotropy with several psychiatric and metabolic traits (17).…”

A framework for conceptualising early intervention for eating disorders

“…Eating disorders have a disease burden comparable to anxiety and depression (Butterfly Foundation for Eating Disorders, 2014 ), with estimated socioeconomic costs in the billions (USD) each year (Streatfeild et al., 2021 ). Despite this, ED research is under‐funded compared to other areas of psychiatry (All‐Party Parliamentary Group on Eating Disorders, 2021 ; Murray et al., 2017 ; Stone et al., 2021 ). These minimal research investments have translated to limited opportunities for innovation and system level advancements.…”