'thoughts of food consume everything:' why eating disorders are rising, and what to do about it

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hospitalizations for eating disorders are rising, death rates remain stark, and the condition disproportionately affects young people and the 2slgbtqia+ community

by lori culbert, vancouver sun

published may 22, 2025

11 minute read

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11 minute read

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why eating disorders are rising in canada and what to do about it

'the thoughts of food and body consumed everything. it made it really difficult to enjoy anything in life,' says kristyne agabob of suffering from an eating disorder. today, she is community engagement and fundraising coordinator for the looking glass foundation for eating disorders. jason payne / png

the 11:11 tattoo on kristyne agabob’s left wrist is inspired by numerology and represents a new beginning.

“it’s a number that assures you that you’re on the right path,” she said. “it’s a constant reminder of how far i’ve come and the possibilities.”

agabob, 34, got the body art several years into her recovery, after she was hospitalized and diagnosed with a life-altering eating disorder.

when she entered puberty at age 12, her body had grown larger. her doctor recommended she attend a weight-loss program. the humiliating and destructive experience sent her on a 15-year journey of starving and binging in a futile effort to achieve society’s expectations of the “right” size.

“the thoughts of food and body consumed everything,” said agabob. “it made it really difficult to enjoy anything in life.”

her weight swung wildly. when she would drop dozens of pounds over a short period of time, everyone celebrated her slimness. no one asked if she was ok.

despite having a university degree and a successful career, she didn’t recognize she was sick until, at age 28, suffering from malnourishment, she was admitted to vancouver general hospital.

“it wasn’t until i was hospitalized that i even realized that i had an eating disorder,” said agabob, who now works for looking glass, an eating disorders organization. “it was like a light-bulb moment.”

experts are raising the alarm about eating disorders because the number of hospitalizations has risen, death rates are stark, and the condition disproportionately affects young people and members of the 2slgtbqia+ community.

a national survey of 3,200 canadians conducted in july 2024 for the charity mental health research canada, with funding from health canada, found nearly one-third of people in this country have thoughts or behaviours that put them at high risk for developing an eating disorder. these include dieting or restrictive eating.

the survey found six per cent of canadians have diagnosed eating disorders, a group of mental illnesses that affect the way people eat and how they feel about their bodies.

the canadian mental health association says the three main types of eating disorders are:

anorexia: when people think their bodies are much bigger than they actually are, and try to lose weight by eating little, refusing to eat or exercising too much. this can lead to problems with the heart, bones and fertility. roughly one-in-10 people with anorexia die from health problems or suicide.

bulimia: when people consume a lot of food in a short period of time, but then typically become scared of gaining weight so purge the food or intentionally vomit. it can be harder to tell if people have bulimia as their weight may not fluctuate as much as with anorexia.

binge-eating or compulsive overeating: when people eat copious amounts of food during a single sitting, and are unable to stop even though they may feel guilty or depressed about it afterwards. unlike bulimia, people with this condition don’t purge the food.

anorexia and bulimia are most common among women, while binge eating affects all genders equally. these disorders typically start in the teen and young adult years, according to the cmha.

someone with a diagnosed eating disorder typically struggles with physical and mental health, which can impact their work, schooling and relationships.

but, experts say, eating disorders don’t get the same public attention as other mental illnesses, or the same amount of funding for research and treatment.

and that needs to urgently change to save lives, argues lisa brooks, executive director of looking glass, a vancouver non-profit that provides treatment and support for people who struggle with their relationship with food.

the 11:11 tattoo on kristyne agabob’s left wrist is inspired by numerology and represents a new beginning. she got the body art several years into her recovery, after she was hospitalized and diagnosed with a life-altering eating disorder. photo by jason payne /png

‘the numbers are rising’

“there’s such a pervasive misunderstanding in the community, and by many health-care professionals, that eating disorders only impact young, skinny, caucasian females,” said brooks. “there’s so much going on in the world that is impacting people’s mental health that eating disorders are certainly increasing.”

this became even more stark when covid-19 restrictions isolated people in their homes.

the number of clients using the looking glass in-person peer support program tripled from 72 in 2019 to 207 in 2024, and online peer support doubled over that period from 150 to nearly 300.

in response to the dire need for help during the pandemic, looking glass began offering counselling in 2021, starting with 15 clients. that jumped to 255 people by last year.

increasingly, social media, movies and tv have created “unattainable” goals for girls to be slim, and for boys to be muscular.

“in our world, dieting, restricting, over-exercising is really praised,” said margaret noel, a registered clinical counsellor who specializes in eating disorders. “and then things can fall under the cracks if we don’t identify it very early on.”

margaret noel, a registered clinical counsellor who specializes in eating disorders, has first-hand experience with this condition. as a former varsity runner, her disordered eating was long dismissed as ‘part of the sport,’ and her struggles went unnoticed. photo by arlen redekop / png

noel, who has a private counselling practice in vancouver and also works for looking glass, has had clients certified under the mental health act and put on a feeding tube in the hospital to save their lives. their fears include gaining weight, being found unattractive or being unloved.

her clients, whether they restrict food or binge-eat, all feel shame. loved ones, she suggested, should treat them with compassion: rather than talk about food or weight, question why they’re struggling.

noel, 30, is speaking from a personal place: while a varsity long-distance runner at university, she developed an eating disorder.

“the belief that the thinner you are, the faster you’ll run, was common,” she said.

noel’s every thought was consumed by what she was putting in her mouth until she could break the cycle. but it wasn’t easy.

“the numbers are rising in terms of people that have eating disorders, and i would say there’s a huge need for resources and clinicians that are trained in the field,” noel said.

brooks agrees b.c. needs more community-based programs like looking glass, more treatment offered by health authorities, and more spaces in the specialized eating disorders programs at b.c. children’s and st. paul’s hospitals.

“because eating disorders are life-threatening mental health conditions, you can’t recover without access to care. and less than 50 per cent of people can access the care they need,” said brooks.

that is due to cost, waiting lists, eligibility rules and a scarcity of health-care workers trained in eating disorders.

“with early access to specialized treatment and support, recovery from an eating disorder is possible, and it is transformative,” added brooks, who has a daughter who struggled with an eating disorder.

federal government research into autism gets more than 50 times the funding compared with the money given for eating disorders research, despite medical statistics showing eating-disorder diagnoses are higher than for autism, brooks said.

looking glass served more than 1,000 clients in 2024. one-quarter identified as 2slgtbqia+, and there were also disproportionate numbers of indigenous people and those from racialized communities. sixty per cent of clients were ages 14 to 29.

the canadian paediatric society estimates five per cent of canadian children have eating disorders, “potentially life-threatening illnesses that typically have their onset during adolescence,” it said in a position statement released last june.

diagnosis can often be delayed, in particular for people who don’t fit the eating-disorder stereotype: males, racial or sexual minorities, prepubescent children and people of above average weight.

the paediatric society statement included advice to help family doctors and other health providers make earlier diagnoses. that includes screening children for eating disorders as part of routine checkups and assessing those who have unexplained weight change.

“you can be very critically ill because you are purging or binging or restricting. but if your body still looks larger, doctors don’t do the investigations that would tell them that your electrolytes, your cardiac functioning is being impacted,” brooks said.

in b.c., a 2023 survey by the mccreary centre society found 14 per cent of children and teens in this province had vomited on purpose after eating, nearly doubling the rate from a decade earlier.

nationally, the canadian mental health association says 40 per cent of nine-year-old girls have dieted to lose weight, regardless of how much they weigh.

“we’re constantly told that thinner is better,” the cmha website says. “some people go to extremes to lose weight.”

hospitalizations for eating disorders increased by two-thirds during covid, with girls ages 12 to 17 accounting for the majority of those new admissions, according to a 2024 study by a group of canadian medical academics, including several affiliated with the university of b.c.

the number of females admitted to hospital for an eating disorder remained stagnant at roughly four in every 10,000 people in the years before the pandemic, but that jumped to seven per 10,000 between 2020 and 2022, and fell slightly by 2023.

the rate for males rose slowly between 2017 and 2023, but never climbed above one per 10,000 people.

brooks believes even more people are suffering but going undiagnosed because of society’s misunderstanding about the condition.

“so many people think that it’s a choice, or it’s a diet gone wrong, and if you just ate more or just ate less, that you’d be fine,” she said.

but they’re not fine.

high mortality rate

for people hospitalized with anorexia, their risk of dying is five times higher than the general population, a 2020 academic study on mortality rates in eating disorders found. the death risk is two times higher for people with bulimia.

in fact, eating disorders have the highest mortality rate of all mental-health and addictions diagnoses, outside of toxic drug poisonings, according to the national eating disorder information centre, run by the university health network in toronto.

b.c. has health authority programs that can help, but they have strict eligibility criteria and long waiting lists, and can be difficult to access for people without a family doctor, brooks said. so her organization is trying to fill those gaps.

the 25-year-old agency has partnered with the provincial health services authority to run a residential treatment facility. phsa provides clinical support, including nutritionists, counsellors, doctors and nurses, while looking glass oversees the building and runs supplemental programming, such as yoga classes, community outings and 2022年世界杯名单猜测 guidance.

in a separate location, the non-profit offers outpatient peer support programs for people struggling with disordered eating (regardless of whether they have an official diagnosis), low-cost counselling, and public outreach through school presentations and other initiatives.

while two-thirds of looking glass clients live in the vancouver coastal health and fraser health authority regions, the rest seek virtual help from vancouver island, the interior and northern b.c.

four out of every five clients said they had difficulty finding help for their eating disorders, citing cost, lack of specialists or programs, waiting lists, location or stigma.

looking glass clients also lived with depression, relationship issues, trauma, abuse, self-harm, and mental-health and alcohol or drug abuse. that’s because it’s common, brooks said, for people with disordered eating to have another mental illness. looking glass, which has seven full-time staff plus additional counsellors like noel and practicum students, receives some government funding, but relies on private donations—and as the need for services has intensified, so too has the need for more donor support, brooks said.

worried families and other members of society need to be better educated, brooks said, about trigger words that can encourage someone to develop an unhealthy relationship with food and their bodies.

“they should be having neutral conversations about food in their homes, so there’s no ‘good’ foods and ‘bad’ foods or ‘cheat’ days,” she said.

and avoid any talk about skipping meals.

‘because eating disorders are life-threatening mental health conditions, you can’t recover without access to care. and less than 50 per cent of people can access the care they need,’ said lisa brooks, executive director of the looking glass foundation for eating disorders. photo by jason payne /png

the national eating disorder information centre has resources online for families, including a help line.

disorders ‘thrive in isolation’

agabob echoes the need for more public knowledge, as society often assumes someone struggling with an eating disorder is emaciated. she didn’t fit the stereotypical image of the too-skinny person, which is why it didn’t occur even to herself that she was at risk.

“i just thought this is what people in larger bodies ate to manage themselves,” said agabob, who started as a peer support volunteer with looking glass four years ago and is now the community engagement and fundraising coordinator.

as a teenager, she got into a pattern of restricting what she ate, but her growing teenage body needed nutrients so the starving girl would then binge. racked by guilt, she would then purge.

“it became a very tumultuous situation of eating one way in public and a different way in private,” she said. “it wasn’t sustainable, of course. so as i got older, it got worse.”

her weight consumed her every thought in university and, in hindsight, she’s amazed she completed her degree. her career as an education manager for a large corporation meant a lot of travel, and throughout that time her body increasingly didn’t “feel right.”

“biologically, your body is going to start to deteriorate if you’re not nourishing it,” she said.

after her hospitalization and diagnosis, agabob said it was hard to get help: she tried several therapists before finding one she could work with; searched for a nutritionist with knowledge about eating disorders; and didn’t know looking glass existed.

she has advice for people who may be struggling with food: trust yourself if you think something is wrong, even if you don’t have a stereotypical body type.

and confide in someone, because eating disorders “thrive in isolation.”

it’s also important, she said, for people to understand that treatment regimes will be different for many people, depending on the type of disorder they have and the additional mental-health challenges they’re facing.

“more diversity and more inclusivity in eating disorder spaces is incredibly important for people to see themselves in this illness,” she said.

while changing her behaviour wasn’t easy and took time, agabob stresses she was able to recover once she understood her diagnosis.

“one of my favourite things about recovery is you have all these opportunities that you didn’t even really realize existed because your brain was so full of thoughts of food and calories and body. life actually seems so much more exciting, which is really great,” she said.

today, agabob has a healthy relationship with food. she doesn’t obsess about counting the calories on labels. she doesn’t check restaurant menus in advance to determine the fat content of meals.

“i do intuitively eat. i don’t follow any diets, obviously. i just do what feels good,” she said. “(before) i couldn’t let my body be the way it needed to be. so now i feel like i can do that, and i’m at a balanced place in my life.”

lculbert@postmedia.com

this article was originally published in the vancouver sun on may 20, 2025.