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Eating Disorders in New Brunswick: Hospitalization Data & Building Care Pathways
Eating disorders (EDs) are dangerous and costly. In Canada, there are regional disparities in the availability of specialized ED treatment options. In New Brunswick, there exist no publicly funded treatment centres. To understand the burden of EDs in the province and inform health system service delivery models, accurate surveillance data are of critical importance. Little is currently known about patterns of ED hospitalizations in NB, the demographics of ED patients in NB, or about the financial burden of EDs on the province. Using provincial administrative healthcare data, we examined the prevalence of ED admissions to NB hospitals between 2003 and 2020. We compiled information about patient clinical and demographic characteristics, length of hospitalizations, and calculated the cost of EDs per hospital admission. Our findings are an important first step to help understand service use among people with EDs in NB, and quantify the financial cost of hospitalizations in this province, informing efforts to build capacity for evidence-based ED treatment. We will discuss health policy recommendations to ensure appropriate care for people with EDs in the province: 1) training NB clinicians in evidence-based interventions; 2) integrating ED treatment into existing hospital and primary care services; 3) building communities of practice for interdisciplinary consultation and support; and 4) establishing care navigation platforms connecting ED patients with care providers.
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Eating Disorders in New Brunswick: Hospitalization Data & Building Care Pathways
- 1. Eating Disorders inNew Brunswick: Hospitalization Data & Community Priorities May 28, 2025 Emilie Lacroix, PhD Assistant Professor of Psychology UNB Fredericton
- 2. Land Acknowledgment The Universityof New Brunswick is situated along the Wolastoq, along which live Wolastoqiyik– the people of the beautiful and bountiful river. We are settlers on unsurrendered and unceded traditional Wolastoqey land.
- 3. • Introduction toeating disorders • 17 years of administrative data on hospitalizations for eating disorders in NB • 2024 NB Eating Disorder Summit Overview
- 4.
- 5. Eating Disorder Diagnoses(DSM -5) • Anorexia Nervosa • Bulimia Nervosa • Binge Eating Disorder • Avoidant -restrictive Food Intake Disorder • Pica • Rumination Disorder • Other Specified Feeding or Eating Disorder (OSFED) • Unspecified Feeding or Eating Disorder (UFED)
- 6. Eating: Weight: Body Image Disturbances: Binge Eating: Compensatory Behaviour: Avoidant/RestrictiveFood Intake Disorder Restriction of all or selected foods & failure to meet nutritional needs Sometimes underweight or fail to gain weight None (if present, consider diagnosis of AN or BN) Not predominant No (if present, consider diagnosis of BN) Binge Eating Disorder Irregular but no extreme restriction; cognitive restriction is common. “Normal” or “above normal” Common, but not required for diagnosis At least once per week for 3+ months No Bulimia Nervosa Irregular. Restriction & skipped meals are common. “Normal” or “above normal” Present (typically overvaluation, body dysmorphia, and fear of fatness) At least once per week for 3+ months At least once per week for 3+ months Anorexia nervosa Severe restriction Low body weight in context (unless “Atypical” AN – OSFED) Present (typically overvaluation, body dysmorphia, and fear of fatness) May occur May occur
- 7. Every healthsystem, including cardiovascular, gastrointestinal, neurological, and endocrine. Mental health • Depression • Anxiety • Self-harm • Alcohol and substance misuse • Suicidality A person’s relationship with others The deadliest mental illness, second only to opioid overdose. Impact of Eating Disorders
- 8. At any giventime, 7.8% of people meet criteria for an eating disorder = 66,074 New Brunswickers Galmiche, M., Déchelotte, P., Lambert, G., & Tavolacci, M. P. (2019). Prevalence of eating disorders over the 2000–2018 period: A systematic literature review. The American Journal of Clinical Nutrition, 109(5), 1402-1413.
- 9. Eating Disorder Carein New Brunswick • No specialized treatment programs in the province (outpatient, day treatment, or residential) • Unclear pathway to care; those requiring specialized treatment may leave the province, but this is not an option for many patients
- 11. Research Questions: 1.How manypeople are hospitalized with eating disorders in New Brunswick? 2.What are the demographic and clinical characteristics of these patients? 3.What are the financial costs associated with these hospitalizations?
- 12. Method • Analyzed administrativehealth data provided by the New Brunswick Institute for Research, Data and Training (NBIRDT) • Discharge Abstract Database (DAD): encompasses patients admitted to hospital • Population: Patients admitted to hospital between 2003 and 2020 with a primary eating disorder diagnosis (i.e., this was the main reason for hospitalization) • Data randomly rounded to multiples of 5, to protect patient confidentiality • Diagnostic codes: AN, BN, other ED (specified or unspecified) • Cost estimation performed using resource intensity weight variable and corresponding estimator from Canadian Institutes of Health Information (CIHI) • Study approved by the University of New Brunswick Fredericton Research Ethics Board (REB 2023-057)
- 13. Acknowledgment This work wassupported by the Department of Health of the Province of New Brunswick under a contract with the New Brunswick Institute for Research, Data and Training at the University of New Brunswick. Financial support for this research was provided through a Harrison McCain Foundation Young Scholars Award. The results and conclusions are those of the authors and no official endorsement by the Government of New Brunswick was intended or should be inferred.
- 14. Between 2003 and2020: • 475 hospitalizations for eating disorders, among 285 patients • 175 children and youth (under 18), 115 adults • 90% female* • 63% Anorexia Nervosa Results
- 15. hospitalizations per year whereeating disorder was the primary concern hospitalizations per year where eating disorder was a secondary concern
- 16. 32.1 days Average lengthof stay in hospital among youth 26.73 days Average length of stay in hospital among adults
- 17. Financial Costs ofEating Disorder Hospitalizations 2017-2020 (years for which financial data were available): • 95 hospitalizations for eating disorders recorded in the Discharge Abstract Database Average cost per admission • Adults: $29,808 • Youth: $22,799
- 18. $2.35 M Cost ofhospitalizations for primary eating disorders in New Brunswick across 4 years $587,668 per year $24,744 per admission
- 19. The tip ofthe iceberg • These data only reflect people who were hospitalized in NB • Most people with eating disorders are not hospitalized • Many people leave the province to access care • Eating disorders are often not diagnosed or listed in databases, even when they are responsible for hospitalizations This study did NOT generate a prevalence estimate.
- 20. New Brunswick EatingDisorder Summit: Building Pathways to Care • May 31, 2024 • Full-day event attended by over 150 stakeholders from across the province • 124 attendees completed an evaluation survey
- 21.
- 22. Stakeholder Priorities Attendees rankedtheir priorities as follows, from highest to lowest: 1. Specialized outpatient treatment options 2. Education and training for care providers 3. Specialized residential/inpatient treatment options 4. Prevention programming ( e.g. in schools) 5. A professional network or community of practice 6. Peer and parent support groups 7. Virtual or hybrid services
- 23. Next Steps • Advocacy •We need long-term investment in care provider training and treatment options along continuum of care • Inter-provincial collaboration • Training for care providers • General background in eating disorders • Specialized, evidence-based outpatient treatments including CBT-T & FBT • Virtual community of practice & patient-facing care navigation platform
- 24. Thank you! Emilie Lacroix,PhD Assistant Professor of Psychology UNB Fredericton [email protected]