Beyond the pandemic surge: building a resilient system for adolescent and young adult eating disorder care

Eating disorders are serious, complex conditions that place a significant burden on health systems, individuals and families. Even before the COVID-19 pandemic, hospitalizations for eating disorders in Ontario were rising and characterized by longer hospital stays, greater medical complexity and increasing admissions among young male adults. Using linked ICES data, our work shows that the pandemic was associated with a disproportionate increase in these existing trends, with emergency department visits and hospitalizations among adolescents rising well above expected levels and remaining elevated through 2023; in contrast, young adult rates have largely returned to baseline. These patterns highlight the unique vulnerabilities of adolescents. We discuss the ongoing challenges of limited workforce capacity, long wait times and fragmented services, and propose solutions informed by Ontario Health’s Eating Disorders quality standard. Coordinated, multidisciplinary and measurement-driven approaches, co-designed with patients and caregivers, are essential to build a resilient, equitable system capable of meeting the complex needs of this population.