While Covid 19 has not resulted in significant increases in pediatric illness, it has driven significant increases in serious eating disorders amongst children and youth, a trend for which the current system was ill-prepared. In 2020, most eating disorders programs, including SickKids, were quickly overwhelmed with a significant increase in seriously ill patients, highly distressed caregivers and a ballooning of outpatient waiting lists. Compounded by the challenges of labour force disruptions and shortages, and the complex nature of these disorders, this crisis compelled the development of new collaborations and innovations. An overview of eating disorder trends, the experience of the SickKids program, strategies employed to respond to the crisis, and future challenges and opportunities will be presented.