Warning: The following post may contain triggering material.
By Shanda Glover
I remember my older sister telling our dad the news. Tears were streaming down her face and her voice shook uncontrollably. She whispered “Alex is starving herself.” Within one month, my niece, an extraordinary ballerina, lost 21 pounds.
At only fourteen years old, my niece was diagnosed with an eating disorder.
As of 2015, 30 million people of all ages and genders suffer from an eating disorder, including anorexia, bulimia, and binge eating disorder, in the United States.
Since losing her daughter in 2000, Kitty Westin has been advocating for a federal bill to help prevent other deaths from eating disorders. This federal bill, The Anna Westin Act, was introduced to Congress in 2015. It is currently in a House subcommittee. Westin’s bill would accomplish three things: train health professionals on how to appropriately identify eating disorders, make insurance companies cover eating disorders in the same manner as other mental health disorders, and finally require a federal study into whether or not the government should regulate the photoshopped images used in today’s advertisements.
Westin’s daughter, Anna, was a sophomore in college when her body weight dropped abnormally fast. Her family knew that she was struggling with anorexia and, when she lost 34% of her body weight, the family’s doctor recommended immediate hospitalization. However, the family’s insurance company told the Westin family that treatment was not necessary and she would not be covered. Unfortunately, in February of 2000, Anna committed suicide.
According to a study by the National Association of Anorexia Nervosa and Associated Disorders (ANAD), eating disorders have the highest rate of mortality compared to any other mental illness. In fact, the mortality rate associated with anorexia nervosa is 12 times higher than any other cause of death for females 15-24 years old. ANAD’s statistics show that 5-10% of individuals who suffer from anorexia die within 10 years after anorexic symptoms become present. Furthermore, 18-20% of individuals with anorexia pass away within 20 years.
Treatment and early identification is necessary and important in lowering mortality rate. According to the National Eating Disorder Association (NEDA), without treatment, up to 20% of people with eating disorders die. However, with treatment, the mortality rate falls to 2-3%.
There are many types of eating disorders, and many of them, unfortunately, stay under the radar because they don’t fall under anorexia, bulimia, or binge eating disorders. The characteristics of these disorders differ widely from one another. Anorexia is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. Individuals with anorexia feel they can never be thin enough and continue to see themselves as fat despite extreme weight loss. Bulimia is marked by cycles of extreme overeating, known as bingeing, followed by purging or laxative abuse. Lastly, binge eating which is characterized by eating enormous amounts of food at one time with no purging after. They often feel like they can’t eat enough.
In October 2008, when the federal Mental Health Parity and Addiction Equity Act was passed, it did not include eating disorders as a mental health issue.
As a result, insurance companies can still deny coverage based on the grounds that it is not mentioned explicitly as a form of mental illness.
When someone has an eating disorder, they also exhibit many neurological changes. Being caught in the downward cycle of an eating disorder, people will go through changes in personality that will be very obvious to all who know them well. These changes include irritably, over-sensitivity to criticism, perfectionism, compulsiveness, depression, and a desire to be alone. These characteristics accompany a distorted body image, food obsession, or an obsession with exercise.
An estimated 77% of individuals with eating disorders report that their illness and its symptoms can last anywhere from 1-15 years or even longer in some cases. For many others, there are long-term, irreversible consequences which can affect their physical and emotional health. Up to now, only 50% of all people with this devastating disease report being cured.
The experts at the F.R.E.E.D Foundation, a nonprofit advocacy group that battles eating disorders, state that the federal law doesn’t do enough. It lacks specifics about coverage limits, covered treatments, and covered drugs. “States and insurance companies continue to balk at treating mental illnesses, including eating disorders. And unfortunately, many people have died as a result,” says Kathleen MacDonald, education coordinator of the F.R.E.E.D. Foundation. One of the problems is that the standard of care at treatment centers across the country differs. Some patients need residential treatment, some need outpatient therapy. It is different with every case.
When insurance companies do cover treatment, they base wellness on the person’s body mass index (BMI), not on the psychiatric care needed after the patient reaches the required BMI. Insurers also place limitations on care often only covering 30 days at a residential treatment center or 25 lifetime outpatient therapy sessions.
This is different from other serious illnesses like cancer, where insurers don’t push patients to be healed in a measurable amount of time.
With greater awareness within our communities comes a great understanding that eating disorders are dangerous to those suffering from them. Eating disorder treatment should not be treated as optional but rather an option for everyone who needs it for the length of time they need it. Insurance companies need to rethink their evaluations and realize that each treatment needs to cater to the individual.
This one-size-fits-all approach that many insurance companies push onto families is not beneficial for anyone suffering with an eating disorder.
If you or someone you know is suffering with an eating disorder, please, ask for help. The University of Idaho offers resources to aid in counseling and testing, or if you need specific nutrition counseling, you can reach Marissa Rudley, the campus dietitian. If you can’t get help on campus, there are counseling centers available for all ages, around the Palouse area.
You are not alone.