Critics Blast Insurers for Poor Coverage of Eating Disorders

[AlphaCentauri]

Source: ABC

More than 11 million people in the United States have eating disorders.
And because an eating disorder can be a life-threatening condition with serious medical consequences, you'd assume that most health insurances polices would cover it. But many people living with eating disorders are falling through the cracks when it comes to health insurance, because in most cases, their treatment is not adequately covered, according to the National Eating Disorders Association.



Read more: http://www.abcnews.go.com/GMA/ChrisCuomo/critics-blast-insurers-poor-coverage-eating-disorders-gma/story?id=8579566

[GreenPartyVoter]

1. Of course they aren't covered. It's a moral issue, not a health one.

:sarcasm:

I'm glad someone is calling the insurers out on this and hope it will shame them into doing the right thing. (Or at least doing it for the sake of better PR)

[CountAllVotes]

2. eating disorders need a lot more attention

I have a niece that weighs 90 lbs. She is in her early 20's and has not yet developed I have been advised. Does she go to a doctor to find out why? Of course not! She is a size 1 for god's sake!

Our country worships thin women. I believe our society is responsible for her problem as nothing has ever been done by anyone to try to help her. No one seems to even mention the word weight and/or anorexia to her. Sadly, I never hear from her nor see her. If I did, I'd haul her off to the hospital!!

I wonder how long she will live? :mad:

:kick: & recommend!!

[Better Today]

3. If society is the cause, is it then a valid medical disorder?

I think that if you believe what you've written, then it's a media disorder and the solution isn't in the medical field at all but in the media field.

Personally I'm not sure how I feel about weight issues, I'm more concerned with nutritional issues, but with examples of your niece on one side and the ever increasing obesity on the other; seems that there is too much to it to be simply a medical disorder.

[CountAllVotes]

4. it is a psychiatric disorder and medical as well

and this disorder comes from being told your entire life that you better not eat much because you might grow up to be FAT and if you are FAT you are a loser.

Society is responsible, yes. Coming from a home that seems to encourage such behavior does not help.

In the end, we have what is now a medical problem as this young woman is starving herself to death.

It requires lots of treatment - both psychiatric and medical intervention are required.

:dem:

[Better Today]

6. If what you say is true, then wouldn't it be better to attack the source, media?

Also it wouldn't explain why obesity is the #1 medical issue today. So are some just more susceptible to the thin is in media hype? If media was to suddenly tell everyone that being fat is great, would these people you're worried about get fat instead? How is it they are susceptible to the thin TPs but not to all the food commercials? I don't know, this is a tough one for me because I am so very resistant to media hype, I literally used to argue out loud with nearly every commercial and even shows that seemed to promote certain stupidities when my children were around (grown and gone now) so they would learn that it was all bs to begin with.

[CountAllVotes]

8. the source =

is a dysfunctional upbringing. It is too late now as she is no longer in that environment. The mother is of the same ilk, bone thin and dieting all of the time.

I suppose we'd need to start from Mommy Dearest and work our way up in this situation. :mad:

[Better Today]

10. I still call BS, my mom was mommy dearest in the truest form,

I remember watching that movie the first time and just feeling like the wind had been knocked out of me it was so much like my mother. But I have no eating disorders.

That being said, I'd agree with you that upbringing is the key and again say that it isn't so much a medical issue, per se.

[No Elephants]

26. Disgree that upringing is the key and also disagree that this is not a medical issue.

Starving to death because you think you are too fat is a condition that requires medical treatment, probably starting with enteral or parenteral nutrition.

[Better Today]

12. I'd like to add...

Again, I think that the difference with me is that I'm naturally a very argumentative person. That may have been my saving grace. When my mother constantly told me I was fat, getting fat, etc., my thoughts immediately became aggressively argumentative and when something akin to "yeah, right bitch, like I want to be a walking skeleton like you. You're one of the most unhappy and unsettling people I know, whereas your heavier friends seem happier and more focused on life instead of food/looks."

[No Elephants]

27. Some experts are saying there may be a genetic tendency toward it.

However, many anorexics have moms who are heavy or plump or within the so called normal weight range.

It may not be the same cause for every person either.

[seleff]

31. Educate yourself...

Eating disorders are indeed complicated and often treatment resistant. A diagnosis of Anorexia Nervosa carries about a 10-15% risk of fatal outcome. Insurers balk in part because they argue it is throwing money at a lost cause, and psychiatry doesn't have a magic bullet in terms of treatment. ED is way more than looking at advertising and wanting to copy societal ideals of beauty. Each presentation has a different root and cause although common signs and symptoms and apparent correlations are found case to case. Go to NEDA's website and another called "something fishy" to learn more. I recommend a film called "Thin" by Lauren Greenfield that appeared on HBO a couple of years ago to see the horrors and struggles graphically.

My family has and still is living through this. Hopefully the worst is over. My Daughter went through five separate rounds of in-patient treatment before becoming relatively stable. She will have personality disorders and medical disorders the rest of her life resulting from the 3-4 years of starving her body. We were naive to limit her first in-patient stay to 4 weeks of re-feeding to get her from 80 to 86 lbs. Insurance ran out and we chose not to use our personal retirement savings to keep her in treatment. She was unwilling to miss more school anyway. Insurance fought paying more than a couple of weeks for every in-patient treatment. The fifth one went 5 and a half months at a center that was listed as in-network on the insurers website, but which had been dropped and the listing was not updated. We paid 60K out of pocket. This is not unusual. How many families can send daughters to multiple rounds of treatment at 20-100K per treatment?

Treatment outpatient was not an option. Sometimes our daughter would wander off on foot or on a bicycle for hours without money and then call because she was starving and exhausted. however, she was too terrified to come home because we had food in the house and she thought she could not control herself and would subsequently binge and try to purge. I would sometimes get calls from local police or ERs to come get her because people had called the police because she looked to be in trouble sitting and crying next to her bicycle.

In the end she had to go away and grow up. And we as a family had to undergrow treatment growth and recovery. With Anorexia, the whole family becomes "anorexic" in the sense that one no longer takes in normal LIFE. The whole family is held hostage by the disease called ED. Think of it as an abusive boyfriend. Things got better when we learned to not be held hostage and force our daughter into a choice...live or die. We are grateful that she has chosen to live for now. EDs deserve medical treatment at least on par with other mental disease and alcoholism.

[GoldenOldie]

9. It is a medical disorder

Having a daughter who became anorexic when she 15-yrs old during 1982, I know this to be a medical disorder. This was during the time that the term anorexia was becoming known to the public. The death of Karen Carpenter and Debbie Boone, daughter of Pat Boone's public announcement of her illness made families aware of the seriousness of this illness. My beautiful teenage daughter went from 125lbs to 80lbs within 1-year. During that year, our entire family joined the fight to help her overcome whatever it was that was slowly killing her. We read books, contacted the only known organization known to be familiar and working with eating disorders, went from doctors, specialists, shrinks, etc., etc. At that time I was also working within a military hospital and access to some of the best medical minds, which not only allowed me to vent but offered sound advice. She finally found a physician that she trusted and could confide in. He recommended immediate hospitalization and when we contacted the eating disorder organization, they told us to follow the physicians advice and no matter what, make her stay, or she would be dead. Needless to say, we followed both the physician's advice and the eating disorder organizations. It was a long battle but she pulled through and although she became a vegetarian, a teacher, and a counselor to young people, I am sure it has affected her system and her long-time health.

Although her family was there for her, it was the medical profession that pulled her through......thus it is medical.

[Better Today]

11. I find your explanation interesting but not convincing. It sounds like

it took more personal than medical treatment, that being primarily the attention and dedication of family and friends and apparently doctors to oversee/force her intake and retention (not unnaturally evacuating) of food.

[No Elephants]

29. Posters seem to be conflating cause and treatment with the nature of the condition

itself. The cause of an illness does not determine whether the illness is an illness or not. Neither does the treatment. They used to treat tuberculosis with rest, fresh air and nutrition. That did not mean tuberculosis was not an illness and potentially fatal to boot.

Add prescried exercise to the tuberculosis regimen and that is how lots of medical conditions (or deaths from medical conditions) are prevented, deferred or treated today, inclusing heart disease. If you can die from it, if left untreated, it's an illness, no matter what caused it or what helps.

I guess I would also take the word of an intelligent parent of an anorexic who has been involved in the diagnosis and treatment of the disorder over someone who just thinks about it. My guess is that the parent has done a boatload of research, besides just talking to docs. (See Reply 13. See also Rozlee's posts)

[No Elephants]

25. No, the media does not have the disorder.

If I cut my foot badly on a piece of glass, I do not have a glass disorder. I have a physical condition that needs medical treatment of some kind. Also, there is, I understand, some evidence that at least a tendency toward eating disorders is hereditary.

[WriteDown]

14. It's not anorexia, its anosexia! nt

[WriteDown]

15. wrong spot

[Festivito]

5. Projection. They won't cover their own money eating disorder. /nt

[Better Today]

7. LMAO! Best response I've read all day to any thread!

[NRaleighLiberal]

13. K&R. As a parent of an Anorexic daughter, I can attest to the complexity,

legitimacy, and seriousness of this condition - and that it is a true illness, as real as any other serious and deadly medical condition - only worse because it is focused in the brain (hence much more difficult to treat and understand), and one does have to fight mightily to get coverage - as we needed to. We continue to live through the nightmare (as to all parents of ED offspring - and the ED victims themselves, of course). It is also a disease shrouded and clouded by false assumptions and ignorance.

[coffeenap]

24. K and R from another who has seen it up close. nt

[No Elephants]

28. I am so very sorry. Blessings.

[Rozlee]

16. Golden Oldie, is right, it is medical, but

also has so many psychiatric and genetic components that no one single or combination of causes can be found. I'm a retired RN that worked primarily with cardiac patients in military hospitals, so most of my patients were middle-aged to elderly active duty or retirees. But, we had a few juvenile cases from Peds for observation secondary to electrolyte depletion, which is the main complication of eating disorders and the one that normally causes the greatest mortality. Potassium loss can lead to deadly heart arrythmias and we had to monitor the patients closely. In one case, we had a middle-aged bulemic that had started purging at 13 years of age and had her teeth worn down to stumps from the acids in her stomach! But, I'm glad your daughter is OK, Golden Oldie. In todays obese society, an eating disorder can also be overeating. But, a new eating disorder called orthorexia nervosa, which is defined by an obsession with eating only healthy "good" foods, has come into the medical and pychiatric milieu. Many experts are still considering if it is a true food disorder. It was first coined by Dr. Steven Bratman. He had a patient who died, that looked anorexic, but ate adequately of only what she considered "healthy" food. 20/20 ran a segment on it that you can see online. But, yeah, these blood-sucking insurance companies will use any loophole to get out of paying for any of these disorders. To say that they will pay for complications that are caused by these illnesses is just bullcrap! Because, then, they can claim it is due to a pre-existing condition.

[CountAllVotes]

22. Rozlee - Welcome to the DU

:hi: & Welcome to the DU!!!

:dem: :kick:

[No Elephants]

30. Thanks for all that good info. Welcome.

[WriteDown]

17. MUST SEE video on the topic

http://www.theonion.com/content/video/diet_book_author_advocates_new_no

[Rozlee]

18. I just swallowed my tongue

How many calories is that?

[WriteDown]

19. That won't help your weight loss goals. nt

[TygrBright]

20. Eating Disorders are part of a class of chronic behavior-related diseases that scare them...

And yes, these diseases are actual, medical conditions, real "diseases," with a behavioral component. And the effective treatment of these diseases involves a complex system of medical intervention, mental health treatment, patient education, and a long, slow process of integrating lifetime behavior modification.

Even when ALL of this is done, even when ALL of these resources are available and of high quality, relapse is frequently part of the recovery profile of these diseases, necessitating further rounds of treatment. Relapse is not a reliable indicator of treatment failure; it is a part of the diseases and their recovery profiles. But because of the relapse factor, and because ALL of these elements are required for successful recovery, these diseases are expensive to address. To effectively treat them, insurance companies would have to pay for the medical intervention, the mental health treatment, the patient education, and the support and professional assistance and tools for lifetime behavior modification.

If you list ALL of the diseases that fall in this class of diseases, you can see why profit-motivated insurance companies are terrified of them. They include:

Nutrition- and endocrinology-related conditions like:
Diabetes
Eating disorders
Obesity

Addiction

Diseases based on compulsive behaviors

Certain kinds of cardiovascular disease

Some allergy-related diseases

And this is by no means a comprehensive list. What these conditions all have in common is that they involve multiple components-- they are mixes of factors that include medical, mental health, behavioral and environmental elements. They can't be "cured" because they are chronic conditions that will pose lifelong risk for the individuals affected. There is no pill or shot or surgery or single intervention that offers a "magic bullet."

And because they are so complex-- involving genetic, physiological, behavioral and environmental source vectors-- all of the research that has already been done has just scratched the surface of understanding how to prevent them, diagnose them reliably, and treat them effectively.

They are all life-threatening conditions that, if uncontrolled, can kill. Most of them, if uncontrolled or poorly-controlled, end up costing large amounts in medical treatments for secondary conditions--sequelae, and the ultimate physical ravages of the diseases. Many of them inflict expensive collateral damage on the patients' families and friends.

And because the private insurance sector is so reluctant to commit to dealing with them, there has been little funding and little attention to building a comprehensive infrastructure of resources for the complex prevention and treatment most of these diseases require. The only way we will ever reduce their cost to all of us, and their toll on lives, is a national effort at health-care cost control that is grounded in a pragmatic, long-term view. And we won't get THAT until we are ALL on the hook for the costs of ALL of our health care.

pessimistically,
Bright

[Rozlee]

23. TygrBright is totally correct !

This is why we see so many amputations, such as in diabetics, instead of the thearapy needed to save a limb. Certain curative methods and wound management can be much more expensive. Sessions with wound nurses, and expensive mechanical therapies such as V.A.C., a 12-30 week $200,000 hyperbaric therapy, and surgery, debridement, grafts, etc., are expensive, whereas simply cutting off the appendage is one-stop shopping. No thought at all is given to the pain, suffering, altered body image, and life readjustment that an amputation will bring to a person's life. Insurance companies and the bean counters looking at the claims forms will only consider the cheapest option and that is all that the patient is reduced to: the amount of money that the insurance company will save. One of my nursing journals had an article a couple of years ago about the number of masectomies being done and how oncologists were fighting with insurance companies to do more proactive, aggressive non-surgical methods that would save womens' breasts. Insurance companies were fighting them tooth and nail because the more invasive surgeries were cheaper. It's unbelievable, but true. This is what Teabaggers are fighting for. The right to be bent over and screwed. And the lives and limbs of tens of thousands of Americans are just collateral damage.

[seleff]

32. Well said

[No Elephants]

34. I agree that obesity is an eating disorder, but I don't think it can be included

in the 11 million figure in the OP. I think something like over half of Americans are obese. That would be way over 100 million.

[damntexdem]

21. Not just 'can be life threatening,' among the most life-threatening of disorders.

Treatment is not adequately covered; and there are almost no inpatient care sites in this country, even though inpatient care of sufficient duration is what is needed in severe cases.

[seleff]

33. Daughter went to a center in Texas

There are centers, but not nearly enough beds for the need. And few insurers will pay for the long treatment and relapses. My daughter did have some success in Texas at a place called Shades of Hope in Buffalo Gap near Abeline.