Childhood Eating Disorders Blog

Dear Readers,

We heard some good news this week. Some of you may have read about the Mental Health Parity Bill that was passed in both the House and the Senate on September 23. This is big news for the eating disorders community because the bill requires health insurers to cover mental illnesses (which include anorexia, bulimia and binge-eating disorder) exactly as they do physical illnesses.

As many of you probably know from first-hand experience, under current law, it’s common for insurers to charge higher co-pays for mental health benefits. Often, in the case of eating disorders, insurers will simply deny coverage, claiming treatment is not medically necessary. (See our LA Times op-ed piece piece on the tragic consequences of this practice for one young anorexic woman in California).

I spoke to Mike Harney, policy advisor to Rep. Patrick Kennedy (D-RI), chief sponsor of the House bill, who explains that while the content of the House and Senate bills is identical, the House bill  

Is a stand-alone bill that provides for a $3.9 billion 10-year budget offset that would pay for the costs of the legislation, while the Senate version is part of a much larger tax bill. They will have to hammer out an agreement on which form of the bill they will send to White House for the president’s signature. “We’re confident we’ll get a bill this year,” says Harney.  

An earlier, more liberal version of the House bill would have required that all health insurance plans cover all illnesses included in the DSM-IV, or Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. Despite losing this stipulation in the bill, Harney says, “We would still expect that most plans will cover [eating disorders] and now they’ll have to cover them on the same basis as physical disorders.”

An earlier version of the Senate’s mental health parity bill, meanwhile, would have pre-empted any state legislation on mental health parity (meaning that even if a state had in place a more inclusive mental health parity bill, only the weaker federal bill would have been enforceable). The revised Senate bill passed on Tuesday allows states that have tougher mental health parity legislation in place to enforce that law. The new bill “establishes a floor, not a ceiling,” explains Harney.

As of 2007, 43 states had mental parity laws, and 17 of those, or 40%, defined mental illness broadly enough to include eating disorders. So you can see how this federal bill, which President Bush is said to support, will help so many more eating-disordered patients and their families get the treatment they need.

Take care,

Nancy

I’m always amazed to hear about people throughout history who had eating disorders before they even  had a name. Today, anorexia, bulimia and even binge-eating disorder are so widely recognized that there’s even an anthology of essays on various author’s struggles with food, weight and self-image. Titled Going Hungry: Writers on Desire, Self-Denial, and Overcoming Anorexia, this book, along with another book on a woman’s struggle with food and weight, Thin is the New Happy: A Memoir, by Valerie Frankel, were both reviewed in the article, Yearning for the Lean Years,  published  the New York Times a few days ago.

The first book is a serious look at the varieties of torture and self-doubt that men and women of varying ages and ethnicities have experienced in pursuit of the holy grail of thinness. Frankel’s book sounds like a tonic to anyone who has grown up with a mother who snatched Twinkies from their hand and groomed them (often unsuccessfuly) not be fat.

I’m glad to see these kinds of stories being told publicly, in both seriousness and humor. We need more public discussion, to hear more stories like these in order to fight the stigma of eating disorders. For every writer willing to dish up details about epic binges or fanatical starvation tactics, there are hundreds, thousands more, who are suffering in secret. I hope you realize you don’t have to do that any more. Good treatment for eating disorders is increasingly available, even in small towns; it’s mustering up the courage to ask for help that’s the hard part.  

Take care,

Nancy