As anyone who hasn’t been living in a cave knows, these are precarious financial times. With Wall Street in disarray, the cost of food and gas skyrocketing and property and 401(k) values plummeting, families are looking for ways to spend less. Studies have shown that in tight financial times, people are more willing to sacrifice mental health expenditures than other forms of medical care.
These thoughts were in Marcia’s mind recently after hearing a young patient tell her about the massive binge she had engaged in over the weekend. “I found myself calculating the food costs of the gorge - nearly $50!” says Marcia. Of course we know that there are bigger economic issues at stake here than the grocery bills of a binge eater or the sometimes highly specialized food demands of the anorexic.
For many parents of Marcia’s patients, the question is, “Can we afford the weekly visits to Marcia, the therapist, and our doctor, each of whom play an important role in keeping our child healthy?” And these are families with health insurance. Families who are uninsured are in much worse shape. “Even the cost of gas is an issue in my rural state of New Hampshire, where families may have to drive several hours several times aweek for treatment,” says Marcia.
A recent Wall Street Journal article, “Angst is Rising, but Many Must Forego Therapy,” tells the story of a family in New Jersey that took out a second mortgage on its home to foot the estimated $80,000 in treatment expenses over the past two years for their eating disordered daughter. “I have been thinking about sacrificing care, how it’s going to have to happen if things keep going the way they are, because we can’t keep paying $400 a week,” the 21-year-old daughter is quoted as saying. The question is, how can we make economic concerns a positive motivating force for the eating-disordered child, rather than another source of fear and anxiety?
This strategy is probably best used with the bulimic or binge eater living at home. “I hope parents will consider sitting down with their child and discussing the economic reasons they won’t be overstocking the house with foods that support the child’s eating disorder,” Marcia advises. “Parents need to do this in a kind way with real care not to make the child feel guilty about having an eating problem.”
In the case of anorexia, where undereating not overeating is the problem, parents may have to actually convince their child that spending a little more money for a food that he or she will be able to eat is well worth the money. After all, they can explain, if spending a few dollars extra a week to get the right kind of ice cream is going to keep their child safe and out of the hospital, then that special ice cream is probably worth its weight in gold.
Just this week Marcia met with her patient Melissa and her parents. Melissa is a sweet 15-year-old newly diagnosed with anorexia nervosa. Marcia had encouraged Melissa to have some frozen yogurt topped with chocolate and nuts in the evening. Melissa thought that it was best if she just had this treat once a week because her parents wouldn’t want to spend money on her favorite local organic frozen yogurt. Doug and Rebecca, Melissa’s mom and dad, made it very clear to Melissa that her health and progress with her food plan was well worth the cost of the yogurt. “You’re more than worth it to us,” both parents said in unison.
These two examples show you how family budget concerns can cut very different ways, depending on the type of eating disorder your child is battling and her personality. If you are unsure about whether or how to bring in financial issues to your child’s treatment plan, please consult your nutritionist or doctor.
Marcia and Nancy