anorexia ac

8/2/2019 Anorexia AC

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A. Anorexia and bulimia are extremely prevalent in the United States

South Carolina Department of Mental Health, Eating Disorder Statistics, 2006. [Available online at

http://www.state.sc.us/dmh/anorexia/statistics.htm]

It is estimated that 8 million Americans have an eating disorder seven million women and one million menOne in 200 American women suffers from anorexia

Two to three in 100 American women suffers from bulimiaNearly half of all Americans personally know someone with an eating disorder (Note: One in five Americans suffers from mental illnesses.)

An estimated 10 15% of people with anorexia or bulimia are males

MORTALITY RATES

Eating disorders have the highest mortality rate of any mental illness

A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 10% of anorexics die within 10 years after contracting the disease; 18-20%of anorexics will be dead after 20 years and only 30 40% ever fully recover

The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 24 years old.

20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems

ACCESS TO TREATMENT

Only 1 in 10 people with eating disorders receive treatment

About 80% of the girls/women who have accessed care for their eating disorders do not get the intensity of treatment they need to stay in recovery they are often sent homeweeks earlier than the recommended stay

Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. The average cost for a month of inpatient treatment is $30,000. It is estimated thatindividuals with eating disorders need anywhere from 3 6 months of inpatient care. Health insurance companies for several reasons do not typically cover the cost oftreating eating disorders

The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more

ADOLESCENTS

Anorexia is the 3rd most common chronic illness among adolescents

95% of those who have eating disorders are between the ages of 12 and 2550% of girls between the ages of 11 and 13 see themselves as overweight
http://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htm


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B. The cost of treatment is prohibitive

Gina Shaw, former senior writer at Association of American Medical Colleges, WebMD, 2005, reviewed

Novermber 8, 2007. Anorexia: The Body Neglected[Available online athttp://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2 ]

Unfortunately, say experts, too many people believe that anorexia is strictly a psychological disorder, and ignore its medical complications unless thepatient becomes visibly, dangerously thin. "A lot of people -- parents, and even some doctors -- think that medical complications of anorexia only happenwhen you're so thin you're wasting away," says Peebles. "Practitioners need to understand that a good therapist is only part of the treatment for anorexiaand other eating disorders, and that these patients need treatment from a medical doctor as well."

"Studies have found that many people who need treatment for anorexia aren't getting it. In large part, this maybe due to cost. Inpatient treatment can cost more than $30,000 per month, while outpatient treatment can runas much as $100,000 per year."

Melissa Romn, a Miami woman who's been in recovery from anorexia for several years, pays $800 per month out ofpocket for therapy sessions that insurance won't cover. According to the National Eating Disorders Coalition, healthinsurance companies pay for an average of 10 to 15 treatment sessions for people with eating disorders, whenmore long-term care -- as many as 40 sessions -- may be needed for true recovery.

C. Insurance often does not cover required treatment

FEAST organization website 2010. [Available at: ]

Eating disorder treatment requires trained, multidisciplinary clinical support over a long period of time. Payingfor eating disorder treatment is, for families living in countries without a national health system, an additional cause of stress. Forthose with national health systems, going outside the system for specialized care is extremely expensive.

For those with health insurance policies, coverage may be limited or difficult to access. For those withouthealth insurance, or without coverage for mental health care, the price of care can be prohibitive.

In the United States, where rules differ across state lines and between insurance carriers, the situation iscomplex. Although a federal "mental health parity" law was recently passed, insurance companies can stillexclude eating disorder treatment. At present it is up to each family to individually negotiate options.

Costs vary widely between clinics and locations, but in the US here are some estimates:$1,200 USD/day inpatient/residential care (often 6 weeks-3 months)$300-500 USD/day initial evaluation at a multi-disciplinary clinic$100-300 USD/hour psychotherapy or nutritionist ongoing hourly appointments

Parents need to know that eating disorders can be treated either as a medical issue (where only emergency stabilization - not treatment to full recovery -are likely to be covered), or a psychological issue (where coverage is often excluded or limited). Since an eating disorder is only technically diagnosable

when the patient is significantly impaired,recovery can be stalled if the family is not able to continue to pay for care whenthe patient is stable; most eating disorder treatment needs to extend long after medical restoration.

In the case of a dispute, parents can contact their state's insurance regulatory agency to seek free assistance. Another resource is local legal aid offices toseek 'pro bono' (free of charge) services.

The price of treatment does not take into account travel costs, phone consultations, and lost wages.

Eating disorders are potentially disabling and deadly conditions. Delay of care, and settling for inadequatecare, can reduce the chance of a patient's recovery.
http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/content/article/109/109395.htmhttp://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/content/article/109/109395.htm


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Harms

A. Anorexia is the leading cause of death for young womenSouth Carolina Department of Mental Health, Eating Disorder Statistics, 2006. [Available online at


MORTALITY RATES

Eating disorders have the highest mortality rate of any mental illness

A study by the National Association of Anorexia Nervosa and Associated Disorders reportedthat 5 10% of anorexics die within 10 years after contracting the disease; 18-20% ofanorexics will be dead after 20 years and only 30 40% ever fully recover

The mortality rate associated with anorexia nervosa is 12 times higher than the death rate ofALL causes of death for females 15 24 years old.

20% of people suffering from anorexia will prematurely die from complications related to their eatingdisorder, including suicide and heart problems

B. Anorexia increases the risk of alcohol abuse, drug abuse, and suicideUniversity of Maryland Medical Center, Eating Disorder Statistics, 2006. [Available online at

http://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htm]

Psychological Effects and Suicide

Adolescents with eating behaviors associated with anorexia (fasting, frequent exercise to lose weight, and self-induced vomiting) are at highrisk for anxiety and depression in young adulthood. Alcohol and drug abuse are more common in patients withanorexia. Suicide has been estimated to account for as many as half the deaths in anorexia with studiesshowing up to a fifth of anorexic patients attempting suicide.
http://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htm


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Plan and Author-Advocate

Therefore I stand resolved that the United States Federal Government shouldsubstantially reform the provision of mental health services to the chronicallymentally ill through the following plan:

Through a bill passed by Congress and signed by the President, the UnitedStates Federal Government shall mandate that all health care insurers, includingMedicaid and Medicare, shall provide coverage for family-based treatment of

patients diagnosed with and suffering from Anorexia Nervosa.

The Federal Government will cover all additional costs incurred by insuranceproviders.

Funding and enforcement will be through normal means.

Author Advocate:1. World-Wide Charter for Action on Eating Disorders 2008 [Available at: ]

Like other BBMI conditions, the etiology of eating disorders is multifactorial and includes a combinationof genetic, biological, andtemperamental vulnerabilities that interact with environmental circumstances to increase risk. Nonetheless, the lack of recognition of th

seriousness of eating disorders has implications for the status of eating disorders globally.In the U.S., eating disorders shouldbe designated as BBMIs, SMIs, and SEDs and receive health care coverage and research funding that is equal to that of medicaldisorders as well as psychiatric conditions categorized as serious forms of mental illness. In other regions of theworld, eating disorders should be recognized as serious forms of mental illness that deserve national recognition and funding.

Changes in these designations and practices will ensure equal access to treatment and resources for all formsof serious mental illnesses.

2. World-Wide Charter for Action on Eating Disorders 2008 [Available at: ]

This Charter Calls Upon Those Responsible For Policy and Practice to: Educate and inform the community with programs that: De-stigmatise eating disorders by promoting the understanding that an eating disorder is not an illness of choice, and by raisingawareness of the causes of eating disorders Increase public awareness of the signs and symptoms of eating disorders Make available comprehensive information about eating disorder services and resources Connect with the media to provide accurate information on eating disorders and to help shift the cultures perspective on body imageissues and weight and food issues Develop and implement effective prevention programs targeting schools and universities

Educate and train healthcare practitioners at all levels in the recognition and treatment of eating disorders to improve the quality ofcare Provide sufficient specialist services based on regional need

Provide people with access to fully funded, specialised treatment and care Fund research into eating disorders.


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1. The New Family-Based treatment method is the best

Patti Neighmond of NPR, October 5, 2010 [Available at: ]

Treating anorexia nervosa in teens can be difficult and challenging. The stakes are high: These children often have to be hospitalized tget better, and some even die from the disease. But in the October issue ofArchives of General Psychiatry, researchers report long-term success for teenagers who undergo intense family-based treatment.

For decades, doctors have been struggling to come up with a really successful way to treat young anorexiapatients. Now they think they may have an approach that lasts. Psychologist Daniel Le Grange is one of the authors ofthis new study. He says the study findings suggest teenagers with anorexia nervosa who are medically stable should be offered family-based treatment rather than individual therapy.

This type of eating disorder treatment turns traditional therapy on its head. In the past, doctors tried to treat theunderlying psychological causes of anorexia in the patient, and the family was often pushed to the side. But infamily-based treatment, the emphasis is on weight gain first, and parents take the pivotal role.

2. The family-based approach is the only scientifically validated method oftreatment.


Without question, the Family-Based Maudsley approach represents a very different way of looking at eatingdisorders and treatment from traditional approaches. Some in the eating disorders community are shocked and evenoffended by the emphasis on nutrition and behaviors instead of insight and motivation. Still others remain skeptical of the role of parent

in the treatment. Yet the results are clear: there is no other scientifically-validated treatment approach for adolescentswith anorexia living at home who have been ill fewer than three years. The approach is also appropriate forbulimia and for older patients whose families are able to take on this role, according to leading researchers in the field.


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3. Family-based treatment cures more than twice as many people as the morecommon methods of treatment.

Maia Szalavitz, Time Healthland staff writer, October 5 2010, Parents allowed, Family-focused TherapyWorks Better for Teens with Eating Disorders. [Available at: ]

Treatment for anorexia has traditionally focused on individual rehabilitation of the patient, often in a residentialtreatment center away from the family. Indeed, for decades, leading treatment centers have recommended"parent-ectomy" removing the influence of a dysfunctional family, who were often blamed for exacerbatingthe patient's eating disorder as part of treatment. But a new study suggests that tactic is misguided.

The first randomized controlled trial to compare outcomes of family-based treatment to individual therapy for teenagers with anorexia

has found that involving the family in treatment is more than twice as effective as individual care.

The study, which was published in the October 4 issue of theArchives of General Psychiatry, was led by researchers at Stanford and

the University of Chicago. It followed 121 adolescents aged 12 to 18 with anorexia. Half of the participants were given individualtherapy, the other half were treated with the "Maudsley Method," also known as family-based treatment (FBT), an approach to familytherapy for anorexia pioneered at the Maudsley Hospital in London. (More on Time.com: Does Teen Drug Rehab Cure Addiction orCreate It?)

In the FBT group, parents were taught to monitor their children's eating and exercise behaviors, and to support and reinforce healthyeating. Individual therapy for anorexia focused more on the psychological problems believed to underly patients' eating disorders;patients were taught to be mindful of their feelings instead of trying to escape them by starving themselves, and were asked to controltheir own eating behavior, rather than ceding responsibility to parents.

Patients in both groups were in treatment for one year.At follow-up, one year after treatment, 49.3% of the family therapygroup were in full remission, defined as reaching at least 95% of normal body weight and scoring in the normalrange on a psychiatric measure of disordered eating. By comparison, 23% of individual-therapy patients werein remission. (More on Time.com: SPECIAL: Health and Happiness).

Relapse rates for family-based treatment were also lower than those typically seen after residential treatment,according to the study authors, at about 10% versus 40%.

Anorexia is more common in females and affects about 1% of women and girls. It is marked by starvation-level dieting and over-exercise, and is fatal in about 10% of severe cases.


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There is not sufficient access to this treatment


At this time it is still difficult to find clinicians trained in the Family-Based Maudsley approach. Unfortunately,

many parents will find that their local clinicians are either unfamiliar with or openly dismissive of the approach.It will take time for information and training to find its way into widespread practice, but parents can travel to evidence-based clinics fortreatment or arrange for consultations between modern clinics and local resources. Clinicians interested in learning about or training inthe approach can contact TRAIN2TREAT4ED.com, a training institute for certification.

Treatment for eating disorders is rare and expensiveSouth Carolina Department of Mental Health, Eating Disorder Statistics, 2006. [Available online at


ACCESS TO TREATMENT

Only 1 in 10 people with eating disorders receive treatment

About 80% of the girls/women who have accessed care for their eating disorders do not getthe intensity of treatment they need to stay in recovery they are often sent home weeksearlier than the recommended stay

Treatment of an eating disorder in the US ranges from $500 per day to $2,000 per day. Theaverage cost for a month of inpatient treatment is $30,000. It is estimated that individuals witheating disorders need anywhere from 3 6 months of inpatient care. Health insurancecompanies for several reasons do not typically cover the cost of treating eating disorders

The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more

Anorexia nervosa is a synonym for bulimiaUniversity of Maryland Medical Center, Eating Disorder Statistics, 2006. [Available online at


DescriptionAn in-depth report on the treatment and prevention of eating disorders.

Alternative NamesAnorexia; Bulimia; Binge eating

Complications of Anorexia:

Anorexia nervosa is a very serious illness that has a wide range of effects on the body and mind. It is also associatedwith other problems, ranging from frequent infections and general poor health to life-threatening conditions. Someresearchers believe that it should not be approached as a simple eating disorder but as a serious condition requiringstaging according to severity.
http://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htmhttp://www.state.sc.us/dmh/anorexia/statistics.htmhttp://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htm


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Up to 18% of those with anorexia dieUniversity of Maryland Medical Center, Eating Disorder Statistics, 2006. [Available online at


Mortality/Morbidity

Anorexia nervosa has one of the highest mortality rates of all psychiatric disorders, with ratesreported from 4-18%.15,17,18 Patients with restricting subtype tend to be more refractory to treatment and are at high risk ofdeath from AN.19Approximately 50% of patients will recover with treatment and maintain a normal weight but often not without relapses and with the

aid of multiple treatment modalities. Mortality is often due to suicide and less frequently due tocomplications of starvation.17,18

The cost of treatment is prohibitiveGina Shaw, former senior writer at Association of American Medical Colleges, WebMD, 2005, reviewed

Novermber 8, 2007. Anorexia: The Body Neglected[Available online athttp://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2 ]

Unfortunately, say experts, too many people believe that anorexia is strictly a psychological disorder, and ignore its medicalcomplications unless the patient becomes visibly, dangerously thin. "A lot of people -- parents, and even some doctors -- think thatmedical complications of anorexia only happen when you're so thin you're wasting away," says Peebles. "Practitioners need tounderstand that a good therapist is only part of the treatment for anorexia and other eating disorders, and that these patients needtreatment from a medical doctor as well."

"Studies have found that many people who need treatment for anorexia aren't getting it. Inlarge part, this may be due to cost. Inpatient treatment can cost more than $30,000 per month,while outpatient treatment can run as much as $100,000 per year."

Melissa Romn, a Miami woman who's been in recovery from anorexia for several years, pays $800 per month out ofpocket for therapy sessions that insurance won't cover. According to the National Eating Disorders Coalition, healthinsurance companies pay for an average of 10 to 15 treatment sessions for people with eating disorders, when

more long-term care -- as many as 40 sessions -- may be needed for true recovery.
http://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htmhttp://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/content/article/109/109395.htmhttp://www.webmd.com/content/article/109/109395.htmhttp://www.umm.edu/patiented/articles/how_serious_anorexia_nervosa_000049_5.htmhttp://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/mental-health/anorexia-nervosa/features/anorexia-body-neglected?page=2http://www.webmd.com/content/article/109/109395.htm

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