February 26th through March 4th represents National Eating Disorder Awareness week. During this week, the general public will likely see articles, tweets and maybe some Facebook posts that will cause them to think for a bit about those suffering from an eating disorder. For those who do suffer however, they’d give anything not to think about their eating disorder for a week. Not to think about calories, food or exercise. Because for those suffering from an eating disorder, this is not just a week but this is all consuming. It’s what keeps you up at night, regretting what you ate that day or how you can make tomorrow “better.” It’s what drives wedges between family members and ruins the notion of a happy family meal. Social lives will be impaired as impromptu happy hours and dinners out become the causes of stress, not stress-relievers. Your relationship with exercise? It’s not a means of keeping healthy but rather, simply a method of burning calories. Eating disorders affect every aspect of an individual’s life thus deeming it impossible not to constantly think about.
By pretty much every definition, Lady Gaga looked in supreme shape as she delivered her epic performance at the Super Bowl 51 half-time show. She vaulted off the roof of the NRG Stadium in Houston, then danced her you-know-what off during her 13-minute run through patriotic American classics and her own hit songs, including a burning-down-the-house rendition of “Bad Romance.”
But all some could focus on is what she exposed when she changed into a second Versace outfit that featured sparkly hot pants and a stomach-baring crop top that showed a softly toned abdomen that critics thought wasn’t toned enough. These critics — mostly men apparently — saw a slight belly roll that to them meant she wasn’t a desirably skinny as she should be.
In response to critics, Gaga took to Instagram late Tuesday to say: “I’m proud of my body.” She told fans they should never “cater to anyone or anything to succeed,” and added, “Be relentlessly you. Finally she thanked them for their support.
Over the last several years, laws in the United States have expanded insurance coverage and made treatment more accessible to individuals with binge eating disorder. While true parity and access to care for marginalized populations remains unrealized, we have seen strides in our country. Providers have in many cases been vocal advocates and helped to push important legislation and change forward. Unfortunately, however, there are still many ways in which providers may inadvertently be working against the process. If you are invested in being one of these individuals, follow our how-to guide below.
- Failing to recognize how being underinsured may impact your patients.
While the Affordable Care Act has increased access to health insurance in the United States, over 31 million insured Americans continued to face underinsurance through 2014 (Commonwealth Fund, 2015). Even those with plans through their employer are increasingly likely to be underinsured. Being underinsured means that, despite having health insurance, an individual cannot adequately afford the deductibles or other out of pocket costs associated with the plan. The result of this is that even those with health insurance are not accessing care when they need it. We know that patients with binge eating disorder face a myriad of barriers to accessing care, such as lack of early identification and social stigma, and underinsurance is a very real and prevalent barrier as well. For those patients who do start treatment, recognize that underinsurance may play a role in early termination of care or refusal to seek higher levels of care even when needed. Perhaps most frustratingly, dropping out of treatment due to resource constraints like underinsurance further undermines patients’ confidence that treatment could eventually be feasible or effective.
Written by: Cyndi Eddington, Ashley Solomon, Psy.D., and Angela Woods
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My therapist told me I was running out of time. She had been recommending I sign myself into the hospital for several weeks. Each time, I said I was fine, that such drastic measures weren’t necessary, especially considering that I was acing all my college classes at my small liberal arts school in western Michigan. I didn’t think I needed to gain weight — in fact, I wasn’t even positive I had an eating disorder, despite weighing less than I had as a fourth-grader. I wrote off my falling-out hair and diminishing body temperature as mere coincidences to my steadily declining weight.
“If you don’t voluntarily sign yourself in, we might have to start thinking about forced commitment. You could die,” she said.
I tried not to laugh in her face. But as her words sunk in, I realized where any court would send me. I had heard stories about that psychiatric unit, and it frankly terrified me. I realized I would have far more control over my care if I signed myself in. So, two days after Christmas, at age 21, I did.
Joey Julius called his mother. It was 2 a.m. on a day after a Penn State football victory, and his feelings of triumph were being gnawed by doubt.
He was that big guy everybody loved but nobody really knew. He was a video sensation, a giant kicker who made crushing tackles. But nobody understood his real fight.
“Mom, I feel like a fraud,” he said. “I feel like I’m not being true to myself.”
Joey Julius then hung up the phone, logged onto Facebook, and began to type.
“After a long consideration of not only myself, my family and my team, I have decided to go public about my absence from the team during spring ball of 2016 and thru out this summer,’’ he wrote. “I was admitted into the McCallum place on May 9th for eating disorders.”
For the approximately 8 million Americans who suffer from binge eating disorder, help could be just a download away.
Psychologists in Drexel’s Laboratory for Innovations in Health-Related Behavior Change are developing a new smartphone application that aims to tackle binge eating, and they are seeking study volunteers to test it out.
The app, called iCAT+, is for patients who suffer from binge eating disorder or bulimia nervosa. It uses an approach called Integrative Cognitive-Affective Therapy (ICAT) to identify users’ binge “triggers” and teaches coping skills to change unhealthy eating behaviors. ICAT is a type of individual psychotherapy that focuses on helping people change their behaviors, feelings and thoughts about themselves.
The average American woman is 5 feet 4 inches and 166 pounds. The average American model is 5 feet 10 inches and 110 pounds, according to the University of Minnesota’s “Guidelines for Adolescent Nutrition Services.”
The media distorts our perception of body image. Shouldn’t models actually be what their job title describes and model the appearance of the average woman in the country they represent? There’s a worldwide epidemic plaguing the First World, and America plays a big part in enabling it.
The media’s depiction of unrealistic standards for body shape affect younger people every year. Altering images with Photoshop and using incredibly skinny women in fashion and pop culture perpetuates low self-esteem among young girls, which often leads to extreme dieting.
SAN FRANCISCO — Paraag Marathe’s structured, analytical mind has served him well in the offices of Silicon Valley and the National Football League. He figured that he could lean on those traits the first time he spoke publicly about his sister, Shilpa, and how anorexia had taken her life.
But composure failed Marathe in 2011, six years after Shilpa’s death, while he spoke to survivors and grieving family members at an event for Andrea’s Voice, a nonprofit foundation that tries to promote education about eating disorders and their treatments.
“Not only did I break down a little bit during that speech,” said Marathe, 39, the San Francisco 49ers’ chief strategy officer and executive vice president for football operations. “It was also one of those weird moments afterwards. I emotionally collapsed in the arms of somebody there who had lost her daughter.”
The memories were back. Marathe had watched his brilliant sister succumb to self-destructive thoughts and starve herself. He had seen Shilpa wither to less than 50 pounds in the last years of her life, had felt the shame and puzzlement that her condition brought to his family.
Los Gatos, CA, Dec. 13, 2016 – Today, President Obama signed the 21st Century Cures Act into law which includes language from the Anna Westin Act so that for the first time in the history of Congress, eating disorders specific language will be included in federal law. On December 7, the act was passed by Congress to help people with eating disorders.
(Technical note: the Anna Westin Act didn’t pass itself, but rather was included in the 21st Century Cures Act language in the section on Mental Health Reform).
Everyone, including Eating Disorders Resource Center, who supported this effort in the South Bay, is cheering and ecstatic for this victory after many years of fighting to get eating disorders legislation passed.
“This is huge and will save lives. In my 45 years struggling with an eating disorder, this is our biggest accomplishment,” says Janice Bremis, executive director of EDRC, which provides resources, support, and advocacy for individuals with an eating disorder and their family members. “Each year we receive hundreds of inquiries from individuals and family members battling their health insurance companies who refuse to authorize the expert treatment needed to recover from this complex, physical and mental illness which so often goes undiagnosed.
Anna Westin was a Minnesota woman who died from an eating disorder when she was 21 years old. Her mother, Kitty Westin, was a founder of the Eating Disorders Coalition (http://www.eatingdisorderscoalition.org) and she has been working on getting this historic legalization passed for nearly 17 years.
The bill allows for expansion of federally funded health professional training on eating disorders recognition and treatment and clarifies that exclusion of eating disorders treatment from insurance policies is not allowed under mental health parity.
In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, and other eating disorders.
Today, as she witnesses the signing of the bill, Kitty Westin said, “I am convinced Anna would be alive today if this legislation had been in effect when she was young. There were many missed opportunities to stop the eating disorder from taking her life. I grieve for Anna every day and I am proud and humbled that we passed this life-saving legislation after a nearly 17-year journey.”
How will the 21st Century Cures Act save lives?
- Expand training
The training of health professionals in early recognition of eating disorders will save lives. All too often, we hear from clients and families that health professionals didn’t intervene early enough, did not recognize the signs and symptoms of eating disorders, and didn’t know what to do when they did. As a result, people suffer needlessly and oftentimes, tragically die. This bill will save lives by significantly improving the likelihood that health professionals can get adequate training on eating disorders during their education or via professional trainings.
- Improve access to care
Mental health parity – or treating physical and mental illnesses equally – became the law in 2008, but insurance companies continued to exclude eating disorders treatment, specifically residential treatment, because they believed this was acceptable under mental health parity. This act clarifies that it is not acceptable to do so. This change will afford people access to the care they need, at all levels of care, and take out barriers to access that so many have faced.
For questions and/or to interview key individuals behind this effort, contact Janice Bremis at firstname.lastname@example.org or 408-607-9748
Most of the anorexia patients Dr. Joanna Steinglass sees in the inpatient eating-disorders unit at the New York State Psychiatric Institute have been to treatment before. While in the hospital or a residential treatment center, they generally gained weight and began to eat a wider variety of foods. But after they left, their old anorexic habits returned. They began skipping meals again or returning to their extreme exercise routines. All too soon, it seemed, the gains made in treatment and the hope for recovery that went along with it began to evaporate.
According to the conventional wisdom around eating disorders, these relapses were really a misguided search for control. Or maybe the patients just weren’t ready for recovery yet. Or perhaps these were signs of self-control gone awry, spurred on by friends who marvel at their seemingly endless willpower. Interesting theories, and yet Steinglass disagreed. “Even when people show up at our hospital and want to make changes, they find it tough,” she said.