The National Association of Anorexia Nervosa and Associated Disorders reports that up to 24 million people in the United States suffer from eating disorders, such as anorexia nervosa and bulimia nervosa. Anorexia nervosa is an eating disorder characterized by restrictive eating and extremely low weight, while bulimia nervosa is a disorder characterized by episodes of over-eating (binging), followed by compensatory behavior such as vomiting or over-exercising (purging). Eating disorders like these, and a myriad of others, have the highest mortality rates for any psychiatric illnesses: 4% for anorexia nervosa and 3.9% for bulimia nervosa.
Eating disorders are a public health concern due to their prevalence, mortality rates, and the large economic cost on affected individuals and their families. Indeed, effective treatment can be extremely costly. Due to the complexity of the disorders, along with the physical and mental symptoms, eating disorders require time-intensive treatment with many professionals (therapists, psychiatrists, nurses, and dietitians).
Affected individuals and their families may encounter many frustrating barriers to obtaining effective treatment. Insurance companies are sometimes hesitant to fully cover the costs of treatment, especially residential or in-patient treatment. To deal with this problem, the National Eating Disorders Association (NEDA) provides a comprehensive “Parent Toolkit” online to help families effectively deal with insurance companies to obtain the best coverage and care that they can.
Some states have passed Mental Health Parity laws that require insurance companies to cover mental health-related treatment options to the same extent as physical treatments are covered, but many individuals still struggle to pay. Additionally, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) that President Bush signed in 2008 has never been fully implemented. Without these Acts, insurance companies can continue to deny coverage for individuals affected by eating disorders, who remain unable to obtain appropriate treatment.
More scientific research is necessary to provide concrete information to insurance companies and compel them to cover the necessary treatments. To address such issues, the 111th Congress introduced the FREED Act (Federal Response to Eliminate Eating Disorders Act). The FREED Act is the first bill in the history of Congress to address the research, treatment, prevention, and education regarding eating disorders. The FREED Act would amend the Public Health Service Act to require the “expansion, intensification, and coordination of eating disorder research.” Specifically, the Act would provide more grant funding for research to determine the prevalence of, incidence of, and possible causes and correlations to other factors that influence eating disorders, to obtain comprehensive Body Mass Index (BMI) data, and that would expand Medicaid coverage for low-income eating disorder patients. The FREED Act would also define “eating disorder” broadly to allow for appropriate treatments for the entire spectrum of eating disorders, including those that have mixed or below-threshold symptoms.
This bill would have great significance for people dealing with eating disorders. By procuring more scientific information about eating disorders, the accuracy of diagnoses and treatment would be increased. Moreover, greater education and prevention efforts could create enhanced awareness of these issues and might help to increase the early identification of eating disorders. This would be desirable, because several research studies have shown that early treatment leads to better long-term health outcomes. Conversely, the longer an individual goes without treatment, the more likely it is that they will suffer from medical complications from the disorder. For example, women who suffer from chronic anorexia experience an increased risk of organ failure, heart problems, and kidney disease that could persist for the rest of their lives.
Ultimately, the FREED Act or a similar bill would not only benefit individuals with eating disorders, but would also help combat the overall healthcare costs associated with treatment. This type of federal research funding is needed to improve the understanding of the etiology, symptomology, and treatment of eating disorders. Hopefully, the enhanced knowledge gained from such research will enable insurance companies to be more willing to cover the most effective treatments for eating disorders, regardless of the costs.