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Recent changes in health insurance coverage, including the Affordable Care Act, have given rise to the number of for-profit residential treatment centers for eating disorders.
This change is because of the increased coverage of mental health disorders given in the Affordable Care Act and other recent changes to health insurance laws, according to The New York Times.
The money spent to produce these new, fast growing care facilities worry some eating disorder experts who feel the programs may prey on vulnerable families and patients, according to The New York Times.
Hannah Cummins, a sophomore studying communication, said she combated an eating disorder starting her senior year of high school.
“It was kind of a mixture I guess,” Cummins said. “It took control of everything. It started with strict dieting. So I would research everything I could, like how to lose 10 pounds the fastest, how to do the military diet, so that was like the beginning of it.”
Cummins said she never sought formal counseling. During her time at BYU, she confided in a roommate and another close friend, and she has now confided in her husband.
“In the companies’ rush to expand, they argue, quality of treatment may be sacrificed for profit,” according to The New York Times. “And they question whether the spa-like atmosphere of some programs is so comfortable that it fosters dependency.”
Katie Harvey, a junior studying communication, said she believes residential care facilities have a time and a place for when an eating disorder is very serious, but she believes if the issue can be addressed by family, friends or religious leaders, formal counseling might not always be necessary.
Harvey said her older sister dealt with bulimia nervosa for about eight years, through high school, her mission and college.
“In her freshman year of high school when it first began, all her friends from middle school just kind of went their separate ways, and she just felt very lonely, stressed out (from) taking on new responsibilities and harder classes in high school then middle school, so it became like a coping mechanism for the stress,” Harvey said.
Common physiological factors with the potential to lead to an eating disorder include feelings of inadequacy, lack of control, lack of self-esteem, depression, anger, stress, loneliness and/or anxiety, according to the National Eating Disorder Association.
“I would work out as much as I possibly could, with eating as little calories as I possibly could,” Cummins said.
Cummins said she would run a 5K in the morning, attend swim practice in the afternoon and do a work out of hot yoga in the evening. She said she would do this sometimes on as little as a handful of cranberries.
“If I was about to crash, I would try to have like a salad with nothing on it, so basically just lettuce,” Cummins said. “And that was like a cycle, over and over again, and that’s obviously not realistic. You can’t function that way.”
Cummins said that when her eating disorder first began, she was in a performing group and she wanted to be thin.
“The guys were picking me up and lifting me, and that was all that was on my mind,” Cummins said. “I just wanted them to think ‘Oh, she’s so thin. She’s so tiny, I can lift her so easily.’ Which is completely ridiculous.”
Cummins said her eating disorder worsened when she went to college due to depression from leaving home and the other pressures of college.
“I mean, I was skinny, but in my mind, I wasn’t at all,” Cummins said.
Emily McClure, a junior studying communication, said she had a roommate who struggled with bulimia nervosa.
“I questioned it a lot because she wouldn’t eat very much at first, in the beginning of the semester, but then she’d come home with a lot of food,” McClure said. “Right after we would eat or go do something as roommates, she would run straight to the bathroom.”
Bulimia nervosa is characterized by binge eating and then compensation behavior like forced vomiting to negate the affects of the binge eating, according to the National Eating Disorder Association.
McClure said her roommate confided in her because McClure was a member of their ward’s Relief Society presidency. She told McClure that she was experiencing feelings of a negative body image, that she felt had begun to influence her eating habits.
“She told me what she had been struggling with, and we brought it up as a ward council,” McClure said.
McClure said her roommate began counseling with their ward’s bishop. McClure said she noticed an innate change in her roommate throughout the counseling process.
“Many eating disorders specialists agree that some patients require the supervision of residential programs and benefit from the treatment,” according to The New York Times. “But studies showing the programs’ effectiveness are scant, Dr. Guarda and other experts said. The methods of the handful of studies that exist have been criticized.”
Harvey said her oldest sister was the first to notice Harvey’s second sister’s eating disorder. Harvey said the oldest sister tried to distract her from the eating disorder by inviting her to do things together and to be with her friends. After a year of this, Harvey said the oldest sister confessed her suspicions to Harvey’s parents.
“She never got formal counseling in high school,” Harvey said. “(My parents) just tried to diagnose what was going on within the family and just tried to help her change that coping mechanism, to try and start talking more with them and siblings to confide in them instead of leaning toward the eating disorder.”
Harvey said this worked, and her sister experienced a kind of off-season on-season way of dealing with the disorder before going to formal counseling through the student counseling office while attending BYU.
“The quality and form of treatment varies widely across centers, and in some cases includes approaches — equine therapy, for example, or ‘faith-based’ treatment — with little or no scientific evidence behind them,” according to The New York Times. “Some programs have full-time psychiatrists and medical doctors on staff, but others lack the expertise to handle emergencies or treat patients with coexisting medical or psychiatric problems.”
Cummins’ eating disorder worsened when she went to college due to depression from leaving home and the other pressures of college.
“I started binging and then throwing up, so then it became like even more of cycle where I would starve, binge and then throw up,” Cummins said. “So starve, binge, purge, basically, over and over again.”
This continued for sometime until Cummins said she realized she had a problem.
“I knew I had a problem deep down,” Cummins said.
Cummins said her disorder began to scare her when it was mentioned to her that eating disorders can causes issues with fertility. Cummins said this caused her to worry but she was unable to stop her behavior.
“One night I was super, just in a dark place, and I just knew I needed to stop doing everything that I was doing. Absolutely everything,” Cummins said. “So the next day I made it a point. I didn’t have a plan necessarily. I just knew I needed to stop everything cold turkey.”
Cummins said she still struggles with her eating disorder daily.
“When I eat something bad, I still want to go to the bathroom and get rid of it. It’s still in the back of my mind.”
Cummins said her husband has helped her with this by being there and making her accountable for her disorder.
“I came to the realization just a few months ago, that I had been like, I don’t have an eating disorder, I never looked like a holocaust victim,” Cummins said. “There was nothing obviously wrong with me to the eye. I guess if someone was looking at me, they wouldn’t be like, ‘Oh she’s totally starving herself.’”
Harvey said the turning point for her sister when dealing with her disorder was when one night she relapsed and purged. Then when tending to her newborn baby, she said to herself that she never wanted her child to feel the way she felt.
“Now I’ve been more passionate about, not helping others specifically with eating disorders but just making it known that it’s OK to not be perfect,” Cummins said.