Bill aids eating disorder care

The act would allocate money to research the causes and treatments for eating disorders.

Tara Bannow

An act propelled by two Minnesota senators seeks to improve the plight of those suffering from eating disorders and prevent future cases from starting. The Freed Act would allocate research money to the National Institutes of Health to better investigate the causes of eating disorders and improve treatment methods. The research would also seek to improve public data on eating disorders, including morbidity and mortality rates. The act was sponsored Sen. Al Franken, D-Minn., and recently introduced by Sens. Amy Klobuchar D-Minn., and Tom Harkin, D-Iowa. âÄúThe fact is, we donâÄôt know nearly enough about diagnosing, treating and preventing these diseases,âÄù Franken wrote in a statement. âÄúTodayâÄôs legislation is a major step forward in understanding eating disorders and how to stop them from destroying lives.âÄù When patients with less obvious eating disorders visit their doctors, itâÄôs not uncommon for them to hear lines like âÄúYou look great, I wish all my patients looked like you,âÄù said Jeanine Cogan, policy director of the Eating Disorders Coalition. âÄúPeople who were appropriately trained on the symptoms of eating disorders would know that telling someone they look great is the worst thing you could say,âÄù she said, âÄúbecause it totally dismisses the fact that theyâÄôre really sick.âÄù For Cogan, ignorance surrounding eating disorders among health care professionals is one of several indications of the need for legislation that will alleviate and prevent them. âÄúIf medical professionals donâÄôt get that, and they instead respond out of ignorance or stigma, then they do harm,âÄù she said. The House version of the bill, sponsored by Rep. Patrick Kennedy, D-R.I., was introduced last year. Klobuchar said she was inspired to work on the issue after meeting Kitty Westin, a Minnesota native whose daughter, Anna, died of anorexia 10 years ago. âÄúWhen you talk to her, itâÄôs very hard to think that we donâÄôt need to do more about this. We do,âÄù she said. At the University of Minnesota, about 5.3 percent of students reported struggling with an eating disorder, according to a 2007 Boynton Health Service survey. Of those, 2.4 percent said they had been diagnosed with anorexia in their lifetime and 1.8 percent with bulimia. The NIH spends about $1.20 in research funding per person with an eating disorder compared with $159 for someone with schizophrenia, which has a much lower incidence rate, said Jillian Croll, director of education, research and program development for the Emily Program, a Minnesota company that offers comprehensive eating disorder treatment. âÄúThat just gives a sense of how little research money there is in eating disorders,âÄù she said. Much of the bill centers on insurance coverage. The Senate version would require Medicaid to cover eating disorders. This is a vital component to the bill, Cogan said, recounting the story of a Pennsylvania woman who died of an eating disorder two days ago. She received Medicaid but could not get treatment because the assistance program didnâÄôt provide coverage for her disorder. âÄúShe really wanted treatment,âÄù Cogan said. âÄúShe was actively trying to get better.âÄù That could place a large burden on care providers, who would receive a dramatic reduction in compensation for their services through Medicaid, Croll said. âÄúItâÄôs like asking a cancer center that usually provides treatment that costs $1,000 to do that for $100,âÄù she said. âÄúThatâÄôs sometimes how different the Medicaid reimbursement rate is than what it actually costs to deliver the care.âÄù With federal health care reform working to improve Medicaid reimbursement, Klobuchar said she doesnâÄôt see that being a problem. âÄúIâÄôm more concerned about kids dying from anorexia,âÄù she said. âÄúUnlike some things âÄî like cancer âÄî there might be some really clear things we can do if we get our act together to stop girls from developing eating disorders, or for that matter, boys.âÄù The House version of the bill includes more dramatic insurance coverage provision, requiring that all insurers who cover physical health also provide coverage for eating disorder treatment. The billâÄôs Senate version would create patient advocacy groups that would support them as they navigate complex insurance issues that arise from denial of care. âÄúWeâÄôve had interactions with insurance companies who are frankly despicable in that practice of saying, âÄòYou have that benefit, but canâÄôt use it,âÄô âÄù Croll said. Under the bill, all federally funded obesity programs would also need to address eating disorders. The bill would also establish a grant program to train health care professionals âÄî in school and in the workplace âÄî how to appropriately address eating disorders. âÄúMost physicians get between zero and two hours of eating disorder education in medical school,âÄù Croll said. âÄúYet they often are on the front lines of screening or assessing someone with an eating disorder, and they just donâÄôt have enough information.âÄù