The last post reviewed the limitations imposed on eating disorder treatment and recovery by health insurance. Too many people leave treatment early and prematurely because of insurance limitations and decisions. The expense of full treatment can run very high as treatment lasts months or longer.
In the current health care climate, insurance will rarely cover adequate treatment for sustained recovery. But the problem just mutates in other health care systems. In a universal health care system, patients will receive full treatment but instead endure long waiting lists for care, also not an ideal situation.
What alternative treatment, likely outside the conventional health care system, could circumvent these issues and provide viable solutions for people in recovery from an eating disorder? Any option must include three basic components of treatment.
First is meal support. Recovery must in part focus on meals and snacks to re-train the mind and body to eat regularly again. The key here is support involving human connection and emotional support to get through each meal. Left alone to face the eating disorder, people in recovery quickly become demoralized and hopeless.
Second is community. Eating disorders isolate people from friends and family. A significant part of recovery is learning how to engage with people and relationships again in an honest, real way. These connections reinforce life outside the illness and remind the person of the myriad reasons to eat each meal. The isolation gives more power to the eating disorder as a source of identity and as the only effective coping mechanism for life.
The third component is directed help to constantly question the eating disorder rules, beliefs and actions. In treatment, clinicians gently but directly shine a light on the destructiveness of the eating disorder. Without those constant reminders, it's too easy for the well-worn patterns of the illness to dominate the person's thoughts and actions and derail every valiant attempt to get well. The eating disorder beliefs become so ingrained that they feel like an absolute truth. A person in recovery needs help to always question these beliefs and not fall under the spell of the eating disorder again.
Yet the standard treatment for people with eating disorders, outside of expensive programs, involves a number of appointments with clinicians per week and group therapy geared specifically to eating disorder patients. This arrangement provides elements of each of the three necessary components but with limitations. The person is left to navigate the treacherous road to recovery alone most of the time. The result is fending off the onslaught of eating disordered thoughts, struggling through each meal and continued painful isolation.
The changes to daily living in the last decade seem tailor-made for eating disorder recovery. The ease of staying connected enables people in recovery to have real-time support and community at every turn and every meal. That support can come from clinicians and friends. In fact numerous studies have lauded text messaging as a tool for eating disorder recovery. A few clinicians have set up an online education systems with forums designed to provide support. Many treatments now involve email for anything from food journals to written therapy. Videochat services offer new alternatives for therapy sessions as well.
However, the pro-anorexia and pro-bulimia websites are still more prevalent and more supportive than the online recovery options. Perhaps the drive for people with eating disorders to get support for their illness is stronger than the drive for clinicians or patients to create similar online forums.
I think it's time for clinicians and patients to join forces and create a portal online to offer the support people need to get well. If the treatment options and health insurance limitations in this country are not sufficient, then it's a duty of people dedicated to eating disorder treatment to create new avenues to help people stay in recovery.
More about this in the next post.