Addiction Treatment: Foreshadowing the Dangers of Corporate Eating Disorder Companies

Lately I have written about the risks associated with the takeover of the eating disorder residential treatment centers by financial investors. As the focus of care has shifted from patient recovery to financial gain, the risks and potential hazards are growing.

A foreshadowing of the possible outcomes is evident in the addiction industry. A recent episode of the podcast The Daily (search for the episode from January 18, 2018) chronicles the rise and fall of an addiction company. Started by a recovered addict eager to share his experience with fellow addicts, the company quickly grew from a small entity into a chain of centers.

Its growth was buoyed by a federal law that increased insurance coverage for mental health treatment. This influx of funds created a large cache that enabled rapid growth of the corporation. Calls to prospective clients transformed from a clinical assessment to a sales pitch. And clinical decisions similarly were tinged with the thoughts of financial gain.

The company grew until it went public and brought tens of millions of dollars into the coffers of the founder, but the slippery slope of commingling financial gain and clinical care eventually went awry.

One center decided to accept a patient too ill to be managed without more complete medical care solely to access insurance payments. The staff was unable to interpret clinical symptoms as signs of instability rather than typical withdrawal symptoms, and the patient died on his first night in treatment.

It’s not hard to see a similar process already playing out in the eating disorder treatment world, and the decisions are stark and risky. When a patient of mine goes to a residential center. My first contact is from an outreach coordinator rather than a clinician. Programs immediately urge all patients to follow the course of residential treatment and the various outpatient programs all run by the same company, ensuring insurance coverage for anywhere from six months to a year. First time diagnosis patients are given tube feedings immediately without a clear assessment of risk, a decision that increases the likelihood of readmission within the next year.

All of these decisions may have generalized clinical value, but the lack of individualized care implies insidious motives of financial gain.

The swift growth of centers and the increased corporate structure of these companies have conflated clinical decisions and financial ones. The downfall of an eating disorder company will be different from what happened to the addiction company. Eating disorder centers were often founded by recovered people who wanted to share their success with others. It’s clear that the powerful urge to heal rarely factors into the function of a corporate center. As the focus shifts from patient care to growth of wealth, only patients will suffer.