Need for Inclusivity

Eating disorders pose serious risks to both physical and mental health, requiring specialized treatment for recovery. However, the financial burden of seeking residential treatment for eating disorders can be overwhelming, with costs reaching up to $2,000 per day or more than $60,000 per month without insurance. These barriers to accessing treatment are particularly evident for those without financial resources or insurance coverage.

Insurance Coverage: An Inadequate Safety Net:

Despite the life-threatening nature of eating disorders, insurance coverage for treatment often falls short. Many commercial insurance plans include mental health coverage for residential and inpatient care, which encompasses eating disorder treatment. However, government-funded plans like Medicaid and Medicare generally lack comprehensive coverage for these critical treatments.

Even for those who have insurance benefits, coverage is not guaranteed. In many cases, insurance policies require prior authorization, also known as precertification, for higher levels of care like residential or inpatient treatment. This authorization process is further complicated by the need for ongoing clinical reviews to prove “Medical Necessity Criteria,” showing that the patient’s condition warrants continued treatment. This leaves many patients without care, effectively closing the door to healing.

Barriers to Inclusivity:

Finding in-network treatment programs and obtaining authorizations become significant hurdles for individuals seeking care. Moreover, insurance providers often rely on outdated and flawed metrics such as Body Mass Index (BMI) to determine the necessity of residential or inpatient care. This perpetuates the misconception that eating disorders are most severe in smaller bodies with specific behaviors. This bias disregards the range of eating disorders, including OSFED, Atypical Anorexia, BED, and ARFID, which may not align with stereotypical criteria. 

Shortcomings in Mental Health Parity:

While the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) mandates equal coverage for mental health and substance use disorder benefits, it falls short in addressing the unique needs of eating disorder treatment. This can lead to limitations in the coverage of levels of care essential for effective treatment, such as residential, partial hospitalization, and intensive outpatient programs.

Overall, evidence shows a lack of inclusivity for those struggling with disordered eating. Ideally, the mental health field calls for more accessible resources to seek care and access a shared community. Social media platforms and other media exposure are often associated with or factors into the development of eating disorders. A unique platform that allows access to free virtual support groups, connections with shared identities, and like-minded friend groups could be an effective resource for support and decreasing isolation.

Conclusion:

It is evident that a more inclusive and accessible system for mental health treatment is urgently needed, including innovative platforms and nonprofit initiatives, along with additional resources to increase psychoeducation and advocacy where healthcare is lacking and the system fails. We must work together as a community, both within and outside the eating disorder landscape, to stand up for inclusivity for all individuals seeking mental health healing and support.