Damage from Anorexia May Be Reversible

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The good news: Many of these complications can be reversible -- if the person returns to a normal weight. "The real focus has to be on weight restoration if you want to reverse outcomes," says Rebecka Peebles, MD, a specialist in adolescent medicine at the Lucile Packard Children's Hospital in Palo Alto, Calif. "That's the most essential part of treatment. You can't wait around for it to happen. It really is an essential first step in treatment and recovery."

Unfortunately, say experts, too many people believe that anorexia is strictly a psychological disorder, and ignore its medical complications unless the patient becomes visibly, dangerously thin. "A lot of people -- parents, and even some doctors -- think that medical complications of anorexia only happen when you're so thin you're wasting away," says Peebles. "Practitioners need to understand that a good therapist is only part of the treatment for anorexia and other eating disorders, and that these patients need treatment from a medical doctor as well."

Studies have found that many people who need treatment for anorexia aren't getting it. In large part, this may be due to cost. Inpatient treatment can cost more than $30,000 per month, while outpatient treatment can run as much as $100,000 per year.

Melissa Román, a Miami woman who's been in recovery from anorexia for several years, pays $800 per month out of pocket for therapy sessions that insurance won't cover. According to the National Eating Disorders Coalition, health insurance companies pay for an average of 10 to 15 treatment sessions for people with eating disorders, when more long-term care -- as many as 40 sessions -- may be needed for true recovery.

"Access to care is a huge issue," says Mickley. "Eating disorders aren't staged the way cancer is, so we don't have the way to convince insurance companies that a low potassium level can be like a small metastasis. It's only recently that we've begun to understand the genetic and neurochemical basis of anorexia and say that this is a real illness, not a whim of spoiled rich girls. It's been treated like it's voluntary and willful as opposed to what it is: a serious, life-threatening psychiatric and medical illness."

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Reviewed: 03/2006