Polly, a curly-haired 30-year-old from Johnson City, Tennessee, was forced to leave eating disorder treatment when her insurance ran out. She explains, "Here I was thinking, It's okay, I'm over the laxatives, I haven't had one in almost three months. But I go outside of Renfrew and I wanted them immediately."
Polly, along with three other young women, are featured in photographer Lauren Greenfield's first documentary film, THIN, debuting on HBO tonight (November 14). It is a gripping and profoundly depressing illustration of the epidemic of eating disorders--7 million girls and women and steadily rising--in this country.
Greenfield follows these women through six months of treatment at the Renfrew Treatment Center in Coconut Creek, Florida, one of the most renowned in the country. Through their friendships and failures, recoveries and rebounds, she captures the complex web that these women must disentangle themselves from if they are to get better. None of them do.
Anorexia is the deadliest psychological disease in existence; up to 20% of those afflicted, eventually die. There are many reasons that eating disorders can be so difficult to heal. Just as alcoholism is not about the alcohol--but about conflict, trauma, personality, pain--eating disorders are not primarily about food. The team of experts and the women they aim to heal are up against formidable roadblocks--family history, genetic predisposition, sexual abuse--but it turns out that one of the most difficult to overcome is actually the insurance companies.
Though bulimia and anorexia are defined as psychological diseases, insurance companies give and withhold treatment based on physiological criteria such as weight, blood pressure and electrolyte balance. Young women still paralyzed by self-hate are kicked out of treatment centers all too often because insurance companies decide they are no longer constitute "medical necessity"; though these women may have gained some necessary weight back due to supervised meal times, their minds and hearts remain half-changed.
Before the rise of cost-conscious, managed-care insurance, the average stay at Renfrew was seven to nine weeks; today the usual stay is only two to four. A recent survey by the National Association of Anorexia Nervosa and Associated Disorders and Glamour magazine of 109 top eating disorder experts in the nation found 100 percent believed some of their patients suffered relapses in their conditions as a direct or indirect consequence of coverage limits.
This phenomenon was captured on film over and over during the course of THIN. Women just beginning to internalize their treatment, just beginning to be honest about their pasts and their problems, just beginning to make healthy, self-motivated choices are yanked from the safety of the Renfrew Center before any of these changes can be actualized. It is as if they punished for taking the first steps in the process of healing.
And what's worse, this approach isn't even saving the insurance companies money. Dr. Janell Mensinger, an expert in eating disorders, explains, "The sad thing about this situation, which happens all of the time, is that everyone gets hurt in the end. The harm to the patient is obvious, but there is harm and financial burden to the system as well a result of such ignorance. The research is clear that the longer the individual has the disease, the more difficult and expensive it is to recover."
How can we stand by and watch the latest casualty in our ineffective and immoral healthcare system? These women, often the best and brightest of their generation, are spending the prime years of their lives cycling in and out of prematurely terminated treatment.
It is time that the new House leadership vote on The Paul Wellstone Mental Health Equitable Treatment Act which calls for an end to insurance discrimination against mental health treatment. It is time that anyone who cares about the 7 million girls and women suffering from eating disorders in this country--which should be all of us--stands up to insurance companies alongside advocacy organizations like the Eating Disorder Coalition for Research, Policy, and Action.
I never want to see another film that so poignantly demonstrates the revolving door that most eating disorder treatment centers have become. I never want to hear about another girl dying because this country--the most rich in the world--didn't think her life was worth saving.