Eating disorders should be recognized as serious mental illnesses

Mar 29 2009

In the U.S. and abroad, the failure of insurers and other gatekeepers to treatment to consistently recognize eating disorders as serious mental illnesses has resulted in an ongoing heath care crisis for sufferers and their families.

In response to growing concern about this crisis, the Academy for Eating Disorders (AED) has released a position paper in the March issue of its scientific journal explaining the scientific rationale for identifying eating disorders as serious mental illnesses.

"Recent research on eating disorders supports the proposition that these are serious mental disorders with significant morbidity and mortality," says Dr. Tom Insel, director of the National Institute of Mental Health. "Based on genetic and neuroimaging studies, eating disorders appear to have a biological basis, analogous to what is observed in other serious mental disorders such as schizophrenia, bipolar disorder and addictive diseases. All of these illnesses, including eating disorders, need to be addressed as biomedical as well as behavioral problems if we are to help people recover."

In summary, eating disorders are biologically-based, serious mental illnesses because:

• There is medical and scientific evidence that anorexia nervosa and bulimia nervosa are as heritable as other psychiatric conditions (e.g. schizophrenia, bipolar disorder and depression) that are considered biologically based.
• The behaviors of restricting food intake, bingeing and purging have been shown to alter brain structure, metabolism and neurochemistry in ways that make it difficult for individuals to discontinue the behaviors.
• Eating disorders are associated with impairment in emotional and cognitive functioning that greatly limits life activities.
• Eating disorders are life-threatening illnesses and are associated with numerous medical complications. Mortality rates for anorexia nervosa are the highest of any psychiatric disorder.

As of 2007, the laws of some U.S. states have excluded eating disorders from conditions considered to be "serious mental illnesses," thus making it possible for patients to be denied insurance coverage for their treatment, leading to serious lifelong health consequences and an increased risk of death. "Eating disorders are associated with the highest level of mortality and medical complications of any psychiatric condition. It is imperative that eating disorders receive the same level and breadth of health care coverage that is available for treatment of medical disorders and other psychiatric conditions," states AED President Judith Banker.

The Academy for Eating Disorders is a global professional association committed to leadership in eating disorders research, education, treatment, and prevention. The Academy issues position papers on issues of highest concern to the organization in their scientific journal, The International Journal of Eating Disorders . The position paper is available in its entirety on the AED Web site: www.aedweb.org.

Access to treatment also will be an issue raised in the upcoming International Conference on Eating Disorders to be held in Cancun, Mexico April 30 through May 2.