Are Eating Disorder Centers a “Rehab Racket”?

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She won a precedent-setting court case in 2011 requiring insurance companies to pay for stays in residential treatment centers for eating disorders. Now, Jeanene Harlick — who has struggled with anorexia herself — has begun writing an expose attacking the ineffective methods and lack of evidence-based approaches that characterize many centers in what she calls a “Rehab Racket.”

On A Disordered World, Harlick writes: “Back in 2011, when my case prevailed, I was happy I won – I was happy more people would get – and continue to get – much-needed treatment. Most of all, I was happy my parents got their money back. But now I question whether my case was such a resounding victory. Now I wonder whether maybe insurance companies have a right to dispute covering an expensive form of treatment that has no evidence to support its efficacy, nor shell out $1,000 daily to centers who don’t provide transparency or use science-based practices. If I could do everything over again, I would sue the treatment centers, not Blue Shield: to get a refund for a product centers never delivered on – and to sanction a system that is not only exacerbating many women’s illness, but destroying our careers and personal lives, brainwashing our families and sometimes, even, killing us.”

“Anorexia is widely known to be the most lethal of psychiatric illnesses: my population has the highest mortality rate of any mental disorder and a markedly reduced life expectancy,” writes Harlick. “And more than half of deaths from anorexia occur from suicide. Compared to the general public, people who suffer from anorexia are 57 times more likely to die of suicide. It is my belief that the inappropriate treatment being administered to older adults with long-term anorexia is playing a role in this. Because when you place hope in a system that says its ‘evidence-based’ practice will make you better, but you fail –- over, and over, and over again to maintain your recovery, post-discharge –- you blame yourself. You think, ‘These reputable centers, they’ve told me they’re providing me the most current, research-based care; they tell me their prescription for recovery is right, and proven, and that if it didn’t work for me, I’m the problem, not them. I’m the one who hasn’t ‘fully surrendered’ to recovery… So clearly it’s me who’s inherently defective, not them; clearly, I’m a hopeless case and clearly, I should stop fighting for my recovery, because it’s never going to happen.”

Harlick writes that this article is the first in a series.

The Eating Disorders “Residential Treatment Industrial Complex”: Harm or Help? Part 1 of an Investigative Series (A Disordered World, June 27, 2015)

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2 COMMENTS

  1. Below is an article – Wetsuit Therapy, from The Nevada Observer, June 15, 2008 on a non drug way of treating anorexia.
    http://www.power2u.org/downloads/Wetsuit%20therapy.pdf

    Wetsuit Therapy?

    by Bob Bennett
    A new therapy for treating anorexia has been developed by psychology professor Martin Grunwald, currently associated with the University of Leipzig in Germany. It came about quite by accident due to his curiosity about something completely different. As it was funded solely from his own pocket, it does not yet have a solid standing in the medical community, but it has attracted the attention of a number of neuroscientists. You don’t need a doctor’s prescription, or even any scientific ability to try it for yourself or with someone you know who has anorexia.
    Grunwald had his class blindfold each other, and then gave them simple items to draw. He wasn’t concerned with artistic ability, merely to see if they would be able to roughly sketch the items. Except for one young woman, each of his students was successful at the task. The questions about why the woman who wasn’t able to approximate the shapes made him curious. If everyone had passed, it wouldn’t have been a very good experiment.
    It turned out the woman also had anorexia. A test with additional anorexia patients revealed that none of them were able to sketch the items while blindfolded. Further tests revealed their right parietal cortex, which helps to integrate the various senses was active, but not able to adequately process the information coming from the hand they couldn’t see. A standard hypothesis has been that anorexia is due to lack of touch during infancy. This investigation suggests anorexia may be due to the right parietal cortex not developing correctly, possibly due to either a lack of testosterone during childhood development, or the inability of the body to utilize the testosterone it does have. This would help to explain why anorexia is primarily an illness of women, who only have trace amounts.
    It is estimated that 272,000 people in the U.S. have anorexia; 85-95 percent of them are female, with onset generally at puberty. One in 200 patients dies each year. Suicide is 60 percent more common for this population than for others in the same age group. Alcoholism is also common. Those who die as a direct result of the illness do so due to the loss of various salts (sodium, chloride, potassium, magnesium) which are needed to conduct electrical impulses in the body. Between 20 percent and 30 percent fully recover.
    Those with anorexia believe themselves to be grossly overweight. If you give one a pair of calipers and ask her to spread them out to the width of their upper arm, she will typically spread it out three or four times the actual width. Due to the malfunctioning right parietal cortex, this is how she actually perceives her arm.
    Those with anorexia dislike being touched, and early brain development is largely dependant on touch. They generally do not like massage or physical therapy which has demonstrated some success in treating those with anorexia. The question Grunwald posed was could a powerful input of touch sensation help to overcome the distorted body image? The second question was how to give touch stimulation to those who would avoid touch?
    A wetsuit was the answer he came up with. The one he experimented with also included a hood over the head. He had a young woman wear it for at least one hour, three times a day. During this time, they measured the electrical activity in her head as well as checked her weight at regular intervals. Within a few weeks, she gained several pounds, her brain activity switched from being left hemisphere dominated to right hemisphere, with a noticeable increase in right parietal cortex activity. The woman also felt much better and enjoyed wearing the suit. However, within three months of not wearing the suit, as part of the experiment, she began losing weight again, and started regaining a distorted body image.
    She then stole the suit and left Germany. Hopefully, the suit is again helping her gain weight and restoring her brain to proper functioning. The scientific data is incomplete on this therapy, at least partially due to the young woman taking off with the suit. But, the only downside risk to trying this experiment for yourself, your daughter, your student, your friend, or who ever, is the cost of the wetsuit. And wetsuits are now being made in stylish fashion. Try it with or without a hood. Try it wearing short versions and with ones that go down to the ankle. See if it works for you. You can tell your doctor you are giving it a try. You don’t have to wait for him to suggest it.
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