Characteristics of eating disorders programs and common problems with third-party providers

The increase in recognition and/or incidence of eating disorders in the past decade has been associated with a growth in programs devoted to their treatment. Correspondingly, there has been some suggestion that third-party providers have been resistant to pay for the treatment of eating disorders. In order to characterize eating disorder programs and how frquently, and why, problems in insurance companies occur, we conducted a survey at a national eating disorder meeting. Several inferences can be made from this survey. First, the majority of inpatient treatment was devoted to anorexia nervosa. Such treatment provided specialized care (for example, dietary or bathroom monitoring, presumably for weight restoration) that might be more difficult to provide and more costly in a general treatment facility. Second, the majority of outpatients had normal-weight bulimia. Third, most programs were relatively small. This might suggest that eating disorders programs are, at best, a modest source of revenue and thus more likely to exist because of the service that they rendered. Finally, this study supported impressions that a substantial number of patients terminated treatment prematurely due to limited benefits. To summarize, we feel it is extremely important to address issues of third-party provision for eating disorders. In order to do this we must clarify the extent of psychological and medical morbidity associated with eating disorders so that third-party providers may offer commensurate benefits to patients suffering from these disorders.