Public Comment

Insurance Coverage Should Be Available for Eating Disorders Not Otherwise Specified

By Natasha Kim
Thursday June 11, 2009 - 07:04:00 PM

In 1996, California mandated that insurance cover anorexia and bulimia, but excluded Eating Disorders Not Otherwise Specified (EDNOS). This policy should change to include EDNOS coverage, as the current information readily available about EDNOS invalidates the original policy’s oversights. 

EDNOS is the psychiatric disorder with the highest mortality rate. The most common EDNOS patient exhibits anorexic and/or bulimic behaviors but gets her period or seems to be of an “average healthy weight.” 

I know the illness well because my best friend has it. 

She sustains the same perfection over her body as she does in her Ivy-League studies. At night you can hear her painful forced vomits; during the day she exercises for at least four hours. She once confided that she thought about food 80 percent of the day and took Benadryl to sleep away the torment. 

She meets all the criteria for anorexia—except she gets menstrual cycles. This one difference classifies her as having EDNOS. It also rejects her from receiving insurance-covered treatment. 

In 1996, Congress may have not considered EDNOS a serious threat due to the relatively low number of Americans suffering from EDNOS and the lack of concrete familiarity with the disorder. However, both of these oversights are now known to be false. Even though the physical signs of EDNOS are not as recognizable as traditional anorexia or bulimia, it is known now that patients suffering from EDNOS face the same fate as anorexic and bulimic people: they die every year, and half meet the criteria for depression. 

In 2008, half of those struggling with eating disorders were diagnosed with EDNOS. According to the Health Education Department’s national survey for college students, the number of people diagnosed with EDNOS has doubled from 8.2 percent in 1995 to 17 percent in 2008. 

People may attribute this increase the entertainment industry’s glorification of unhealthy female body images, ultra-thin fashion models and the surge in eating disorder websites. However, governmental restriction on the media is not a feasible option. There are so many sects of the media that making one sweeping law would be difficult. Additionally, the vastness of the Internet makes it next to impossible to deter someone who seeks information. Courts are also reluctant to allow any exceptions to the First Amendment freedom of speech. 

Results must come through policy change. As you read this, there are EDNOS patients who have found the courage to seek treatment, yet are being denied under an outdated policy created more than ten years ago. This is unacceptable. The difference of one single criterion should not deny such a large group of Americans treatment coverage. EDNOS is non-discriminatory: it affects people of all socioeconomic statuses, races, sexes and education levels, even someone with an ivy league education like my best friend. EDNOS affects such a wide spectrum of Americans that politicians have a duty to advocate on behalf of this steadily rising population. 

It was only in 2008, after a twelve-year struggle led by Ted Kennedy, that the Senate passed a bill mandating wider insurance coverage for mental illness treatment. The fact that it took this long even for a politician who had no fears of losing an election and had a personal connection through his son’s manic depression, testaments to the pervading stigma our American society has towards mental illness. 

We cannot afford to wait this long again for EDNOS patients. Hundreds of lives are at stake. If politicians recognized that it was necessary to insure anorexic and bulimic people, then it is illogical that those who face the same daily torment and possibility of death do not receive the same coverage. 


Natasha Kim is an Albany resident.