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Into thin air
As eating disorders surge, victims and their families struggle to get these illnesses recognized — and to pay for treatment
BY DEIRDRE FULTON

And sometimes I really want to get better. I really do. But most times I just want to hide away in all the counted calories and miles run. I feel like all I know how to do is push harder and harder, to abuse myself with guilt and shame and standards. To rage at the only body I’m ever gonna have.

— The Mind/Body Dialogues, a play by Jennifer Campbell and Jessica Cunningham, of the Massachusetts Eating Disorder Association (MEDA)

THIS FALL, Glenna McPartland will turn 18. She’ll soon graduate from high school, apply to Berklee College of Music, and take the next steps toward her future. But while she tackles these typical teenage endeavors, Glenna must also learn to navigate a convoluted health-insurance system, to assess her own ability to live outside of an institutional environment, and to control the eating disorder that has consumed almost her entire adolescence.

Glenna, who grew up in Canton, has been in and out of recovery homes, treatment facilities, and therapeutic schools since she was 12 years old, grappling with a near-fatal case of anorexia nervosa (starving) made worse by occasional bouts of bulimia nervosa (binging and purging). She’s been living in Arlington’s Germaine Lawrence treatment facility, a residential home for girls with emotional problems, since December. Gradually, she’s learning to accept more freedom without using it toward destructive ends. She’s started working part-time at the local library, and she’s permitted to take an art class outside of the school.

These are significant steps for a girl whose repressed memories of a childhood sexual trauma began plaguing her in fifth grade; whose use of the anti-anxiety drug Paxil to help relieve those memories caused her to gain more than 40 pounds right before she started middle school; and whose worsening food-related behavior — an effort to lose that extra weight — through her early teenage years had the effect of making her thinner and thinner.

And also, strangely, more popular. "It was kind of eerie," Glenna says of the admiration she garnered from peers when she dropped weight. "It kind of reinforced what I was doing." She continued severely restricting her diet, throwing up after eating, and living in a world dictated by her body’s relationship with food.

Glenna was first hospitalized for anorexia at the beginning of eighth grade. Her mother, Christine Meimarides, recalls days that Glenna spent "surviving on a cup of soup and a couple popsicles." Glenna spent four days at Children’s Hospital and then started a day program at the Boston Center, which treats acute eating disorders. Since 2000, she’s been in and out of multiple treatment programs, both inpatient and outpatient. She never went back to public school. Today, Glenna and Meimarides talk frankly about their struggles through myriad treatments, therapies, medications, relapses, and what Meimarides calls the "two voices." "There was my daughter, and then there was the eating-disorder voice," she says, recalling extreme binges, followed by purging and not eating. "I was just so helpless."

The family’s already difficult situation was exacerbated by restrictive state insurance laws that provide little help in paying for the horrendously expensive eating-disorder treatments. Meimarides estimates that she’s spent tens of thousands of dollars on nutritionists, therapists, specialists, and alternative housing and schooling since 2000. As Glenna prepares to leave Germaine Lawrence (she expects to graduate in September, only a few months later than she would have anyway) and assume some responsibility for her own care, she’s discovering that despite her arduous fight with this destructive disorder — which she is tenuously winning — she might not get the assistance she needs.

That’s why health advocates, eating-disorder experts, families like Glenna’s, and State Representative Kay Khan gathered Wednesday to lobby for better insurance coverage for eating-disorder sufferers. People like Glenna need much better weapons.

Ever been to the supermarket and feel like everyone is watching to see what you put in your carriage? As they walk by you in the condiment aisle, quickly sneaking a glance to see what you are buying. Judging you by the contents in your shopping cart.

— The Mind/Body Dialogues

UNTIL FIVE years ago, in Massachusetts, mental-health disorders such as depression, obsessive-compulsive disorder (OCD), and schizophrenia were not afforded the same insurance benefits as physical ailments. Recognizing the inequity, the state legislature, in 2000, passed the Mental Health Parity Law, whereby "biologically based" mental-health disorders would be eligible for coverage "on par" with that of physical illnesses.

However, eating disorders were left off the biological-basis list, leaving many sufferers struggling to pay steep bills for various treatments. It’s true that patients can appeal to the state’s Department of Mental Health (DMH) — which helps regulate mental-health-insurance benefits — to get their treatment covered. But such requests must be made on a treatment-by-treatment basis, leaving patients with uneven and unstable therapeutic programs.

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Issue Date: March 11 - 17, 2005
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