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Ask the Mental Health Expert Archives 2001-2004

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Chronic Eating Disorder

Q. My 23-year-old daughter has a 8+ year history of anorexia with bulemic tendencies. She has been in inpatient treatment centers across the country 5 times and is currently in need of further treatment. Her compliance in an inpatient setting is never a problem.

I believe that relatively short periods of treatment allowed by insurance providers, as well as her lack of continued follow-up of aftercare, may be to blame for her continued relapses. Is there any current research that you are aware of for eating disorders (ED) that might be of value for someone with a chronic ED that may include funding once insurance steps out? Are there any current publications that you might know of comparing treatment modalities and successful long term abstinence in ED amongst the well known treatment centers?

A. This sounds like a very frustrating situation for both you and your daughter. As I'm sure you are aware, many of us in the health care professions believe the current system of third-party "payers" is a disaster for the patient, particularly for many with chronic psychiatric disorders. So, I have no simple solution to your problem. Certainly, for many individuals with eating disorders, follow-up care as an outpatient is probably critical in maintaining the gains of the inpatient unit. You may want to check out the Alfred I. duPont Hospital for Children, even though your daughter may be too old to qualify for child services. This hospital has a Financial Services Program available to families who request and qualify for assistance. You can call them at (302) 651-4228. Families with special financial needs may be eligible for financial assistance to cover all or part of the services received at duPont Hospital for Children. They might be able to point you toward resources in your area, for which your daughter may qualify (see http://www.nemours.org/no/aidhc/insurance.html). You may also want to look into these resource books: Surviving an Eating Disorder: Perspectives and Strategies for Family and Friends by Michelle Siegel, PhD, and Margot Weinshel, PhD, Harper Collins Publishers, Toronto, Canada, Rev ed. 1997 Gürze 2001 Eating Disorders Resource Catalogue, Gürze Books, Carlsbad, California, 800-756-7533 I am not aware of any publications that compare treatment modalities among treatment centers. However, the Gurze text may be of some help. You may also get some guidance from the National Association of Anorexia Nervosa and Related Disorders PO Box 7, Highland Park IL 60035 (Hotline: 847-831-3438). Finally, Dr. Katherine Halmi, Dept. of Psychiatry, Cornell Medical Center, White Plains NY, is a world-renowned authority on the treatment of eating disorders, and has one of the most active treatment programs in the country—perhaps writing to her for some further suggestions would be useful. I do hope you find some "long-lasting" help for your daughter.

Other Resources:

June 2003

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