User Tag List

+ Reply to Thread
Results 1 to 10 of 10

Thread: Gaps in care for those with eating disorders

  1. #1

    tPF Moderator
    Points: 152,038, Level: 93
    Level completed: 48%, Points required for next Level: 2,012
    Overall activity: 1.0%
    Achievements:
    SocialTagger First ClassCreated Album picturesYour first GroupRecommendation First Class50000 Experience PointsVeteran
    Adelaide's Avatar tPF Moderator
    Karma
    341325
    Join Date
    Sep 2012
    Location
    N. Pole and VA
    Posts
    30,757
    Points
    152,038
    Level
    93
    Thanks Given
    4,025
    Thanked 18,449x in 11,739 Posts
    Mentioned
    1723 Post(s)
    Tagged
    3 Thread(s)

    Gaps in care for those with eating disorders

    An anorexic mother’s death could have been prevented if the NHS had not allowed her to “fall through the net,” a coroner warned yesterday, after hearing that she was left “entirely unmonitored” for several months.
    Amanda Bowles, 45, was failed by the doctors before she died at her home in Cambridge, her inquest heard.

    Sean Horstead, assistant coroner for Cambridgeshire and Peterborough, described aspects of Ms Bowles’s care as “disappointing” and “surprising”, noting a "conspicuous lack of safeguarding measures."

    He warned of widespread “structural failings” in the monitoring of eating disorder patients which extend across the UK.
    Anorexia mother's death might have been avoided, coroner warns, in damning assessment of her care - The Telegraph (UK)

    So, this is a case that is a hot topic in the UK right now but this is actually a massive issue in the United States. Eating disorders tend to reqiure lengthy residential treatment and often multiple times which may not be covered by private or medicaid. Eating disorders are an extremely complex disorders that often involve personality traits and those issues take a long time to work through. Residential treatment facilities in the US in general tend to be small in numbers and capacity which is part of why you end up seeing prisons used as de facto mental health institutions.

    Nonetheless, I cannot imagine having a family member or friend who died because of a lack of access to care. Residential facilities are needed and there is a major gap in the UK, Canada and the United States.
    FYIWDWYTM

  2. The Following User Says Thank You to Adelaide For This Useful Post:

    donttread (09-20-2020)

  3. #2
    Points: 16,561, Level: 31
    Level completed: 12%, Points required for next Level: 889
    Overall activity: 0.1%
    Achievements:
    Social10000 Experience PointsVeteran
    US Conservative's Avatar Senior Member
    Karma
    5455
    Join Date
    Aug 2020
    Posts
    4,242
    Points
    16,561
    Level
    31
    Thanks Given
    6,760
    Thanked 5,445x in 2,856 Posts
    Mentioned
    6 Post(s)
    Tagged
    0 Thread(s)
    Anorexia and Bulimia are terrible but dwarfed by obesity in every sense.

  4. #3
    Original Ranter
    Points: 859,042, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 90.0%
    Achievements:
    SocialCreated Album picturesOverdrive50000 Experience PointsVeteran
    Awards:
    Posting Award
    Peter1469's Avatar Advisor
    Karma
    496573
    Join Date
    Jun 2011
    Location
    NOVA
    Posts
    241,693
    Points
    859,042
    Level
    100
    Thanks Given
    153,218
    Thanked 147,583x in 94,415 Posts
    Mentioned
    2552 Post(s)
    Tagged
    0 Thread(s)
    The British NHS isn't set up for extensive chronic one on one long term care. But for something as specific as eating disorders, the best the US does is psychiatrists and psychologists unless you have the money for residential treatment. I am not sure that insurance covers that in the US and those facilities that I have heard about appear to cater to the wealthy.
    ΜOΛΩΝ ΛΑΒΕ


  5. #4
    Points: 123,366, Level: 85
    Level completed: 17%, Points required for next Level: 2,684
    Overall activity: 60.0%
    Achievements:
    50000 Experience PointsSocialVeteran
    FindersKeepers's Avatar Senior Member
    Karma
    173984
    Join Date
    Jan 2016
    Posts
    35,702
    Points
    123,366
    Level
    85
    Thanks Given
    25,436
    Thanked 26,625x in 16,267 Posts
    Mentioned
    271 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Adelaide View Post
    Anorexia mother's death might have been avoided, coroner warns, in damning assessment of her care - The Telegraph (UK)

    So, this is a case that is a hot topic in the UK right now but this is actually a massive issue in the United States. Eating disorders tend to reqiure lengthy residential treatment and often multiple times which may not be covered by private or medicaid. Eating disorders are an extremely complex disorders that often involve personality traits and those issues take a long time to work through. Residential treatment facilities in the US in general tend to be small in numbers and capacity which is part of why you end up seeing prisons used as de facto mental health institutions.

    Nonetheless, I cannot imagine having a family member or friend who died because of a lack of access to care. Residential facilities are needed and there is a major gap in the UK, Canada and the United States.


    Starving oneself is odd, and occasionally I've seen a very, VERY thin person out and about and I've wondered if they were anorexic.

    But, at the same time, I'm not sure society is responsible for taking on the economic burden of the long-term care an anorexic needs to stay alive.

    I don't think most anorexics reach the state where they actually starve themselves to death although they may struggle for years--or for life--with being able to eat in a healthy manner.

    The OP link is behind a firewall but it would have been interesting to read the actual case.
    ""A government which robs Peter to pay Paul can always depend on the support of Paul" ~George Bernard Shaw

  6. #5
    Original Ranter
    Points: 859,042, Level: 100
    Level completed: 0%, Points required for next Level: 0
    Overall activity: 90.0%
    Achievements:
    SocialCreated Album picturesOverdrive50000 Experience PointsVeteran
    Awards:
    Posting Award
    Peter1469's Avatar Advisor
    Karma
    496573
    Join Date
    Jun 2011
    Location
    NOVA
    Posts
    241,693
    Points
    859,042
    Level
    100
    Thanks Given
    153,218
    Thanked 147,583x in 94,415 Posts
    Mentioned
    2552 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by FindersKeepers View Post
    Starving oneself is odd, and occasionally I've seen a very, VERY thin person out and about and I've wondered if they were anorexic.

    But, at the same time, I'm not sure society is responsible for taking on the economic burden of the long-term care an anorexic needs to stay alive.

    I don't think most anorexics reach the state where they actually starve themselves to death although they may struggle for years--or for life--with being able to eat in a healthy manner.

    The OP link is behind a firewall but it would have been interesting to read the actual case.
    Most browsers have a Private Window option, although it may be called something else depending on what browser you are using. If you open a Private Window and go to the website there, you should be able to get past most firewalls.
    ΜOΛΩΝ ΛΑΒΕ


  7. The Following User Says Thank You to Peter1469 For This Useful Post:

    FindersKeepers (09-19-2020)

  8. #6

    tPF Moderator
    Points: 152,038, Level: 93
    Level completed: 48%, Points required for next Level: 2,012
    Overall activity: 1.0%
    Achievements:
    SocialTagger First ClassCreated Album picturesYour first GroupRecommendation First Class50000 Experience PointsVeteran
    Adelaide's Avatar tPF Moderator
    Karma
    341325
    Join Date
    Sep 2012
    Location
    N. Pole and VA
    Posts
    30,757
    Points
    152,038
    Level
    93
    Thanks Given
    4,025
    Thanked 18,449x in 11,739 Posts
    Mentioned
    1723 Post(s)
    Tagged
    3 Thread(s)
    Quote Originally Posted by Peter1469 View Post
    The British NHS isn't set up for extensive chronic one on one long term care. But for something as specific as eating disorders, the best the US does is psychiatrists and psychologists unless you have the money for residential treatment. I am not sure that insurance covers that in the US and those facilities that I have heard about appear to cater to the wealthy.
    Eating disorders require inpatient treatment pretty often, and no one can really afford it (except people who are wealthy). Insurance will often cut off people after about 30 days, even if the insurance is very good. The inpatient facilities that are covered by insurance or Medicaid tend to be less than ideal, and unfortunately, eating disorders require highly specialized care across a number of disciplines that you won't find in a poorly run, cheap facility.
    FYIWDWYTM

  9. #7

    tPF Moderator
    Points: 74,315, Level: 66
    Level completed: 51%, Points required for next Level: 1,135
    Overall activity: 14.0%
    Achievements:
    50000 Experience PointsVeteran
    Cletus's Avatar tPF Moderator
    Karma
    195694
    Join Date
    Jun 2015
    Posts
    32,312
    Points
    74,315
    Level
    66
    Thanks Given
    3,680
    Thanked 27,379x in 15,848 Posts
    Mentioned
    412 Post(s)
    Tagged
    0 Thread(s)
    I don't see how this is the responsibility of Society to fix.
    “Extremism in defense of liberty is no vice. Moderation in pursuit of justice is no virtue.” - Barry Goldwater

  10. #8
    Points: 172,955, Level: 98
    Level completed: 83%, Points required for next Level: 695
    Overall activity: 48.0%
    Achievements:
    50000 Experience PointsSocialVeteran
    donttread's Avatar Senior Member
    Karma
    88551
    Join Date
    Nov 2013
    Posts
    51,913
    Points
    172,955
    Level
    98
    Thanks Given
    18,300
    Thanked 20,519x in 14,779 Posts
    Mentioned
    318 Post(s)
    Tagged
    0 Thread(s)
    Quote Originally Posted by Adelaide View Post
    Anorexia mother's death might have been avoided, coroner warns, in damning assessment of her care - The Telegraph (UK)

    So, this is a case that is a hot topic in the UK right now but this is actually a massive issue in the United States. Eating disorders tend to reqiure lengthy residential treatment and often multiple times which may not be covered by private or medicaid. Eating disorders are an extremely complex disorders that often involve personality traits and those issues take a long time to work through. Residential treatment facilities in the US in general tend to be small in numbers and capacity which is part of why you end up seeing prisons used as de facto mental health institutions.

    Nonetheless, I cannot imagine having a family member or friend who died because of a lack of access to care. Residential facilities are needed and there is a major gap in the UK, Canada and the United States.

    Sad but true that access to care for some disorders even including Opiate addiction can be difficult. I'm not certain what they meant by unmonitored? That does not necessarily mean she wanted care and we cannot force people into treatment in most cases. Many will die regardless of what is done but we should not stop trying.


    If by "personality traits" you mean personaslity disorders and especially borderline then the odds just went down.

  11. #9
    Points: 47,380, Level: 53
    Level completed: 19%, Points required for next Level: 1,470
    Overall activity: 0.2%
    Achievements:
    SocialVeteranTagger First Class25000 Experience Points
    Perianne's Avatar Senior Member
    Karma
    11366
    Join Date
    May 2013
    Posts
    6,767
    Points
    47,380
    Level
    53
    Thanks Given
    2,360
    Thanked 2,534x in 1,379 Posts
    Mentioned
    41 Post(s)
    Tagged
    0 Thread(s)
    Simple solution to eating disorders: Obesity, eat less. Anorexia, eat more.

    I, too, have an "eating disorder". I often don't eat enough to maintain a healthy weight for myself. My doctor prescribes me a medication that increases my appetite. Last year this time I was about 105 and losing weight. I got the medication and was up to 128 by Christmas. I am now at 116.

  12. The Following User Says Thank You to Perianne For This Useful Post:

    Peter1469 (09-21-2020)

  13. #10

    tPF Moderator
    Points: 152,038, Level: 93
    Level completed: 48%, Points required for next Level: 2,012
    Overall activity: 1.0%
    Achievements:
    SocialTagger First ClassCreated Album picturesYour first GroupRecommendation First Class50000 Experience PointsVeteran
    Adelaide's Avatar tPF Moderator
    Karma
    341325
    Join Date
    Sep 2012
    Location
    N. Pole and VA
    Posts
    30,757
    Points
    152,038
    Level
    93
    Thanks Given
    4,025
    Thanked 18,449x in 11,739 Posts
    Mentioned
    1723 Post(s)
    Tagged
    3 Thread(s)
    Quote Originally Posted by donttread View Post
    Sad but true that access to care for some disorders even including Opiate addiction can be difficult. I'm not certain what they meant by unmonitored? That does not necessarily mean she wanted care and we cannot force people into treatment in most cases. Many will die regardless of what is done but we should not stop trying.


    If by "personality traits," you mean personaslity disorders and especially borderline then the odds just went down.
    Traits, too. There are also ways to measure resistance to treatment and medical care that frequently occur in ED patients. Perfectionism is another trait. Also, post-traumatic stress disorder, obsessive-compulsive disorder, any of the cluster B or C personality disorders, substance use, NSSI, and so on... personality traits, body image issues, identity issues, anxiety, and depression, then a history of abuse/trauma - those seem to be sort of a core set of issues that often arise in ED patients. Interestingly, if you feed and nourish someone with anorexia nervosa, the personality traits viewed as extreme or negatively impacting them will often diminish in severity or disappear.

    The problem with anyone in treatment with substance abuse or eating disorders is that comorbid and co-occurring disorders are abundant. You have to identify the primary diagnosis and establish more complex treatment plans, including medical care like enteral feeds or medical detox. This is expensive, time-consuming, and a lot of insurance companies don't want the hassle. They'll cover a period of residential care, but often not a long enough period to see a remission. Then, they come back repeatedly, and it ends up costing more, anyway (assuming the individual survives).
    FYIWDWYTM

+ Reply to Thread

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts