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I applaud Stephanie Mencimer for putting the spotlight on the struggle young people face with obesity in our city (“Hiding in Plain Sight,” 6/16). I was disappointed, however, that Mencimer portrayed anorexia nervosa as a white middle-class problem that gets more medical attention than other forms of eating disorders. Eating disorders of all kinds—anorexia and bulimia nervosa, binge eating, and reverse anorexia nervosa, to list a few—do not get the medical, societal, or media attention they deserve.
More than 8 million people—who have been identified—suffer from eating disorders. Those numbers would rise significantly if medical tests were culturally and gender-sensitive. People of color, men, and gay, lesbian, bisexual, or transgendered men and women are often overlooked when it comes to diagnosing eating disorders.
Mencimer proved this point when she quoted a physician who said, “They thought they looked good. They don’t see [obesity] as a beauty stigma.” I wonder if the young people’s answers were skewed by how the question was asked along with the pressure they felt to fit into the stereotype that black men and women are heavier than white people. When doctors asked me, I thought I look good at 78 pounds, 5-foot-5, but my opinion was also a bit skewed by the eating disorder!
An article written by a young person in the Kansas City Star highlighted the rise of eating disorders in minority groups and the fact they often go undiagnosed because of the lack of education and awareness of doctors and families. This goes for all eating disorders, not simply obesity.
Fary Cachelin, a psychology professor at California State University, who has researched the issue in Los Angeles communities, stated, “The rates [of minorities with eating disorders] are almost the same as those for white women.” In a survey by Essence, a magazine aimed at African-American females, 53.5 percent of respondents were identified as at risk for an eating disorder.
Mencimer continued misconceptions with the following statement: “If Shala had been admitted to the hospital as a middle-class white teen wasting away from anorexia rather than a low-income African-American suffering from obesity-related complications, her story would likely have turned out very differently. Once she was diagnosed, her insurance company would probably have paid for individual and group therapy. She would have gotten regular nutritional counseling and doctor visits, or even been hospitalized until her weight stabilized.”
My family’s insurance did not cover the needed treatment for anorexia nervosa; nor did it cover the cost of the hospital’s “stabilizing” my weight. That all came out of my parents’ already drained finances. In fact, my credit is shot because of the medical bills. Furthermore, as is the case for all eating disorders, treatment is much more than “stabilizing” the weight.
The problem with getting eating disorders covered, according to the “Health Insurance Answer Book,” is that group health insurance plans generally limit coverage for mental illnesses, because a lack of understanding and agreement among health-care professionals about the nature and causes of mental illnesses. The insurance companies will not cover the treatment for eating disorders because there is not enough research and evidence to make them “diseases.” A more difficult challenge, noted by Mencimer, is faced by low-income families who cannot afford the insurance in the first place.
In my experience, people struggling with obesity have a far better chance of getting the physical—not mental—help they need, because obesity is an acceptable medical problem. However, anorexia and bulimia nervosa are automatically labeled mental illnesses. Regardless of the eating disorder, the medical treatment is insufficient.
Anorexia and bulimia nervosa do not get more attention than obesity or binge eating, nor are there “eating-disorder clinics focused on problems like anorexia and bulimia abound,” as Mencimer would have readers believe. In fact, a quick Internet search on msn.com proves this point. Anorexia got 53 matches; bulimia, 57; obesity, 173.
Furthermore, the American Obesity Association, one of the leading obesity advocacy groups, is very close to winning a case with Internal Revenue Service that would make treatment of obesity a medical expense tax deduction. The case does not include anorexia nor bulimia nervosa; nor do any pending or past cases.
I applaud Mencimer for pointing out that “[s]ome D.C. neighborhoods don’t even have supermarkets, much less a decent, affordable supply of fresh produce.” There is a solution to this problem so people of all income can have access to healthy food. John Robbins, author of Diet for a New America, believes that if our government stopped giving tax subsidies to cattle companies so that our hamburger is cheaper at the grocery store and subsidize vegetables instead, we could have healthy options affordable for all families.
The underlying message that Mencimer delivers is that there are not enough resources for young people dealing with an eating disorder. I couldn’t agree more. I have started an organization called Wearing Thin, which mobilizes young people to eliminate eating disorders through direct-action campaigns, lobbying Congress and health insurance companies for more research and coverage, and educating other young people in their community about the many layers of eating disorders. I hope the Washington City Paper publishes more articles that do not diminish the importance and seriousness of all eating disorders. Together we can raise the consciousness of our society, to eliminate eating disorders.
Other resources include www.something-fishy.org and www.obesity.org.