An interesting article on CNN.com today reports that upwards of 60% of people suffering with an eating disorder do not meet the DSM-IV diagnostic requirements to receive treatment.
These patients may medically need hospitalization, but their insurance companies won't authorize the treatment. If they don't meet the diagnostic criteria for anorexia or bulimia, regardless of their medical status and need for in-patient treatment, they are classified as EDNOS (eating disorder not otherwise specified) and could be denied treatment until they get even sicker.
"It is often the case that admission to an inpatient program for eating disorders is denied because individuals do not meet the full diagnostic criteria," said Michael Strober, professor of psychiatry and director of the eating disorders program at the University of California, Los Angeles Neuropsychiatric Institute and Hospital.
The article points out that insurance companies often mandate releasing patients from in-patient care once they no longer meet the clinical definition of the specific eating disorder. For me this would have been terrible. And the same is true for so many of the people I met in treatment. If they had been released once they got their period, for example, (and thus, no longer met the diagnostic criteria for anorexia) they would have been heading out into the same world where they got sick in the first place. And they would have been entering that world without the necessary tools to properly deal and cope with the issues that led them to their eating disorder.
I am encouraged that the article hinted at upcoming changes for the DSM-V in regards to criteria for diagnosing eating disorders in the future. For example, the absence of menstruation would no longer be necessary for a diagnosis of anorexia. I am also encouraged that Binge Eating looks to be getting it's own diagnostic category rather than being included in the broad scope of EDNOS.
We are still a few years out from the publishing of the new DSM-V (2013), but I hope that physicians, psychiatrists, psychologists and others involved in the treatment of those with eating disorders will do everything that they can to encourage these changes and others to make it easier for those suffering to get the help they need.
And, keep in mind that as a patient, you are always your biggest advocate. Talk to your insurance company. Talk to your physician and other providers. Do everything you can to fight for your treatment. You are worth it!