Food for Thought on Eating Disorders

Research from the Agency for Healthcare Research and Quality has found that following a steady increase in the number of hospitalizations for eating disorders from 1999 to 2007, the number of individuals checking into hospitals with these principal diagnoses has fallen by 23 percent from 2007 to 2009, the latest year for which numbers are available. Eating disorders have the highest mortality rate of any psychiatric disorder, with anorexia specifically being the leading cause of mortality in women between the ages of 15 and 24. During this time period, the severity of reported eating disorders decreased, as well.

However, patients found to have eating disorders were often hospitalized for other presenting conditions, such as depression, fluid or electrolyte disorders, schizophrenia, or alcohol-related issues. Statistics showed that although 90 percent of those suffering from eating disorders were female, eating disorders in men increased 53 percent since 2007.

In light of the recent decrease in eating disorders, from 1999 to 2009, hospitalizations skyrocketed 93 percent for the disorder pica. Pica is usually diagnosed in women and children and causes them to eat inedible materials like clay, dirt, chalk, or feces. During the 10-year period, the number of hospitalizations for patients with pica increased from 964 to 1,862.

Why do you think the number of eating disorders in general has gone down while the number of individuals diagnosed with pica has increased?

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One Response

  1. I don’t think it’s clear at all based upon a reduced number of hospitalizations that the number of people suffering from eating disorders has gone down. Insurance companies have made a national pasttime out of making it nearly impossible to get patients admitted to the hospital. I have no problem imagining that insurance refusal to pay and therefore hospitals’ inability to admit could account for this change in the numbers, which essentially could merely signify that insurance companies have gotten more effective at refusing to pay for hospitalization for the LEAST SICK 23% of the cases. Those folks at the less severe end of the range of people who would have been hospitalized in 2007 possibly were no longer getting authorized for payment for inpatient stays in 2009. Clinicians deal with this issue all the time. Think about it. Eventually a patient will have to be at death’s door to get payment for an inpatient program/psych admission, and nationally respected expert ED treatment centers are already talking about expecting to eventualy have to completely cease inpatient treatment due to insurance pressures. To get an accurate reading of the rate of ED’s and whether they are changing, one needs to do broader sampling in community based studies. Rates of hospitalization are not the proper indicator for prevalence.

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