I was on Facebook today and once again found an advertisement that has pissed me off from day one. It was for Denver ACUTE eating disorder program, it states they take the sickest of the sickest. To meet the criteria for "sickest" one must be under 70% of their ideal body weight. I have been working my recovery for almost four years, but after reading the ad and looking at the website I began to think what someone struggling with their ED might think when they see the way the site is worded.
Almost every person I know who has faced an eating disorder or is still struggling has used the phrase "I'm not sick enough to go to treatment" which then turns to "I'm not thin enough for help". In my opinion ACUTE perpetuates those thoughts...it is right there in bold print that they admit under seventy percent of IBW. It translates to someone with ED brain that they are too fat for help, which is untrue. You don't have to be a certain number on the scale to be very sick people die at all weights...underweight,overweight,and normal weights. Bulimics can often be at a stable weight while in serious trouble medically. They can die of stomach rupture, electrolyte imbalances, heart attack, and even choking...all the while looking "fine".
I emailed the intake director of ACUTE asking about the program. To prove my point I left out that I was currently in recovery and told her I was really struggling with my eating disorder and to complicate things I had a disease that has made me dependent on a feeding tube and IV line to survive and every residential treatment program told me I was too medically compromised to be there. I said I couldn't keep my ED behaviors under control and it was really compromising my health. And, I finished by saying I wasn't under seventy percent of IBW. She replied the next day and said she was terribly sorry to hear about my situation and admittance to ACUTE was a case by case basis and she would gladly talk to me, but since my wt was still in its range they would need to recommend me to a different place or hospital. If someone would have said that to me while I was actively in my disorder I would have gone insane, all day long I would obsess over the numbers while ignoring my failing body. I would have been repeating the same phrases from above. Luckily I am in recovery, but what about those who aren't? Knowing the competitive dynamic of ED patients using the phrase "we take the sickest of the sickest" is practically a friggin challenge and to put it on Facebook makes it that much worse.
All I ever heard about during my eating disorder was that it isn't about the numbers, but yet it seems like that is what everyone focuses on. Yes, nutrition is the first step in getting a person out of brain lock but even people overweight can be malnourished. By focusing on simply the numbers you can't possibly get to the core of the disease. I know so many people who are severely ill and trapped in their eating disorder that can't get help because their insurance company says they aren't at a low enough weight to be in the hospital or treatment center. My first treatment center as a teenager started getting pressured by insurance when I restored to eighty five percent IBW even though I was still actively using behaviors and was constantly losing privileges because I was too stuck in my ED to control myself. I ended up stepping down to day treatment where within the first two weekends at home I had gotten my wt in trouble along with everything else and when they tried to put me back in residential insurance said that by their numbers and their doctor who had never met me I was well into recovery and could be discharged from their program. That was the beginning of a very long road of hospitalizations, treatment programs, ER visits, and losing pretty much everything and everyone I loved because I just couldn't find space for anyone except the anorexia.
I was luckier than most because I had a doctor who was devoted to his patients, who kept encouraging and pushing when it seemed like a lost cause, he went above and beyond to help his patients and I owe him my life. There are so many people out there struggling today who can't find help, they feel they aren't sick enough therefore don't deserve it or they are told they aren't sick enough by insurance companies and sometimes even doctors. I firmly believe if I would have been kept in treatment as a teenager rather than booted after two months because of insurance I might not have spent my adolescence and early twenties trapped in this awful disorder destroying my body in the process. I did permanent damage to my body because of the years I waged war on it, and I'm lucky compared to others. I came through the war wounded others lose their lives because they couldn't get the help they needed.
We have been fighting for a long time to get the diagnosis criteria changed, taking the weight out of the equation. Yes, they have a diagnosis for people who don't fit into either the anorexic or bulimic category and it is called eating disorder not otherwise specified aka EDNOS.Once again, another way to tell someone they aren't sick enough or worthy enough for help, which with an EDNOS diagnosis is pretty tough to get. Sure they will pay for outpatient therapy, which is very helpful in some cases especially caught early, but in a lot of cases the person's behaviors are out of control and they need that structured environment and extra support to make a change. A bulimic who binges and purges two times a week wouldn't fit into the diagnosis of bulimia because they don't B/P three times a week or more. Can we not see that someone eating thousands of calories in one sitting and then throwing them all up even once a week is a big problem and extremely dangerous. The fact is your body doesn't care what the papers say or what number is on the scale, your heart can give out at any moment, your stomach could rupture after a week of purging and you die with your head in the toilet all because of some BS criteria.
I've been under weight and at a stable weight, and to be honest some of my most scary health issues happened at a stable weight. We have to fight for this to change, so many lives are lost because they don't fit in some perfect little box that the treatment centers and insurance companies must have. If you are struggling, please don't let the lies in that you aren't worthy of help, your eating disorder wants you to think that because if you think you are worthless and failing then you won't fight back and take control of your own mind. You have the right to get help, don't give up and keep calling the insurance companies, there are programs that will help you in fighting for treatment coverage, and if it all feels too much ask for help. Believe me, I know asking for help is one of the hardest things to do because you are admitting you aren't ok. Please understand the strain you are putting on your body and the longer you go without help the worse it gets. Screw the numbers and focus on you because you deserve it. When you are stuck inside your ED you aren't living rather you simply exist as a host to an awful parasite and we are all better than that, we deserve to live a life that doesn't revolve around calories, scales, purging, and restricting. Don't give up the fight!
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