I just finished watching the HBO documentary Thin. It was a really well done film about a group of women in inpatient treatment for severe eating disorders. Throughout the movie, individual and group therapy is portrayed, as well as the women's personal struggles with eating and living a restricted lifestyle for the sake of recovery.
This movie should not be watched for happy endings. Of the women most closely followed, all seemed to return to lives dominated by eating disorders once they left treatment. Many women were discharged before they felt ready because their insurance would no longer cover them; this is an all too common issue in all therapy today. Suicide attempts before and following treatment are all too prevalent. Sadly, one of the women who was discharged due to a combination of insurance issues and not following treatment rules was recently found dead, likely as a result of suicide.
I read a ton of research and sometimes worry that I get too detached from people by turning them into statistics. To some extent, I feel this is necessary in studying high risk populations. However, I like watching things like this from time to time to remind myself just how real these people are. This movie brought tears to my eyes: this is a struggle for millions of people and 10% of those with anorexia will die from it. Even with teams of therapists, nurses, nutritionists, and group support, these women still continue to restrict and purge.
Clearly more needs to be done, and I think a large part of it rests with insurance. Many of the women seem to be doing much better while in treatment, but are suddenly thrust out with virtually no transitional services when they cannot pay any longer. Living healthfully in a residential facility is not sufficient. People need help learning how to function in their own worlds while maintaining a healthy weight. Transition and outpatient services are necessary for that, but realistically few people can afford to receive them. People's lives are at stake, and insurance companies really need to step up to the plate. Chances are good, paying for the therapy will be much cheaper than paying for numerous hospital visits as one's body stops functioning from malnutrition.