The Minnesota Starvation Study, conducted over 70 years ago, provides us with enlightening and important information about the power of starvation on the human body. While the findings of this study are not news to most of us in this field, it is an immediate reminder as to why weight restoration on its own is not the answer. It is a reminder of both the physical and emotional influences that starvation and food deprivation have on the body. It is a reminder of the definitive treatment needed to alleviate both physical and mental symptoms. It is a reminder of the significance of achieving medical stability, as well as the value of allowing a patient adequate time to engage in the intensive therapeutic work of recovery. It is a reminder that although weight restoration is complete, our work is just beginning.
Do you hear that insurance companies??? The work is just beginning.
As insurance lawyers and eating disorder recovery activists, we see insurance claims for eating disorder treatment being denied every single day. Of the many nonsensical reasons and explanations given for why a particular claim has been denied, the one that frustrates me the most is the weight based insurance denial. Essentially, what this means is that the insurance company is denying a claim for treatment based solely on a number: the insureds weight. This number, while it represents movement in the right direction, does not indicate that health and recovery have been restored. It does not indicate that a person has recovered from their eating disorder, and it does not indicate that they are ready to re-enter their lives without careful and vigilant support. Without proper treatment, it is entirely possible for a patient to become weight restored - yet still lack the ability to maintain this weight outside of treatment…resorting to unhealthy (and oftentimes dangerous) behaviors. These particular types of insurance denials set our clients up for something worrisome - something that could end up costing the insurance company more money (and the patient more suffering) in the long run: the revolving door phenomenon. Relapse.
The Minnesota Starvation Study is just as its name implies: researchers manipulated their participants to experience starvation, then recorded the long lasting impacts this had on the brain and body. In 1944, 36 healthy men were put on a semi-starvation diet. In addition to the physical effects of malnutrition, researchers noticed a number of troubling behavioral and psychological effects that coincided with starvation and weight loss. The participants experienced a dramatic preoccupation with food, increased levels of depression/anxiety/anger/irritability, were withdrawn socially, felt less alert, and experienced impaired judgment. In most cases, these changes persisted during the rehabilitation or renourishment phase.
What makes the study so important is that many of the experiences observed in the participants are the same as those experienced by patients with eating disorders. Futhermore, it reinforces what we already understand about eating disorder recovery. First, weight must be restored. Then, proper treatment can begin.
We often see insurance companies deny coverage of eating disorder treatment (or cut treatment short) once weight has been restored. The Minnesota Starvation Study shows just how much work remains after weight restoration. In fact, the journey to recovery is just beginning - and continued and consistent treatment is crucial.