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The Impact of Eating Disorders on Native-Americans Revealed by New Study
Scientists in Connecticut have carried out one of the first psychological studies into eating disorders in Native American (NA) populations. The research, published in The International Journal of Eating Disorders, provides new insights into the extent to which Native American populations experience eating disorders, revealing that women are more likely to report behavioral symptoms then men, while challenging views that NA men and ethnically white men will experience different psychological symptoms.
The team, led by Professor Ruth Striegel-Moore from Wesleyan University in Connecticut, studied data taken from the National Longitudinal Study of Adolescent Health for over 10,000 men and women with a average age of 22. Of these, 236 women and 253 men were either Native American or Inuit.
Research into eating disorders in Native Americans has lagged behind research of other mental disorders, leaving many unanswered basic questions about prevalence in major demographic groups of populations indigenous to the US, including Native American, Native Hawaiian, or Alaskan Natives.
"Little is known about eating disorder symptoms in Native American populations for several reasons," said Striegel-Moore. "Even though the U.S. government recognizes over 500 NA tribes one of the biggest research challenges is to find an adequate sample size. Our aim was to examine prevalence of behavioral symptoms of eating disorders in a public access data base to get an initial estimate of the extent to which young NA adults experience such problems."
The team confirmed the theory that NA women were more likely than NA men to report behavioral symptoms of eating disorders, revealing that regardless of race, ethnicity or nationality, research consistently shows that women are more vulnerable to developing disordered eating behaviors or full syndrome eating disorders than men.
The team also found a parallel between NA women and ethnically white women when considering the prevalence of binge eating, purging and "ever having been diagnosed with an eating disorder."
"This commonality between NA and white women refutes the myth that eating disorders are problems that only affect white girls and women" said Striegel-Moore.
Finally the team found that there was no significant difference between NA men and ethnically white men, again demonstrating how the affects of eating disorders are not restricted by racial groups.
While this research was one of the first into the psychological effect of eating disorders in NA populations it can now lead to further, longer studies. The team's findings were based on 7 days which is shorter than similar studies conducted over 28 days. Further research will also be conducted into the attitudinal symptoms of eating disorders, compared to the behavioral symptoms being discussed in this paper.
"This research provides us with a first glimpse into the extent to which young adult NA populations experience behavioral symptoms of eating disorders," concluded Striegel-Moore. "In the eating disorder field this type of epidemiological study has lagged behind other research, but now we have a foundation to study the distribution of eating disorders and identify psychological risk factors in Native American populations."
Choosing the Right level of Care for Patients with Eating Disorders
Eating disorders are a progressive disease they start out as a mild problem that gradually develops into major medical issues. When diagnosis of an eating disorder is given the patient can be at any stage of the disease progression. Treatment for eating disorder goes hand in hand with the disease progression; there are five general levels of care for eating disorders, Outpatient, Intensive Outpatient, partial hospitalization, residential and inpatient hospitalization.
The main criteria for determining the level of treatment is the patient’s medical condition. For insurance those that reach the point of being at risk of losing their life if they do not receive immediate hospitalization. If a patient shows any signs of acute medical distress, they may need emergency inpatient care until they are medically stable. Doctors use certain criteria when determining level of treatment for those that are medically stable. The most important, weight it is the major factor in determining level of care. If a patient has lost a lot of weight due to refusing to eat then inpatient treatment might be the right decisions.
A critical factor or determining if inpatient treatment is needed is whether the patient is suicidal. The doctor will assess if the patient is at risk and if they need an inpatient facility with psychiatric monitoring. Other coexisting factors like psychiatric disorders or substance abuse may be contributing problems and doctors may recommend inpatient treatment for recovery from the eating disorder as well as the coexisting conditions.
Less intensive treatment options are available as well for those clients who do not show acute medical distress or mental issues. With motivation and support patients can succeed in recovery at outpatient or partial hospitalization facilities.
Another good way to determine the appropriate level of care is whether the patient is dealing with too much stress at home. Stressful living environments may trigger episodes of unhealthy eating behaviors. With this in mind, a patient might need inpatient or residential treatment for at least a short period of time.
All of these discussed in this article can determine proper level of care for treatment from eating disorder. You doctor can aide in making decisions for you depending on your medical condition.
Eating Disorders and Insurance
According to the National Institute of Mental Health, up to 10 million people in the United States suffer from eating disorders. Even with this being such a tragic issue there is health insurance companies that refuse to cover treatment of this disease.
Those agencies that do provide coverage usually will only provide partial coverage. The main reason to this problem s the fact that there is no legislation in place at the federal level to help classify eating disorders as a medical condition requiring treatment. Instead eating disorders are classified as “behavioral choices”, which gets insurance agencies off the hook in most states. Certain states have legislation in place, but it is not standardized and patients often have to fight the insurance companies for coverage. Here are things that you can do to get insurance involved in the case.
Most insurance companies will cover the costs associated with treating the physical symptoms related to the disease. For example, they will cover costs associated with body breaking down after a prolonged battle with bulimia or anorexia nervosa, everything from heart and kidney failure to high blood pressure and esophageal damage. However, they will not provide coverage to treat the underlying disorders that lead to the eating disorder and thus to the physical symptoms. The sad irony is that the physical symptoms often get to the point where the patient needs acute, emergency medical intervention that the insurance covers but at a greater cost than the mental health aspect would to prevent it from getting to that point.
Treatment facilities often can work with your insurance company to determine coverage. If your insurance refuses to cover the treatment you have the options to appeal the decision. In addition insurance companies will likely require you use a facility within a certain geographical boundary, insurance may also refuse to cover treatment if facility is out of state.
Remember; just because your insurance company approves you or a loved one into a treatment facility do not expect the battle to be over. Insurance companies will work hard to discharge patients as soon as possible; they will go after the facility daily and will request the patient to be discharges even with minimal progress. It is important to be a strong advocate in order to help the patient, even yourself, get through this process.
Eating Disorders and the Holidays
The holiday season can be hard for those who struggle with anorexia, bulimia or binge eating.
It’s the holiday season, filled with joy, love, laughter, plenty of food and for some fear. Fear of triggering their eating disorder, fear of being caught in their eating disorder or even fear of being watched by close family and friends.
If you are in recovery from an eating disorder this is the time of year to share those special holiday moments and share the happiness and joy with those near and dear. You may need some helpful hints to guide you through this season that is filled with times around the dinner table.
Planning ahead in the season is the most beneficial way to minimize stress and maintain your recovery focus. Your first thought may be towards food, arranging ahead of time for something you are comfortable eating at the holiday gathering. Create a plan for yourself by looking ahead at the environment and your energy, choosing your attendance at gatherings that inspire and fill you with the joy of the season. If you choose to attend an event that has known stressors, plan ahead for an exit strategy and have your support system check in with you throughout the day and even at the event by phone or text.
“Holiday times can be stressful for anybody specifically for those with eating disorders since there is so much emphasis on food.” says Caryn Attianese MA, NCC, LPC, Clinical Director at Rosewood, “We recommend increasing your support system around the stressful times because it is helpful to know that I never have to go through it alone”
Even though the holiday season is focused on feasting and having those great meals, keep in mind to eat only what your body can handle.
“Continue to follow your meal plan if you think your hunger and fullness cues are not strong and reliable. Remember that this holiday is only one eating event and your reliable hunger cues will come back when the stress is lessened,” says Cindy Elms RD, Clinical Nutrition Manager at Rosewood, “Stay strong in your recovery to ensure success and avoid setbacks that may hinder your progress so far. Having a copy of an affirmation that has helped in your recovery may be something you repeat throughout the day to keep you focused and inspired.”
New holiday traditions can be wonderful and meet the needs of the family and also support the person in recovery. Knowing this is a stressful time, plan ahead for time to check in with each other, be willing to be flexible with plans if it seems unmanageable and talk about how the changes affect each of you. This change in relating with each other will have the effect of decreased stress and decreased potential urges to engage in the eating disorder.
“If you do see behaviors that concern you, be specific about how it affects you and offer support using the communication tools you have learned such as the feedback loop” says Attianese. The worst thing to do is avoid the problem, effective communication is essential for you and your loved ones, showing them that you care for their well being will maybe even result in developing trust and confidence. Remember, this is only one holiday season, and each year will be a little different, moving in the direction of greater enjoyment for everyone.
This is the season to be surrounded by our friends and family and surrounded with those we love and support us. Please have a safe and happy holiday season!
Author Box: Rosewood Centers for Eating Disorders is committed to offering a full continuum of care of eating disorder treatment services including, Inpatient, Residential, Partial Hospitalization with residential living, Intensive Outpatient Programs, Outpatient Services and Transitional living. We believe that the longer the patient and Rosewood are engaged in a productive treatment dialog, the greater the chances of success and lifelong recovery. For more information please visit www.rosewoodranch.com or call 1800-845-2211.