by Dr. Christine Peat
On May 7th, 2019, Christine Peat, PhD (NCEED Director), Jean Doak, PhD (NCEED Deputy Director) and Stephanie Zerwas, PhD (NCEED Content Expert) were able to attend the Eating Disorder Coalition’s (EDC) Advocacy Day in Washington, DC. The annual event, now in its 19th year, is an incredible opportunity to connect with other professionals, advocates, and families to educate Congress on eating disorders, their impact, and the importance of policies focused on these conditions.
The focus of this year’s Advocacy Day was on improving access to medical nutrition therapy for those with Medicare—the federally-funded health insurance plan for individuals 65 or older and those younger than 65 who have a disability. Although stereotypes about eating disorders might lead some to believe that the Medicare population does not struggle with these conditions, we know that eating disorders do not discriminate based on age, ability, or any other demographic characteristic.
As you may be aware, the evidence-based treatment of eating disorders is typically a multidisciplinary approach that involves psychology, nutrition, psychiatry, and medicine. Each of these disciplines has a crucial role in providing interventions to those affected by eating disorders. Psychologists, for example, work closely with patients and their families to work on decreasing eating disorder thoughts and behaviors, while primary care providers work to monitor physical health and provide medical stabilization. These multidisciplinary efforts combine to deliver the standard of care for eating disorders, and the majority of insurance companies recognize their importance by providing coverage for each type of service.
Currently, Medicare provides coverage for all components of eating disorder treatment in the outpatient setting EXCEPT medical nutrition therapy. This inequity means that patients covered by Medicare who have eating disorders are often not receiving one of the critically important components of treatment which may limit their ability to achieve full recovery. In other cases, patients may feel their only option is to turn to the internet for information and advice on nutrition which can lead to misinformation and, even worse, an exacerbation of eating disorder symptoms given the pervasiveness of diet culture throughout online media.
Enter, the Nutrition Counseling Aiding Recovery for Eating Disorders (CARE) Act! This brand new piece of legislation was sponsored by Congresswoman Judy Chu of California (a clinical psychologist by training!) just days prior to the 2019 EDC Advocacy Day. The Nutrition CARE Act provides for 13 hours of coverage for the first year of treatment (1 60-minute initial assessment and 24 thirty-minute sessions thereafter) and 4 hours of coverage in subsequent years (8 thirty-minute sessions; and extra hours if needed). Importantly, this proposal is asking for Medicare to provide the same level of coverage currently available for those with diabetes or kidney disease—the ONLY medical conditions eligible for medical nutrition therapy in the outpatient setting under Medicare.
With this background in mind, Drs. Peat, Doak, and Zerwas were able to visit with staffers of North Carolina senators and representatives. During these meetings, they were able to educate the staffers (and, by proxy, their bosses) about how their own constituents are affected by eating disorders, the challenges patients face when they are receiving inadequate care, and how the Nutrition CARE Act would help improve access to the crucial component of medical nutrition therapy. It was a busy day of prep and training in the morning, followed by 5 consecutive meetings with congressional staffers, and a debriefing session which included remarks by Congresswoman Chu herself!
Advocacy Day was certainly an experience that will not soon be forgotten by those who were able to attend. It was incredible to see professionals, patients, families, and advocates come from all across the country to engage our elected officials in this important discussion. In fact, with 145 participants registered for the day, the 2019 Advocacy Day was the 2nd largest turnout in the EDC’s history! The passion and energy in the room was palpable, and it was an honor to be able to directly participate in our legislative process.
But there is still much work to be done! The Nutrition CARE Act is early in its progress to becoming law, so if you were unable to attend Advocacy Day but would like to stay involved, please sign up here for the EDC’s Action Alerts. And, if you are able, consider attending next year’s Advocacy Day (details forthcoming) as the event is open to anyone regardless of background or experience. The more voices we can bring to Washington, the greater the potential for us to bring about meaningful change for those affected by eating disorders!