Is it wrong for for an insurance company to pay for obesity treatment but not treatment for an ED?

So I just wanted to hear some opinions on this issue. One of my dearest friends has been struggling with an eating disorder for about 10 months now. She's a wonderful girl but has developed this ED because of bad relationships with men and a mentally abusive ex roommate/ ex friend. She told to her boss at work and he is allowing her to take some time off. Now she has gotten medical help and is going to therapy and also seeing a nutritionist regularly.

So she went to her normal doctor who then sent her to a nutritionist and a therapist. She goes to the nutritionist and finds out her $20 co-pay is not accepted at the nutritionists office. So she thinks "Okay maybe my insure does not cover certain specialests". So she pays the normal price and sees the therapist and again can't use the co-pay. So she decides to call the insurance company and explains the situation and tries to get some answers. Turns out her insurance company does not cover anything related to eating disorders. They consider it an elective treatment. BUT they do cover gastric bypass surgery and any other treatment involving obesity and will even help pay for things like nutrisystem but will not help a 22 year old women see the doctor because they consider her ED  elective??!?!?!?!

In my opinion that is horrible. Anorexia is a real, terrible and deadly disease! She's sick and her insurance wont help because they think her treatment is elective! I was so heated when she called me crying. I am so proud of her seeking professional help for this and now she may have to stop because it's too expensive without help from her insurance. I can't believe they will help and obese individual but not one with an eating disorder. It's terrible in my book. Reason I am so heated because I was in her boat a few years back and thankfully the insurance my step-father had through work did not hold me back from seeking help. 

I just can't get over how our health system will not help a wonderful, caring, beautiful and bright young women who could die from this disease but they will help someone lose weight. I mean yes it is great that someone wants to get healthy and the insurance company will help them, but my friend wants to be healthy too in a different way and they wont help. I would like to hear others opinions on this topic. 

the reality is that ED treatment isn't very effective, and insurance companies make decisions based on statistics.  gastric by-pass is a one-off shot; ED treatment can last years. they don't want to pay because it's going to be expensive, not because it's elective.

your friend needs an advocate, maybe a lawyer, and she needs to look at the fine print of her insurance plan.  they may be able to get away with calling her treatment elective now, because her illness isn't life threatening (yet?).  but there may be a way around it.  she may have to call it something other than an eating disorder. 

rather than pursuing ED treatment, she can take the approach of finding out what she is eligible for, then applying for that.  like i said, the usual approaches to eating disorders aren't particularly effective anyway; she'll probably get as much benefit from talk therapy, at much less cost.

there is a new mental health parity bill that passed at the national level late last year, perhaps they can make a case for depression or anxiety, which i think are both "parity" diagnosis (meaning insurance has to cover a certain extent of treatment and can't discriminate legally), im not sure about ptsd or the other traumatic stress responses, but from what you post, a case for those diagnosis might be possible, with the ed as a symptom/secondary condition arising from the emotional impact of life stressors..... does that make sense? that would at least get the therapy part paid. not sure how to make a case for the nutritionist. . . . 

My insurance compny pays for my ED treatment, but you're right, that is horrible.

You'd think that treatment for obesity would be considered "elective" also.

I am sorry for your friend and I hope she receives the help she needs an deserves.

Thank you everyone!! Sorry I am heated over this issue! I just don't get it. I love her to pieces and want her better, she did the same for me when I hit my rock bottom. I think I just have a beef with the healthy care system and will do the best I can to help her.

This is slightly different, but may help.

I have a medical reimbursement plan that my employer pays for.  In order to use that to cover my Psychiatrist and my "Nutritional Therapy" sessions I had to get a note from my General Practitioner at my HMO that said this therapy was "medically necessary".  They considered the therapy sessions optional unless deemed "medically necessary" by my doctor.  

In that case, treatment for obesity shouldn't be covered either, as obesity is OFTEN (but not always) caused by Binge Eating Disorder.

So insurance covers for people that over-eat, but not those who starve themselves. Great. shows hows well our health care is. 

I know where your coming from, all my nutritionist (though she was whacky) visits, weren't covered, but my therapist was! (though it was for depression... even though I wasn't freakin' depressed!) 

This makes me mad too! Honestly - people look at obesity as "it's not your fault" and ED as "it's all your fault!". Makes me so mad!

that's not what it's about, lindsey.  with insurance companies, it's always about money.

Original Post by lindseyanderson:

This makes me mad too! Honestly - people look at obesity as "it's not your fault" and ED as "it's all your fault!". Makes me so mad!

i would say its the other way around.  i think people see an eating disorder as way more of a real, psychological issue that just being fat.  i dont know anything about insurance companies though.  im sure it all boils down to money.

In a word, yes.  It is wrong for insurance companies to be unwilling to pay for treatment for EDs, especially since they are among the most lethal of psychiatric conditions, and often require long-term treatment for effective resolution.

I'm hoping the new 'health care parity' bills out there will actually help, but having read a fair bit into them, I don't have much confidence in them.

Original Post by lindseyanderson:

This makes me mad too! Honestly - people look at obesity as "it's not your fault" and ED as "it's all your fault!". Makes me so mad!

I think both get the "it's all your fault" attitude. You ate too much, you starved, etc. Alot of stigma behind both, which is sad and unfair really.

Nutritionists aren't on my parents insurance either and they're both obese. When I was on their insurance, the insurance paid very little towards mental therapy (any kind of therapy).

Most insurance coverages suck and if you want everything you have to literally pay through the teeth. :(