Wednesday, October 27, 2010

Renfrew presents: "What are you waiting for? The possibilities of long-term recovery"

Register Now!  The Renfrew Center Foundation Presents

What are you Waiting for?
The Possibilities of Long-Term Recovery

A FREE Webinar for Those in Recovery
November 16, 2010
12:00 PM – 1:15 PM EDT


November 17, 2010
8:00 PM – 9:15 PM EDT

Join us for our next Renfrew Webinar, What are you Waiting for? The Possibilities of Long-Term Recovery. Jen Nardozzi, PsyD will interview Kristen Moeller about how she has maintained long-term recovery and Kristen will share from her recently published book, Waiting for Jack.

About Kristen
Kristen Moeller is living proof of the joy that long-term recovery can bring. At age 23, her future seemed hopeless. Now, 21 years later, she knows that life happens, there will be bumps in the road – both minor and major – and we can move through all of it while maintaining our center and not losing ourselves. She also has realized success beyond her wildest imagination. She attributes all of this to developing a strong foundation of recovery from the beginning and continually placing that before all things. Now, a bestselling author, speaker, radio show host and coach, she spreads her message of not waiting for someday to come. Instead, with willingness and action, we can live a life of recovery now.

Who Can Attend
The webinar series is open to both Renfrew alumni and anyone who is struggling with disordered eating.

How to Register
Click Here to register for the Tuesday, November 16 webinar
Click Here to register for the Wednesday, November 17 webinar

For more information, contact Kelly Fieni at 1-877-367-3383 ext. 3299 or

Monday, July 26, 2010

Ask the Expert: Why doesn’t Medicare have to follow the Mental Health Parity Act?

Q.  Why doesn’t Medicare have to follow the Mental Health Parity Act, which mandates that insurance plans cover both physical and mental ailments equally, including maximum limits on hospital stays? 
mileena, California

Medicare will cover office- and clinic-based therapy as well as services you receive in an outpatient hospital program, as long as your provider is one of the following:
• a general practitioner
• a nurse practitioner
• a physicians’ assistant
• a psychiatrist
• a clinical psychologist
• a clinical social worker
• a clinical nurse specialist

Medicare will help pay for the services of non-medical doctors (like psychologists and clinical social workers) only if the providers are Medicare-certified and take assignment, meaning that they accept Medicare’s approved amount as payment in full.

For your initial visit to a mental health professional to determine your diagnosis, and for brief appointments to manage your medications, Medicare pays 80 percent of its approved amount. For other appointments after your initial visit, Medicare pays 55 percent of its approved amount. You or your supplemental insurer are responsible for the remainder of the bill (20 percent or 45 percent coinsurance, respectively).

These are among the mental health services Medicare covers:
• Individual and group therapy.
• Family counseling to help with your treatment.
• Tests to make sure you are getting the right care.
• Activity therapies, like art, dance or music therapy.
• Occupational therapy.
• Training and education (like training on how to inject a needed medication or education about your condition).
• Substance abuse treatment.
• Laboratory tests.
• Prescription drugs that you cannot administer yourself, like injections that a doctor must give you.

You are correct that the Mental Health Parity and Addiction Equity Act of 2008 prohibits insurers from charging more for mental services than other services, but the law applies only to employment-based insurance plans. Thus, Medicare is not affected. But under the Medicare Improvement for Patients and Providers Act of 2008, Medicare coinsurance for mental health services will be gradually reduced over the next five years. This year and next year, consumers will pay 45 percent for most mental health services, in 2012, they will pay 40 percent, in 2013 they will pay 35 percent and by 2014, consumers will pay 20 percent — just as they do for most other services.

The Medicare improvement law will not change how Medicare covers inpatient mental health services. If you receive care in a psychiatric hospital, Medicare helps pay for up to 190 days of inpatient care in your lifetime. After you have reached that limit, Medicare may help pay for mental health care at a general hospital. Your out-of-pocket costs are the same in a psychiatric hospital as they are in any hospital. In February, Senators John Kerry and Olympia Snowe introduced the Medicare Mental Health Inpatient Equity Act, which would eliminate the 190-day limit on inpatient psychiatric hospital stays and cover inpatient psychiatric hospital stays much as it does all other hospital stays under Medicare. Congress has yet to take action on this legislation.

Thursday, July 1, 2010

NEDA: New Health Care Coverage for Pre-Existing Conditions! (Sadly not in NJ)

The U.S. Department of Health and Human Services (HHS) announced on July 1st the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition.

States have the opportunity to develop their own plan for assuming this coverage, and have until 2014 to do so, or they can opt to have HHS oversee this on their behalf. Altogether, 21 states have turned implementation over to HHS; the national Pre-Existing Condition Insurance Plan is now open to applicants in these 21 states where HHS is operating the program.

Click here to see if your state is one of the 21 states where coverage is now available.

PLEASE NOTE THAT NEW JERSEY IS NOT ON THE EARLY IMPLIMENTATION LIST!  The national Pre-Existing Condition Insurance Plan will launch in NJ in 2014. 

To find out more information, or to enroll in coverage, you can visit:

HuffPo: Understanding 'Non-Specified Eating Disorders'

Imagine that your doctor told you that you suffered from a disorder that was "not otherwise specified." How would you feel about the seriousness of your condition? Would you feel nervous? Or maybe you would dismiss it as unimportant? These are the questions that confront nearly 70 percent of patients with eating disorders. We have all heard of anorexia and bulimia, but what you may not know is that there is a class of eating disorders called Eating Disorder Not Otherwise Specified (EDNOS).

EDNOS causes more deaths than either anorexia or bulimia (1). Currently, patients are diagnosed with EDNOS if they fail to meet all the requirements for anorexia and bulimia. However, the newest revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a cornerstone of psychiatry, plans to address this vagueness so that current EDNOS patients will no longer struggle with that uncertainty.

In our image-obsessed society -- where fashion models are fired for not being skinny enough and a clothing company can cause uproar by featuring the slogan "Eat Less" on a t-shirt -- eating disorders are a dangerous reality. More Americans suffer from eating disorders than Alzheimer's disease and schizophrenia combined (2). In addition, more than a third of normal dieters develop an eating disorder (3).

Eating disorders often point to more serious underlying mental illnesses, like body image issues or depression. Disrupted eating patterns are the common sign, but there are other signs that suggest that someone is suffering from an eating disorder. These include never wanting to eat, uncontrollable eating tied to emotional states, repeatedly chewing and spitting out food without swallowing, frequently using laxatives or enemas, and self-evaluation heavily dependent on body image (4).

To address the high number of EDNOS cases, DSM-5 (the latest version of the manual) will better specify illnesses like Binge Eating Disorder, for example. This is useful because many disorders that are grouped together under EDNOS are not very similar; they have different characteristics and require separate attention and treatment. By doing this, both doctors and patients have a clearer understanding of which eating behaviors need to be treated, instead of shrugging it off as "unspecified."

If you were a patient, wouldn't you feel more positive about the outcome of your disease knowing that it is more than just "non-anorexia" or "non-bulimia?" Also, doctors will be able to choose more suitable strategies for how to treat these behaviors.

This change is not without controversy, though, as some doctors think that "over-specifying" these disorders in DSM-5 means patients will be diagnosed with disorders that they don't truly have (5). Will this really happen? We don't know, but I believe it will allow for eating disorders in patients to be identified more clearly and treated more effectively.

Eating disorders are a serious medical condition. If you notice these signs in yourself or someone you know, get help. Speak with a doctor about counseling. Join a local support group or one on the internet. Educate yourself on the signs of eating disorders and learn how to prevent them.

As updates to the DSM show, these disorders are legitimate mental illnesses and they require treatment; they don't just go away on their own. The medical community is doing its part to deal with unspecified eating disorders by revising its guidelines, and we each need to do our parts by educating ourselves and intervening when we suspect eating disorders in friends or loved ones.

Wednesday, June 30, 2010

Do dentists know how to recognise and treat patients with eating disorders?

Eating disorders affect dental health in a number of ways that are visible to dentists, but most noticeable are acid reflux effects. The symptoms include swelling of the cheeks and jaw, tooth and gum sensitivity, tooth decay, tooth discolouration, and halitosis. Stomach acid increase due to bulimia erodes teeth and causes sensitivity to the teeth with staining, and irritated gums. Fizzy drinks often used by those with anorexia also contain acid that causes damage to tooth enamel, and the gums. Once dentin becomes exposed and gums irritated, the likelihood of bacterial infection and oral disease is higher.

These acidic reactions in people with eating disorders cause pungent bad breath that peppermints, chewing gum and mouth rinse do not conceal. Besides swelling of the cheeks and jaws, dentists may also notice wounds on the upper hand surface and knuckles caused by excessive purging as a result of bulimia. Dentists are usually the first to notice these warning signs and can act before the damage is irreversible not only to oral health but also to the physical and mental health of the patient.

Eating disorders like anorexia where patients starve themselves or bulimia where patients binge and purge are biological mental illnesses and have to be very sensitively handled for a positive outcome for the patient. Many do not easily acknowledge their illness or accept treatment for the disorder. Dr. Emmett R. Bishop Jr., MD, CEDS, of the Eating Recovery Centre in Colorado suggests direct non-labelling type questions said with concern, such as “Do you make yourself throw up?” Rather than questions like: “Do you have bulimia?” Engaging the patient in a gentle and caring discussion can open the door to a referral for psychological support, such as through the new 2010 NHS Psychological Therapies. Facilitating treatment for the underlying eating disorder is step towards holistically-improved dental health.

Tuesday, June 29, 2010

Project Body Talk: A new site from author Harriet Brown

Check out Harriet's new site!  It features commentaries on a variety of body and health issues in a style similar to This American Life - i..e:  personal vignettes!

From the site:
Body image has become a hot-button topic in contemporary America. For women—and, increasingly, for men—there’s intense pressure to look a certain way: the unattainable thin ideal for women, and the unattainable buff ideal for men. Never before has so much time, energy, and money been spent talking about how we look—and how we think we should look.

Project BodyTalk is a safe place where people can share how they feel about their bodies and body image, their relationship with food and eating, and the cultural pressures that are so much a part of American life today.

We invite you to send us your commentaries—and to listen to other people’s. Record your story and submit it here. Learn about efforts around the country to spread body-positive messages and awareness. Start coming to terms with your body, whatever its size and shape, and see how that simple act can change your life.

Ask the Expert: Can Strep Throat Lead to Anorexia?

Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, previously responded to readers’ questions about anorexia, bulimia, binge eating and related problems. Here, she responds to a reader who developed anorexia after a severe case of strep throat.

Q.A number of years ago, several studies indicated there might be a link between strep infections and the onset of anorexia nervosa. When I was young, my own anorexia began immediately after a severe strep infection, though I was already “ripe” for a.n. beforehand. Have any further studies been done?
Tinytim, France

A.Dr. Kathryn Zerbe responds:

You are referring to a small number of case reports that linked the development of anorexia to a condition called PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. Since these reports were published in the late 1990s, there have been studies that specifically link some cases of anorexia to acute strep infection.

There is also ongoing investigation of how tics and obsessive-compulsive disorder, or OCD, may worsen after a strep infection in some children up to the age of puberty. Because anorexia and obsessive-compulsive disorder often occur together, it is possible that antibodies produced by the strep bacteria could affect the brain and trigger or worsen both disorders.

At the present time, however, the National Institute of Mental Health only links the PANDAS syndrome with tics and OCD, attention-deficit hyperactivity disorder, separation anxiety, sleep problems and mood changes. Children who have have OCD and tics associated with PANDAS usually improve once the infection clears, only to get worse if they get another strep infection.

Children without PANDAS but who have tics and OCD tend to have the disorder for a long time, with good days and bad days, but they don’t necessarily get worse when they get a strep infection. The mechanism for PANDAS remains unknown.

Wednesday, June 23, 2010

Pro Ana Versus Pro Recovery Sites: New Study by Johns Hopkins and Stanford University raises concerns

Pro Ana websites are popular, enticing and potentially deadly to young women. They promote thinness at all costs and often disregard health, well being and common sense. The June 17th issue of American Journal of Public Health published a recent study of Pro Ana websites. This innovative study conducted by Johns Hopkins Bloomberg School of Public Health and the Stanford University School of Medicine, has raised questions about how we can meet the needs of these Pro Ana website visitors in healthier ways. It is important that Pro Recovery sites are supported and promoted by leaders and those influential to young woman. Professors, Teachers, Coaches, Physicians, Nurse Practitioners, Parents and Therapists all can help offset the pro ana movement by supporting organizations that emphasize health and self esteem over thinness. It may save a life.

Fort Worth, TX (PRWEB) June 22, 2010 -- A recent study of Pro Ana websites, published in the June 17th issue of American Journal of Public Health, shed some light on why young women are drawn to these sites and what they find there. This illuminating study has created a flurry of discussion and concern in the public.

Pro Ana websites are prolific across the internet. These sites provide tips, advice and encouragement to women on how to become thinner, emaciated or practice anorexia nervosa. Dramatic calorie restriction, fasting, excessive exercise, purging, laxatives and other unhealthy behaviors are often glorified as a magic key to achieving the media glorified waif look that has so deeply influenced women today. Eating disorder treatment is not advised or suggested. Thus, in most cases, these Pro Anorexia websites are promoting a deadly lifestyle and self destruction.

"These Pro Ana sites provide a sense of camaraderie and collaboration among the website visitors. These sites also can create a sense of pursuing a more perfect version of the self, or at least the body" commented Jacquelyn Ekern, MS, LPC, and Director of Eating Disorder Hope. Sadly, the Pro Ana sites are focused on thinness as a status symbol and promise increased confidence and power in the world if one can just become thin enough.

Fortunately, there are Pro Recovery sites that refute these claims and encourage visitors to find a sense of inner value, self esteem and worth in the content of the character - rather than the external image of the individual. Sites such as Eating Disorder Hope promote healthy self care, embracing life and pursuing recovery. This site's mission is to foster appreciation of one's uniqueness and value in the world, unrelated to appearance, achievement or applause.

Eating Disorder Hope and other recovery websites, provide treatment resources such as a Treatment Directory and a Specialist Library. These provide sufferers from anorexia, bulimia, binge eating disorder and compulsive overeating with contacts to professionals who can treat the destructive condition and the underlying issues that led to this maladaptive behavior.

Recovery Tools are provided and explained to offer practical suggestions for developing a healthier lifestyle and self esteem. Tools are given, such as nutrition tips, mindfulness skills, spirituality, improving rational thinking, body image improvement advice and relapse prevention techniques.

Resources are also provided that direct the individual to articles on recovery, inspirational real stories of recovered women, pro recovery newsletters and blogs, support groups, and excellent non profit organizations that support eating disorder awareness and prevention.

If you know of a woman suffering from anorexia, bulimia, binge eating disorder or seemingly becoming far too preoccupied with weight, eating and diet - Please, seek help for them. A good starting point may be to refer them to a resource such as Eating Disorder Hope where they can find eating disorder treatment referrals, recovery tips and resources, and most of all, inspiration to choose a full and meaningful life over the empty existence of anorexia and other related conditions.

Jacquelyn Ekern, MS, LPC is Director and Founder of Eating Disorder Hope.  Eating Disorder Hope is the one stop eating disorder treatment, resource and information site. Eating Disorder Hope promotes ending eating disordered behavior, embracing life and pursuing recovery through implementing the best eating disorder treatment available for the individual with anorexia, bulimia or binge-eating disorder.

Tuesday, June 22, 2010

Around the Dinner Table Plate Drive - June 1 until June 30, 2010

The Around The Dinner Table online forum has been empowering and supporting parents since 2004: offering a 24 hour sounding board for thousands of users. This month we are holding our first annual "Plate Drive" as a fundraiser for our organization. By adding your personal messages to these plates -- created for this project by our graphic designer, Liana Mensh -- you become part of the the legacy of this organization. Your donation of at least $1 (US) for each word on the plate helps us keep the forum and F.E.A.S.T. going. We are a frugal organization - staffed by volunteers and using donated office space and materials - but need donations to pay for expenses like Internet services, telephone, insurance, and travel. By supporting this organization you show us what having this forum means to you and your family.

Anyone can participate: invite your friends and extended family to join in. Make your message anonymous or use your name. Be funny or serious. Use three words or (up to) 50. We want to hear from you and we want to include you!

Ready to add your plate?

Chicago Tribune - Eating with an anorexic child: A controversial treatment

War broke out on the day Rina Ranalli and her husband told their 12-year-old anorexic daughter the strict new house rules: three meals and three snacks a day.

Initially, their bright and previously sweet-natured girl cried, screamed insults and raged. She threw things. Punched holes in the wall. And she pretended to eat while plotting ways to hide the food. But when the seventh-grader realized her parents had her trapped — they would sit with her 24/7 if they had to — she ventured down the only available path. She began eating.

Chicago's Ranalli family was using the little-known Maudsley Approach, a grueling but evidence-based treatment for adolescents suffering from the eating disorder anorexia nervosa. The approach, also called "family-based therapy," flips conventional treatment on its head.

Often parents are advised to put their starving child in therapy or residential treatment, distance themselves to preserve the teen's independence and wait for the day the child decides to resume eating.

But under Maudsley, parents immediately start the daunting task of "re-feeding" their malnourished child. Once weight is restored — and, theoretically, rational thinking returns because the brain has some nourishment — parents step back, and control over eating is gradually returned to the child. The final phase of treatment is the initial step in traditional therapy; it addresses the underlying psychological issues that may have caused the disorder.
Read the full article here