The treatment of eating disorders has reached a point so contentious that it has made its way to the high courts, The New York Times reports.

Insurance companies and eating disorder advocates are at odds as to whether insurers are within their rights to deny people struggling with anorexia and bulimia coverage for stays in residential treatment centers. The around-the-clock monitoring is the only way to ensure that those with eating disorders stick to their treatment and continue on the path to getting better, say proponents of the centers. But certain doctors and insurance companies are arguing that few studies are available to back up the effectiveness of the costly method, which can sometimes reach more than $1,000 a day.

In August, the U.S. Court of Appeals for the Ninth Circuit in California ruled that insurers in the state must pay for residential treatment for eating disorders and other serious mental illnesses under the state’s mental health parity law.

However, doctors nationwide are seeing their patients unable to partake in residential treatment because of insurance refusals.

“We’ve seen an increase in denials,” said Kathleen MacDonald, education and prevention coordinator for the Gail R. Schoenbach FREED Foundation, an advocacy group for those with eating disorders. “Now, I go to bed every night and I can’t answer all the emails I get. It’s heartbreaking.”

Read the rest of The New York Times article

Heather Rudow is a staff writer for Counseling Today. Email her at hrudow@counseling.org.

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