Medical field lacks eating-disorder treatments

Israeli women have highest rate of body dissatisfaction, says head of Rambam Medical Center clinic.

By
November 15, 2011 00:59
3 minute read.
weight loss, eating disorder

weight loss, eating disorder_311. (photo credit: Thinkstock/Imagebank)

The lack of medical services to treat sufferers of anorexia, bulimia and other eating disorders cause the preventable deaths of teens and adults, experts said on Monday.

A daylong symposium at the Knesset organized by the Israel Association for Eating Disorders along with Health Lobby head Kadima MK Rachel Adatto heard that at the same time hospitals are reimbursed for only half the expenses such units cost them, many millions are wasted in inappropriate care at designated inpatient hospital departments and day hospital units.

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One woman who became anorexic as a teenager and underwent 14 short and ineffective hospitalizations within a year cost the public purse NIS 1.2 million because she wasn’t treated by experts, the audience of more than 200 was told. This is the cost of running a hostel for the rehabilitation for a year of 15 young women after hospitalization for anorexia and bulimia.

There is only one hospital – Ziv in Safed – with inpatient departments for adults (mostly women) suffering from eating disorders, it was said, and only two (Schneider in Petah Tikva and Sheba in Tel Hashomer) for teens.

Dr. Yitzhak Vorgaft, head of the Ziv department, said there are children as young as seven diagnosed with eating disorders – mostly inspired by the fashion industry, advertising and the media.

With 13.4 percent of girls and 7.1% of boys in the nine- 14 age group – totaling 215,000 children – having the potential for developing eating disorders, action must be taken immediately, said Vorgaft.

Few hospitals had incentive to set up designated units, because they get only about NIS 340 per child to treat them with an interdisciplinary staff and food when it costs them NIS 700, he said.



Vorgaft called for an amendment to the Psychiatry Law that would enable hospital staffers to force patients with eating disorders who were in danger of dying to get treatment. At present, they cannot be force-fed. He said 1.2% of Israeli youths suffer from anorexia, 2% from bulimia and 3-5% from nonspecific eating disorders.

The Health Ministry told The Jerusalem Post on Monday that ministry director-general Dr.

Ronni Gamzu had instructed the budgeting division to look into changing the pricing for such services.

In addition, the ministry will offer an incentive payment of NIS 50,000 to each hospital that agrees to open (or expand) an eating disorders clinic. He also asked four hospitals to open such clinics in the periphery.

As for force-feeding, Gamzu said there were many opponents in the judicial system and human rights groups to giving treatment against the will of people who were not in psychotic conditions. Instead, he suggested that appointing a guardian to make the decision would be better.

But Adatto, a gynecologist and lawyer by training, said at the symposium that she was interested in initiating such a bill to save lives.

She said there were two other bills now in the pipeline – requiring those under the age of 24 to receive a prescription to buy laxatives and monitoring websites that give advice on drastically losing weight, vomiting out food – and others to promote awareness of anorexia and bulimia.

Adatto is pushing for a second and third (final) reading of her bill to prevent models (and their photographs) with less than an 18.5 body mass index (indicating severe underweight) from appearing in the media, including on billboards.


In addition, images of starved models whose images undergo Photoshop manipulation to make them look skinnier than they are would have to have warnings stating they are not authentic.

Prof. Yael Latzer, head of Rambam Medical Center’s eating disorders clinic, said that an international comparison found Israeli girls and women have the highest rate in the world of dissatisfaction with their bodies. A large percentage of them are chronically on unsupervised weight-loss diets. This can lead to eating disorders, she said.

Einat Tzuberi, head of the eating disorders clinic at the Shalvata Mental Health Center in Ra’anana, reported on her study of seven intermediate and high schools where dance is studied. These included two high schools for the arts, which she found were much more likely than regular schools to cultivate the rigid thinking, perfectionism, feeling of being overwhelmed and the belief that looks are “everything.”

A feature on the symposium will appear in the Sunday Health Page on November 27.


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