Eating Disorders: Vermont lawmakers step in to help with treatment options

BURLINGTON, Vt. (WCAX) - Help could be on the way to create higher levels of care in Vermont for those with eating disorders.

A report from several eating disorder treatment advocacy groups says 9%, or 55,132 Vermonters, will have an eating disorder in their lifetime.

It affects men and women, but women are twice as likely to have an eating disorder.

It can be in kids as young as 5 up to elderly people. But adolescents, teens and young adults are affected most.

And it comes at an economic cost. The study estimates $123.9 million a year in lost productivity, informal care, efficiency losses and health system costs due to eating disorders.

I told you a few weeks ago how families and providers felt the problem wasn’t being addressed by the state, and said access to care was a significant challenge here.

Now, I learned lawmakers are stepping in.

At the Kahm Clinic in Burlington, Registered Dietician Elaina Efird has been treating eating disorders for years.

Reporter Cat Viglienzoni: How far are people driving to come to you for treatment?

Elaina Efird: I think my farthest is two-and-a-half hours.

Cat Viglienzoni: What does that say to you?

Elaina Efird: That there’s not enough treatment in the state of Vermont.

She says the Kahm Clinic’s waitlists reflect that. They try to prioritize eating disorder patients but even then it might take a month to see someone new.

“That’s really scary if someone’s got a really dire situation,” Efird said.

In those dire situations she tries to help as best she can with meal planning and metabolic testing, which measures what a patient’s body is doing and how their eating disorder is affecting them physically.

But she says the reality is severe cases need inpatient care with meal support three times a day. And if patients need that, they have to pack their bags because the Green Mountain State can’t help them.

Elaina Efird: They literally have to leave the state and go seek treatment

Cat Viglienzoni: Have some of your patients had to do that?

Elaina Efird: Yes.

Abby Hawkins was one of them.

“I was so tired I couldn’t get out of bed and I was skipping classes,” Hawkins said.

The 22-year-old from Rutland says her eating disorder started when she was just 12 years old. But it wasn’t until about a decade later, in winter 2021, that the George Mason University student and Type 1 diabetic realized it was slowly killing her.

“That was the point where I realized that if I didn’t do something about this it was just going to kill me or I’m just not going to live any life that’s worth living,” Hawkins said.

She was home in Vermont while school was remote. She spent a week in the hospital here. But it was in Massachusetts where she finally got the inpatient treatment she really needed to start recovery. Even after that, she says her insurance wouldn’t cover residential care.

“It took a long time to come to terms with how bad the problem was to get to the point to ask for help, and then to hit so many walls in access to treatment, it made me question if my eating disorder was actually that bad, if I actually needed to get help,” Hawkins said.

Cat Viglienzoni: Do you think that if eating disorder treatment had been more available and had been more widely talked about that you would have sought help prior to being in your 20s?

Abby Hawkins: If the resources had been available, I would have sought treatment earlier. But I just didn’t know where to turn to or what there was available. And realizing that there isn’t a lot in Vermont in terms of resources.

Sen. Ruth Hardy, D-Addison County, wants to change that.

Sen. Ruth Hardy: It’s clear that our health system, broadly speaking, isn’t really adequate to help people who are struggling.

Cat Viglienzoni: Has the state taken agency over this problem?

Sen. Ruth Hardy: I don’t think so. And to be fair, there are a lot of problems the state is trying to solve.

Hardy says her teenage daughters have friends whose families told her finding care-- even support groups-- is impossible here, especially for those who don’t have the means to travel.

And she knows too well that eating disorders are the second deadliest mental health disorder, second only to substance abuse.

“Back when I was a kid one of my friends had a severe eating disorder and eventually passed away because of it,” Hardy said.

Language she’s adding this week to a Senate bill would require the health department to create a working group to find out what services Vermont has and doesn’t have, and report to lawmakers on how to improve them. The goal is to have a report in January 2023 so they could take action next session.

Cat Viglienzoni: Do you think this is fast enough for families who are struggling?

Sen. Ruth Hardy: Unfortunately, no, I don’t think so.

Back at the Kahm Clinic, Efird welcomes any progress that might lead to more options for her patients.

Cat Viglienzoni: If you had a wishlist for Vermont for eating disorder care, what would be on that list?

Elaina Efird: So, in an ideal world there would be a residential place, and then a partial and an outpatient place.

Cat Viglienzoni: Why do you think the state doesn’t have that yet?

Elaina Efird: To be honest, I don’t know.

There might be some movement on that soon. The Green Mountain Care Board right now is looking at a certificate of need from the Kahm Clinic for an intensive outpatient and partial hospitalization treatment center here in Vermont.

It wouldn’t treat residential patients but would be able to address higher levels of care than the Kahm Clinic can take on now so that someone’s eating disorder might not progress to the point where they need full inpatient care.

The Kahm Clinic says the roughly $1 million project would be built in Chittenden County and serve about 30-40 patients at a time. They would be able to take Medicaid patients.

If you want to comment on the proposal, you can reach out to the Green Mountain Care Board. Click here for more information.

Related Stories:

Eating Disorders: Providers say Vermont must do more

Eating Disorders: The trouble finding treatment in Vermont

Does Vermont have enough eating disorder treatment for youth?

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