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Bills aimed at addressing disordered eating spotlight a growing public health issue

This is an image of two people who appear to be women, seated with their hands clasped in their laps. One person is in the right edge of the frame facing to the left and slightly out of focus while the other person is behind them in focus in the background. The image cuts off their faces and focuses on their hands.
Priscilla Du Preez
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Unsplash
Two new bills at the State Capitol aim to address eating disorders in Colorado. One out of every ten Coloradans have a diagnosed eating disorder. Many more are undiagnosed.

In the fall of 2020, when she was a junior at Cherry Creek High School, Aimee Resnick’s body was shutting down. She weighed less than 100 pounds, her skin was pallid, and her hair was patchy. Doctors said her organs were failing.

Anorexia was killing her. She ended up in the hospital.

“When I was in the hospital, I kind of realized, I probably have to recover. Like, I don't really have any choice at this point,” says Resnick. “So I started the recovery process.”

Resnick went through months of treatment to overcome her eating disorder, and she’s not alone. According to the Denver-based Eating Disorder Foundation, at least 10% of Coloradans have a diagnosed eating disorder. Many more are undiagnosed. The most prevalent eating disorders are anorexia, bulimia and binge eating disorder.

Now, experiences like Resnick’s are pushing one Colorado lawmaker to take up the issue in the state legislature. Senate Majority Leader Dominick Moreno is sponsoring two bills - one that deals with eating disorder prevention and another that aims to improve treatment.

Advocacy organization Mental Health Colorado helped craft the bill focused on eating disorder treatment, which is expected to be officially introduced in the Senate this week. It would limit the use of Body Mass Index (BMI) or other ideal body-weight measurements in health insurance and managed care plans.

BMI is a standardized measurement system for identifying ideal body-weight. Some insurance companies use it to determine what level of care is necessary for a person with an eating disorder and whether or not the care is covered.

“The reality is that our lives are more complicated than that,” Moreno said. “People come with different characteristics depending on their culture, depending on their ethnic background. And the reality is, BMI doesn't capture any of that.”

Doctors increasingly consider the system inaccurate. Kaiser Health News reports the system does not distinguish between muscle and fat and, according to obesity medicine experts, can wrongly classify muscular people as overweight. It also doesn’t account for cultural and ethnic reasons for body-weight differences.

The bill would also outlaw the sale of diet pills to anyone under the age of 18 unless they have a prescription. There are currently no age restrictions for selling diet pills.

“That is often how eating disorders develop,” Moreno said. “People start with diet pills because they feel some kind of way about their own body image. And so they're trying to get that under control.”

This is a picture of Colorado Senate Majority Leader Dominick Moreno sitting in his office at the Colorado State Capitol. He is sitting at his wooden desk with his laptop open and is facing the camera.
Lucas Brady Woods
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KUNC
Senate Majority Leader Dominick Moreno in his office at the State Capitol on Friday, Feb. 24, 2023. He's sponsoring two new bills that address eating disorders.

Moreno is also sponsoring Senate Bill 014 with Representative Mandy Lindsay. The measure focuses on eating disorder prevention rather than treatment and would launch the Office of Disordered Eating Prevention to collect data and centralize resources.

Eating disorder experts emphasized the importance of the data collection element. They say expanding available data is the first step in motivating public health authorities to deal with eating disorders more directly.

“The eating disorder field has so far been severely neglected in terms of awareness, as well as research, regulatory oversight and funding,” said McKenna Ganz with the Eating Disorder Foundation. “Part of the problem is that we simply don't have a lot of good data.”

The stigma behind eating disorders is another reason there’s not a lot of awareness around them. Socially-accepted body types, which are usually thin, drive people to hide their eating disorders out of embarrassment or shame.

Ganz says eating disorder stigma also adversely impacts marginalized communities.

“A lot of folks think that this only impacts wealthy, white, young women,” she said. “But the truth is that vulnerable populations are often just as impacted by eating disorders, or more impacted. And we often see a lot of overlap with eating disorders and other things like substance use, but also with trauma, food insecurity, and other issues that often impact vulnerable populations.”

Only 17% of Black women who are struggling with an eating disorder are accurately diagnosed, according to the Eating Disorder Foundation.

There was also an increase in eating disorders due to the COVID-19 pandemic. The Eating Disorder Foundation saw about a 15% increase in eating disorders between 2019 and 2020.

Aimee Resnick, in recovery since her hospitalization for anorexia in high school, worked with Sen. Moreno on eating disorder policy as a member of the Colorado Youth Advisory Council, a statewide group of youth representation from across the state.

“It's about preventing eating disorders from ever developing in the first place,” said Resnick. “Disordered eating truly is a public health concern.”

She hopes that, with these bills, Colorado can be an example for other states to also expand awareness and resources to address eating disorders. They will have to be approved in legislative committee hearings before moving on to consideration by the Senate and the House.

A previous version of this story incorrectly stated that Mental Health Colorado helped craft Senate Bill 014. Mental Health Colorado helped craft the bill focused on treatment, not Senate Bill 014.

I’m the Statehouse Reporter at KUNC, which means I help make sense of the latest developments at the Colorado State Capitol. I cover the legislature, the governor, and government agencies.