Detroit Free Press Kristen Jordan Shamus column

March 02--"It was tough when I was a child, but I didn't really emotionally process it, and I never talked about anything that was going on at home. ... When I was a sophomore in high school, it all started to bubble up and it manifested into an eating disorder."

-- Jenna Jaworowicz, 19, Farmington Hills

"In the beginning, I was in denial. ... I couldn't stop. As soon as I'd get out of treatment, I'd just go right back. ... Things would happen, and I'd say as soon as I get this bad, I'm not going to use my eating disorder anymore. I'd end up in the ER with electrolyte disorder or heart problems."

-- Sarah Davis, 25, Scranton, Pa.

"I had a scare when I was running on the treadmill and I almost fainted. I thought oh my God, I really could die. That really was my wake-up moment. I was 16 years old."

-- Kirsten Haglund, 25, and formerly of Farmington Hills

Three women, three different stories with striking similarities.

Jenna Jaworowicz, Sarah Davis and Kirsten Haglund all struggled with eating disorders. All three were willing to starve themselves to be unrealistically thin. All three needed help to overcome it.

Eating disorders affect as many as 24 million people in the U.S., and they have the highest mortality rate of any mental illness, according to the National Association of Anorexia Nervosa and Associated Disorders.

But getting that help is harder than it ought to be, says Haglund, a Farmington Hills native who on a whim tried out for a Miss Oakland County competition to earn scholarship money for college, and went on to win not only Miss Oakland County, but also Miss Michigan and the Miss America crown in 2008.

Treatment for eating disorders is expensive, especially when it comes to residential programs for the most severe patients. It can cost as much as $2,500 a day, and some people need treatment for months, Haglund says.

Her own struggle with anorexia became her platform in the Miss America competition, and when her reign was over, she went on to found the Kirsten Haglund Foundation, which offers education and support to people with eating disorders and funds treatment for those in need.

Since then, she has been an advocate for changes in health care coverage of eating disorders, and has appeared on several Fox News shows, including "Hannity," "A Healthy You & Carol Alt," and "Fox & Friends," as well as CBS's "The Doctors." And she plans a fund-raiser for the foundation's scholarships called the Celebration of Life Gala and Auction, 7-11 p.m. Friday at Weber's Inn in Ann Arbor.

"Mental health has always been maligned in the coverage battle, especially when it comes to addiction and eating disorders, partially because there's a portion of legislators who believe eating disorders are a choice, and you can choose to get into it and you can choose to get out of it," Haglund says.

No matter how much Davis thought she could control her anorexia and bulimia, she couldn't.

"When I was 13, my father passed away from cancer. The eating disorder started around then," Davis says. "Ever since that point, until 10 years after that, I was in and out of hospitals and treatment centers. I was unable to get treatment more than 30 days at a time because my insurance wouldn't cover it."

For patients like Davis, the only way to get better is through residential treatment, where they undergo intensive therapy for several months, says Dr. Olivia Thakkar, a psychotherapist at the Birmingham Maple Clinic in Troy. Yet that's the most expensive and least likely form of treatment to be covered by insurance.

"It is an economic issue," says Thakkar. "When people have health insurance, the two main mental disorders that companies do cover are eating disorders and substance abuse, but often times the co-pay is high and the deductible is high. If we're talking $2,500 a day for two or three months, sometimes people have to take out a second mortgage on their homes to pay for it."

People with a family history of depression, mental illness or disordered eating are more at risk of developing an eating disorder.

"It's not just fat phobia. ... It also is about something much deeper," Thakkar says. "Genetics load the gun and the environment pulls the trigger.

"There usually is a trauma; something needs to happen for the drive for thinness to become so important. That's what it takes for you to know that you're hungry and completely ignore it; that's what it takes to ignore what your body needs to get to the thinness. It's usually someone who feels really out of control in their life. It's the only thing that they feel that they're good at is the control of their weight."

Davis was at a treatment facility in Arizona when she met Haglund and Haglund's mother, Iora Haglund, for the first time. It's also where she learned of the help that was available through the foundation. Insurance covered about 45 days of her treatment, but she needed more.

"I asked them if there was any way they could help me stay there longer and continue treatment. ... They helped me stay out there four more months. That was the best thing for me. Now, I have a treatment team here, and I started back at college, and I'm graduating this year."

Jenna Jaworowicz says she hit rock bottom a dozen times. Her sophomore year at North Farmington High School might have been her lowest point.

"I was literally dying," she says, explaining how anorexia and purging left her so weak, she couldn't get out of bed. "But the thing was, when that was going on, I didn't recognize it. I thought I was fat, and I didn't think I was dying. ... That's what the eating disorder does to you. It distorts everything."

She was in and out of treatment centers, hospitalized, and in the end, her insurance company wouldn't pay for extended residential treatment.

"Insurance refused to pay for any of it, so I had to go home. It was really hard, because I did need to be there. The weekend after I got home, I was purging again. So it's like that week was all for nothing," Jaworowicz says.

The Haglunds helped Jaworowicz find a residential treatment center in Colorado, and the foundation helped pay for it. Jaworowicz's mother and uncle chipped in to cover the rest of the cost, which she estimates was at least $40,000 for more than a month of therapy.

It made all the difference.

Now, she says, "I'm eating my meals and am doing better about honoring my hunger. It's hard for me to be proud of myself, but I really have come so far. I could have died, but look where I am today. ... Something about my treatment this past summer, it really made something click. It made me realize that there's so much more to life than obsessing about my weight and starving myself. It changed my view. It made me realize that maybe there's more to my life than this. I think I'm starting to believe that."

Sources: Dr. Olivia Thakkar and the www.anad.org/get-information/get-informationanorexia-nervosa/

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