RIGHTEOUS INDIGNATION ?

Recently, after expressing my views on the eating disorder community and its many dysfunctions, I was informed by an “eating disorder advocate” that I only had “righteous indignation.” In the past, this same person also opined that I was in the eating disorder community solely to make money.

Righteous indignation? Solely to make money? Let me answer both plainly: my anger is earned, and my motives are grief-forged — not mercenary. I paid my entry fee into this dysfunctional community with the dearest blood possible: my daughter’s. I did not come here to be liked, or to join the chorus of vapid, comfortable, egomaniacal voices. I came because someone I loved was ripped from life. Silence would be complicity.

Make no mistake, there are some incredible, soulful, intelligent, compassionate souls in the eating disorder community. Unfortunately, they largely remain silent, on the sidelines. Fearful of being ostracized or cancelled by the hate filled, social justice warriors.

I wish with every fiber of my being that I was not in this decaying eating disorder community. I wish that I did not know even one person in this horrifically comical, appalling community. For that would mean my daughter, Morgan lived. But since she died, I will allow my “righteous indignation” to illuminate what having a beloved child ripped from life is like.

Sunday nights in an intensive care unit in a hospital in a large city can be very quiet. But, not for you. You hear the ear shattering blaring of alarms, screaming out “Code Blue.” Death is sounding for your daughter. Death has come for you!

With panic in your eyes, you look into her room and cannot even count the number of hospital employees trying to bring her back to life. For at that moment, she is dead. Her heart is not beating. And you feel nothing at that point. The greatest fear a parent can face has you in its powerful, icy grip. Your brain has stopped working. You are not aware of anything… except the frantic efforts to bring her back to life. Finally … they detect a faint heartbeat after nine excruciating minutes.

Do you know what it’s like to have your child dead for 9 minutes while you look on helplessly? It is a lifetime. You are drenched in sweat. You are aware of nothing. Except … for the briefest of times, she is living again.

Until once again … she dies … and you again hear those horrific alarms of death. Again … her room is filled with employees doing all they can to bring her back. You are numb. Your entire world is in that room … on that incredibly dark night. And once more … they briefly bring her back.

That is when the doctors pull you aside and tell you … each time it is more difficult. You ask if she feels any pain. They cannot give you a straight answer. They tell you that in all likelihood, there is already substantial brain and organ damage. You ask them if there is truly any hope. They cannot look you in the eyes and are mumbling non-answers. And you know. You know. You are faced with the most difficult decision any person will ever have to make.

You remember one time in the past, your beloved daughter saying … “Daddy … don’t let me die.” And you know, you know, for an absolute certainty … that your life will never be the same. You wonder if you can ever forgive yourself for betraying those sacred words.

There is nothing performative about that grief. It is not a credential.

You slowly nod your head and quietly, while tears are pouring down your cheeks, say … no more alarms. No more bells. She will go in peace.

You sit next to her, holding her hand, praying for a miracle … knowing that one will not come. Finally, you hear those words which rip the heart from any parent … “She’s gone.”

You slowly walk down the dark hospital hallways. Sunday nights can be quiet in a hospital. You go to a waiting room where your daughter’s mom is waiting with friends. You can’t say the words… only shake your head. And you hear that heart wrenching scream of anguish. And yet, you feel nothing.

Your life as you knew it … is over.

You live in a fog. Making funeral arrangements, service arrangements. You feel nothing. Food has no taste. Your soul is numb. You wonder if you even want to wake up.

But you find a way, some way, to wake up and to keep living. Now, imagine that for most of your professional life, you had been a shallow, superficial, asshole. An attorney without a soul. But something has awakened within you. You begin to feel driven. Perhaps for the first time in your life, you are aware of something far greater than you.

In your daughter’s name, you only want to make a difference. You want to help others. But you are so broken. You make mistakes. You live in a constant state of guilt and shame. Nonetheless, you pledge to help others. And so, you try.

You then discover in the eating disorder community, children’s lives are being reduced to talking points, a and mortality is sidelined in favor of crowd-measuring. You read that this is no place for thin, white people to jump in. You realize that families are being betrayed by radical activists who only wish to parade their own ignorance and internal pain. Nonetheless, you continue to try. You try to serve.

You give two TEDx talks on eating disorders.

You organize and with a medical doctor, present a talk to Apple … and its 150,000 employees. The talk was broadcast on Apple’s North American network.

You organize and with that same medical doctor, present a talk to Raytheon … and its 75,000 employees. Also broadcast on its national network. This talk was so informative and compelling that the Raytheon office hosting it won a national corporate award for collaboration with the community.

You organize and present a 30-minute segment every week on a local radio station entitled, the Mental Health Moment. You have national experts on mental health appear on your show.

You appear on the local CBS and Warner affiliates talking about eating disorders.

The methodist church you belonged to does a video on your daughter and her struggles. With over 300,000 views, no other videos this church has done comes even close.

You speak to school district’s counselors and nurses. You organize presentations to communities. You visit young people in treatment programs. That is still not enough.

You are still living in a twilight that knows not joy, nor love, nor happiness.

Because you do not check the correct political and social boxes, because you frighten people, the eating disorder community turns on you. Have you made mistakes? Hell yes.

But it gets worse. Just five years ago, your father, your mother and your older brother all die within 14 months of each other. Your brother was the picture of health. And he only trusted you to tell the doctors to end his bodily functions. Imagine that much death in such a short period of time.

At that moment in time, your son and his wife have a baby. Imagine the very first time you hold your granddaughter in your arms, you have to tell your son you are flying to Florida the very next day to tell doctors to remove life sustaining equipment from your brother.

You know the eating disorder community doesn’t care. You frighten them because you do not play their pedantic games. You care about life and death not social justice and political statements.

And so, your mindset begins to evolve. You see the vile, on-going corruption in the community. You see the illness which claimed your daughter’s life being used as a platform to spew forth the community’s social justice and political viewpoints. And you reach a point where you say … enough!

Donors to NEDA come to you so angry that NEDA is being turned into a social justice and political side show by Chevese Turner and her social justice warriors. You have the ability and skill to take action. But first, you give NEDA almost 20 opportunities to talk before you file suit. An expeditious settlement is reached, a settlement which also financially benefits research into the genetic aspects of eating disorders. And yet, the very person who attempted to destroy NEDA’s purpose, skates by with no tangible consequences. She knows that her minions and cohorts in the community will continue to breathe life into her. Consequences and ramifications are foreign to the eating disorder community.

Undeterred, you go after more inappropriate conduct in the community. You see the specter of death appear in the words, “Terminal Anorexia.” Like many others, you are horrified. University-based professors write neatly composed articles opposing it, articles which accomplish nothing. Nothing tangible is being done.

So, you take action. You file a number of medical board complaints. That changed everything. You meet Dr. Jennifer Gaudiani and look her in the eyes. Much to your surprise, you do not find a monster. Instead, you find a professional. A soul. A human being. A person then in pain. You talk. And then collaborate with many others. What grew from that hard work was not triumphalism but human connection: colleagues turned collaborators, pain turned toward repair. And maybe … just maybe, you find through adversity a greater understanding about life and death. You realize that the manner in which we face death is just as important as the manner in which we face life.

Then, there is iaedp. The corruption and stupidity in that organization were and are legion. And the eating disorder community DID NOTHING. It cowered. The rot there was obvious and long tolerated. You initially do not pursue headlines and seek to meet and resolve all issues privately. That outreach is rejected. So, professionals in the community request action. The result: past due taxes, penalties and interest in the hundreds of thousands of dollars are being required to be paid. Board certification is being reformed and made more affordable. Individual chapters are gaining their independence. Thousands of therapists are now being spared needless expense. The community has improved — slightly, imperfectly — and for that action, very, very few people have said thank you. Predictable.

You are not finished. Not nearly. You expose how Chevese Turner and others of her ilk took down the Legacy of Hope. And for their misconduct, they have been rewarded and still have a voice. The community blindly accepts those who think like they do. Contrarily, you continue to exist. Living with the greatest heartache possible.

No matter how many times textbooks say, “it’s not a parent’s fault,” or some vacuous therapist tries to convince you of that, they fail. They haven’t lived it. They don’t live with the daily pain, the heartache. The anguish.

I do. Every … single … day.

I have made mistakes, and I will make more in the future. Grief is not a moral compass. But the stubborn refusal to confront corruption, the eagerness to defend the performative rather than the practical, that is the real moral failure. When children’s lives are reduced to talking points, when mortality is sidelined in favor of crowd-measuring, the community betrays the very people it claims to serve.

So — righteous indignation? It is paid in blood and sleepless nights. It is the only honest response left when an industry cloaks politics in the language of care and ignores the medical science in front of it. If you are offended by my anger, consider why the community has earned it.

I do not wish to be part of this community. I wish — every day — that I did not know anyone in it. I wish my daughter, Morgan, were alive. I mourn her constantly. My activism is not grandstanding; it is grief turned toward accountability, toward saving the next life.

If you call that righteous indignation, so be it. I am guilty as charged. And I will keep speaking and acting until this feckless culture chooses truth over theater.

So … righteous indignation?

A brilliant light was extinguished in Dallas on October 30, 2016. That tragedy is the ledger against which I measure every day. Righteous indignation is paid with the dearest blood possible — and I will not apologize for the balance I keep.

When Maladjusted Masquerades as Activism … Weight Stigma Awareness Suffers

Weight Stigma Awareness Week should be an opportunity to confront one of the most damaging forces in healthcare: bias against people in larger bodies. This should be a week for data, clinical rigor, and constructive collaboration. Done well, it can highlight evidence-based solutions, elevate medical leadership, and foster collaboration across disciplines. And families who are suffering are the ultimate recipients of this shared wisdom.

Next week’s agenda includes sessions that could help shape our response to stigma and patient care. For example:

Rebecka Peebles, MD, FAAP, DABOM, & Lauren Hartman, MD — “Healing Without Harm: Ending Weight Stigma in Healthcare.” Practical, evidence-based strategies for clinicians who treat real patients in real exam rooms. The goal is not slogans but practical training rooted in science.

Leslie L. Williams, MD — “Navigating Eating Disorder Risks in the Age of GLP-1 Medications: A Weight-Inclusive Clinical Approach.” With GLP-1 drugs reshaping public conversations about weight and health, the need for clear, medically sound guidance has never been greater. Families deserve facts, not fearmongering.

Abigail Pont, MD — “Anti-Fat Bias in Medical Education Through the Eyes of a Medical Trainee.” Change must begin with training. Reforming curricula to prepare physicians to treat all patients with dignity and competence is not optional — it is essential.

These are the conversations that deserve attention, funding, and follow-through. They are the ones that have the potential to save lives.

But here lies the danger: while some leaders are advancing medicine, others are actively working to undermine it. Instead of fostering collaboration, maladjusted activists reject it. Instead of engaging with science, maladjusted activists ignore and dismiss it. Instead of building trust between patients and the medical community, maladjusted activists sow division, reject science, reject collaboration, and replace patient-centered work with grievance theater.

The weapons they use are fatuous ideology and vacuous grievances void of real substance and merit. This leaves patients and families caught in the crossfire.

This is the dark side of the ledger: militant, maladjusted, angry activists, wallowing in such internal pain, who reject collaboration, denigrate clinicians, and weaponize grievance for influence. This sadly is not theoretical.

It played out in 2021 at the Legacy of Hope Summit — a convening of some of the field’s foremost experts intended to build consensus and advance patient-centered solutions. Instead of joining that work, some radical activists not only opposed it, both before and after, but they tried to burn it down.

The most vocal critic was Chevese Underhill Turner, co-host of Weight Stigma Awareness Week, who also serves on the Board of Advisors of Within Health and is “Queen of the Ashes.”

Regarding the Legacy of Hope, Turner wrote:

“The entire ED community is getting ‘upskirted’ by certain men and we cannot put our own FOMO aside long enough to see it. Instead, we attend these men’s meetings and give them power to continue their gaslighting and lack of any willingness to see the intersections affecting our field. I’d love for other women to join me (and a few others) in being difficult when it comes to these people.”

This was not a critique grounded in evidence. It was not a call for better data or stronger collaboration. It was a deliberate attempt to sabotage a convening of experts — through crude language, ad hominem attacks, and an open invitation to disrupt and destroy.

Turner’s misguided viewpoints do not end there. On various podcasts and in social media, Turner has attacked clinicians, mocks evidence, and replaces medicine and science with grievance politics.

Her own words make it clear:

“It bothered me that all the air was taken by a white perspective.”

“My heart is in the higher weight community, whether a person has an eating disorder or not.”

“I believe bodies are political.”

“Everything is political.”

“I came out of the womb as a political beast.”

“When I hear “marketing” in the context of ED services to marginalized communities I hear white folks not learning from colonization and slavery. We need to stand down.”

“We must also be centering and supporting BiPOC, LGBTQ+, fat therapists and professionals. This is no space for white, straight and thin folks to jump in.”

“When we constantly protect the feelings of those who are oppressing then we never actually get to the work needed to undo the oppression.”

Turner, in writing stated that she supported and was working toward the following: “ … providing reparations to Black People, Indigenous people and People of Color, (“BIPOC”) especially queer and transgender BIPOC; hiring a transgender consultant to revise your marketing material; establishing sliding fee scales for BIPOC, transgender and gender diverse clients; redistributing wealth from the for-profit ED treatment world; embracing and incorporating non-western treatment practices; providing access to Hormone Replacement Therapy.”

These extremist radical views come from ignorance and distrust of the medical community. In Turner’s own words:

“The DSM [Diagnostic and Statistical Manual of Mental Disorders], it is what it is … it’s not great.”

“Those of us who have done the work around our internalized biases no longer trust the medical establishment to actually help us.”

“That has only grown into a place where we are now. Body Positivity Movement. We don’t want to be judged on our looks and our size. The medical community said, ‘Ok. We’re going to judge you on your health.’”

“Most of the country is at a higher BMI, but when you begin to talk about people above a 35 who are visually fat, the oppression increases — plenty of data on that. People in the 50, 60 etc (superfat) range experience even more oppression. These are the folks who are publicly chastised and harmed continuously by the medical profession. Oh, the stories I could tell. Public health in this country is getting it so wrong and there is a better way, but we need to be willing to actually listen to those being harmed.”

“There may be some things with eating disorders that are brain issues … I don’t know.”

Turner’s harmful, illogical, extreme points of view do not constitute insight – they are ignorance masquerading in cartoon regalia, strutting as wisdom. They demonstrate contempt for medical science disguised as activism, reckless to the point of sabotage. And yet, somehow, they earn you the golden ticket to co-host Weight Stigma Awareness Week. Turner’s very presence doesn’t elevate the cause; it cheapens it, hollowing the message until nothing credible remains.

In the past, Turner redirected organizational platforms away from patient-centered care and toward political crusades. As a former officer of NEDA, one of the largest eating disorder organizations in the country, she proudly declared, “We won’t be deterred in our social justice work.” Under her “leadership,” donors were encouraged to contribute to the Minnesota Freedom Fund — an organization later revealed to have posted bail for accused murderers, rapists, and other violent offenders.

Ask yourself: who benefits from public disruption? Certainly not patients. Nor families. Nor clinicians attempting to balance complex risks and benefits. Disruption for its own sake only produces a cacophony of racket instead of clarity. It produces division where we need partnership and collaboration.

And yet, Turner is annually trotted out as a co-host of Weight Stigma Awareness Week even though her message never changes. She is still handed the microphone. Still made co-host. Still rewarded.

Turner’s destructive, insidious pattern is consistent and consequential. When so called leaders prioritize ideological purity tests over rigorous science, they do more than dispute ideas — they undermine care. When organizational platforms are repurposed for partisan causes, and donors are steered toward politically charged funds with questionable implications, the field’s credibility erodes. When individuals who oppose expert collaboration are nonetheless rewarded with boards, speaking invitations, and opportunity, the message is clear: rhetoric is encouraged; results are irrelevant. And yet, that is the reality in the eating disorder community.

In any other professional community, such conduct would bring harsh consequences. Suspension. Banishment. In the eating disorder world, it brings greater influence and opportunity. But it does not have to be that way.

The way forward is clear but it requires courage and resolve:

Elevate science-first voices. Medical experts who ground their work in data and clinical care should be at the center of not just this week, but every week and this field.
Insist on collaboration. Medicine is not the enemy. Progress depends on partnership between clinicians, researchers, and advocates willing to engage constructively.
Enforce accountability. Organizations must set standards of conduct. Those who undermine collaboration with reckless rhetoric cannot continue to hold leadership roles.
Protect patient-centered care. Eating disorder treatment should not be a platform for partisan politics. The focus must remain on evidence-based approaches that save lives.

Patients deserve better than empty slogans. Families deserve better than spectacle and disruption. The eating disorder community deserves leaders who are accountable, collaborative, and grounded in science.

Weight Stigma Awareness Week should not be a stage for any one person’s hate filled ideology. It should be a platform for medical and science based workable solutions.

The choices confronting us are simple.

Evidence based treatment over drama and dysfunction.

Clinicians and researchers who do the hard work of translating evidence into care over charlatans who sell social justice snake oil.

Collaboration over spectacle.

Accountability over impunity.

Lives are at stake. Families are desperate for solutions grounded in competent, humane care. Patients cannot wait for ideology to sort itself out. If we allow disruption to replace discourse, we become complicit in the harm that follows.

And the escalating mortality rate.

When Social Justice Therapists Go Too Far …

Since prolific anti-semitism directed toward Jewish therapists by non-Jewish therapists is an appalling reality, it was predictable that the assassination of Charlie Kirk would reveal the worst in humanity … including of course, eating disorder therapists and family liaisons. More’s the pity.

When a loved one has an eating disorder, families are already living in a war zone. Every meal feels like a battlefield. Every doctor’s appointment feels like judgment day. And when parents turn to therapy, they are not looking for ideology, slogans, or someone’s Twitter feed come to life. They are looking for life saving help.

Eating disorders don’t care about politics. They don’t care about hashtags. Eating disorders only care about shutting down organs, hijacking minds, and killing people. But too many therapists, treatment centers, and professional organizations are importing America’s divisiveness into treatment. The result? Families are left paralyzed, distracted, and betrayed.

More and more therapists and family liaisons are peddling something else: politics disguised as treatment. Some wave the flag of “Free Palestine” with militant zeal. And yet, most could not even remotely explain the complex nuances of Middle East politics going back thousands of years. When the phrase, “From the River to the Sea,” is spewed forth with all the hatred and horror which exists within the soul, many therapists and activists cannot even identify which river or which sea is being referred to, let alone identify the dark significance of that phrase.

These militant therapists and family liaisons sneer that the death of Charlie Kirk, a conservative commentator was deserved, and in their ignorance and room temperature IQs, slap “ism” labels on him and then rejoice that his life was tragically cut short. These providers and activists are intentionally obliterating the line between activism and care. Families should take this as the clearest possible warning sign: walk away. As fast as you possibly can. Do not trust those people or their organizations.

It is bad enough that families seeking help often find therapy rooms that sound more like activist seminars than clinical spaces. Instead of guidance on food and recovery, they get:

“Diet culture is colonialism.”
“Anorexia is a symptom of white supremacy.”
“Thin privilege is the real disease.”

These are not treatment strategies. They are slogans, ripped from Twitter and recycled in therapy sessions. When families should be hearing about family-based treatment (FBT), CBT-E, or medical stabilization, they’re handed culture-war scripts that do nothing but fracture trust.

Eating disorders thrive on chaos and division. They feed on families who are fractured, therapists who are distracted, and organizations that are broken. Every minute spent arguing over slogans is a minute not spent on saving a life. Every resource squandered on activism is a resource stolen from recovery.

Therapy is supposed to be a sanctuary from the chaos of the outside world. It is supposed to be a space where pain is met with compassion, not political litmus tests. Injecting social justice battles into that space doesn’t just distract — it actively harms.

Here’s how:

It replaces healing with indoctrination. Patients and families arrive desperate for answers about food, weight, fear, and survival. Instead, they may be handed lectures about geopolitics, race, or privilege. The family’s suffering becomes a prop for the therapist’s personal crusade. That is gross exploitation, not care.

It breeds division when unity is essential. Eating disorders tear families apart. Recovery depends on pulling together. A therapist who filters everything through activism risks turning family members against each other based on political or cultural identity. That kind of manufactured division is gasoline on the fire.

It signals contempt for dissent. A therapist who proudly mocks the death of someone they dislike politically is broadcasting one thing: if you disagree with me, I do not respect you. How could any family trust such a provider to respect their child, their family bond, or their values? Trust collapses before therapy even begins.

It encourages rigidity instead of curiosity. The most effective therapists know they don’t have all the answers. They ask, they listen, they adapt. But the activist-therapist thrives on certainty: oppressors vs. oppressed, good vs. evil, us vs. them. That rigidity suffocates the flexibility patients desperately need for recovery.

It undermines professional ethics. The ethical codes of every counseling profession warn against imposing personal beliefs on clients. Therapists who cannot resist bringing their political militancy into the room have already failed the most basic test of professionalism.

Let’s be clear: cultural awareness and respect for diversity are good things. But respect is not the same as ideology. Sensitivity is not the same as indoctrination. Families need therapists who can meet them where they are, not therapists who drag them into battles they never signed up to fight.

Eating disorders are the second most lethal mental health illness, outpaced only by opioid addiction. This is life-or-death work. Families should demand nothing less than evidence-based treatment, humility, and compassion. When a therapist instead advertises their political rage as part of their practice, they are showing you what matters most to them — and it isn’t your child’s recovery.

The therapy room should be sacrosanct and must never be allowed to become another front line in America’s political battles. Families: if your loved one’s treatment starts to look like activism instead of medicine, get out. Your child’s survival depends on science, unity, and clarity — not the noise of a broken country bleeding into a broken field.

LIVE OR DIES … Ai DECIDES

Your 18-year-old daughter, who is struggling with severe anorexia, desperately needs a higher level of care. Biologically, her organs are failing. You make a claim with your health insurance company. And you receive a denial.

You quickly research and then discover an Ai program utilized by the insurance company made the decision to deny saving your daughter’s life.

Welcome to the world in which we live. Where Ai programs may be making life and death decisions about your loved ones. That is the very harsh reality. So, let’s explore that reality.

First, what is “artificial intelligence?” The term itself is so vague as to be mystifying. What makes it artificial? The fact that human beings invented it? That it is silicone based instead of carbon based? Is the programmed intelligence, which is designed to learn at a rate far faster than humans can possibly comprehend, deemed artificial because it lacks a sentient existence?

Is Ai artificial because whereas it may “learn,” it does not experience the subtle nuances and life experiences which make us all unique? Does Ai have a soul? For that matter, do we?

Regardless, with Ai still being in an early stage of development, and with Ai’s developing interaction with humans, we must find ways to build guard rails so that Ai is not in a position where it could singularly make life and death decisions. Decisions which are often made by health insurance companies when deciding to pay, or not pay, for life saving surgeries or treatment. Or is it already too late?

Imagine if you will, an Ai program being utilized, without human interaction, to review and decide a claim or an appeal of a claim for a higher level of care, or to receive necessary treatment or to receive a life-saving procedure. An Ai program with no human experiences, no ethics, no soul, no subtlety, no morality. To leave our very existence in the hands of a machine, a machine that cannot love, cannot experience sorry, or joy, or happiness, or despair. And yet … that is happening. Today.

In 2020, UnitedHealth Group division Optum acquired naviHealth and its algorithm for predicting care, called nH Predict, which UnitedHealth uses and contracts out to other insurers, including Humana. Multiple industry sources estimate that Optum paid at least $1.1 billion dollars and when considering debt and related financial structuring—the purchase price is estimated to be as high as $2.5 billion. When asked by the Guardian, a spokesperson for UnitedHealth Group denied that the algorithm is used to make coverage decisions. [Like when UBH denied it ran its guidelines through its accounting and finance departments?]

UnitedHealth, Humana and Cigna are facing class action lawsuits alleging the insurers unethically relied upon Ai generated algorithms to deny lifesaving care.

One of the lawsuits alleges that Cigna denied more than 300,000 claims in a two-month period. This equates to spending approximately 1.2 seconds for each presumably physician-reviewed claim. Such a practice is aided by algorithms, the lawsuit alleged.

The Cigna lawsuit also alleged that nH Predict had a 90% error rate, meaning nine out of 10 denials were reversed upon appeal – but that vanishingly few patients (about 0.2%) appeal their denied claims, leading them to pay bills out of pocket or forgo necessary treatment.

Appealing denied claims means big business. The US Centers for Medicare and Medicaid Services estimate that when insureds appeal initial denials administrative costs for insurance providers exceed $7.2 billion annually.

According to a United States Senate Report issued in October 2024, UnitedHealthcare, CVS and Humana – the three largest providers of Medicare Advantage, together provide almost 60% of all Medicare Advantage coverage – but reject prior authorization claims at higher rates using technology and automation. That report can be found here:

Click to access 2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf

To support the implementation of Ai, health insurance companies argue that Ai programs streamline claims processing, more effectively flag fraud, and promise greater speed, efficiency and cost savings. They claim that by automating routine claims, Ai frees up human reviewers to focus on complex or borderline cases that require medical judgment and nuance. (For that matter, don’t all claims require medical judgment?)

Despite its alleged advantages in claims processing, Ai has faced fierce criticism, especially when its role extends to denying coverage or appeals for essential care. Ai is not immune to flaws, as its decisions depend on data quality and programming — both of which can perpetuate mistakes or systemic biases. Garbage in Garbage out.

Many Ai systems operate opaquely, leaving patients, providers, and even insurers unsure how specific decisions are made. This undermines trust and impedes meaningful appeals.

Numerous lawsuits allege that Ai tools prioritize cost-saving over medical necessity. In some cases, Ai has overridden physician recommendations, resulting in denials of rehabilitation, mental health services, or life-saving treatments.

There is a widespread perception—and often a harsh reality—that health insurers prioritize profits above the needs of their insureds. Ai tools, by automating denials or aggressively limiting coverage, can exacerbate this distrust, especially when decisions feel impersonal or unjust.

Critics argue that Ai systems are often deployed as “rubber stamps,” with little or no meaningful physician review—contravening legal and ethical obligations.

Meanwhile, states like California have moved to ban Ai-only coverage denials, signaling a wave of regulatory intervention.

As for those health insurance companies which utilize Ai alone to decide claims or appeals, the major issues focus on:

Risk of Profit-Driven Bias: Ai tools influenced by financial priorities may embed cost-saving incentives that override medical necessity, echoing problems revealed in the Wit v. UBH case.

Lack of Clinical Nuance: Ai lacks the ability to fully understand complex medical contexts or patient histories that human clinicians evaluate.

Transparency and Accountability: Patients have a right to clear explanations and meaningful appeals, which Ai-alone systems often fail to provide.

But that is where we are. Ai is being utilized by insurance companies to decide claims and appeals. Although the insurance companies may deny this fact, it is a reality. Especially since widespread use of Ai in denying claims and appeals will result in much greater profits for these companies.

To counter this reality, the future must be shaped by the following:

Stronger Regulatory Frameworks

States and potentially federal regulators are developing rules to ensure Ai complements—not replaces—human medical judgment. Requirements for physician involvement, transparency, and appeal rights are expected to expand.

Increased Legal Scrutiny

As lawsuits proceed, courts will clarify the legal boundaries of Ai’s role in coverage decisions, particularly under ERISA, Medicare Advantage rules, and consumer protection laws.

Pressure for Transparency and Explainability

Insurers may face mounting demands to disclose how Ai tools function, how decisions are made, and how patients can challenge automated denials.

Smarter, More Ethical Ai Development

Future Ai systems may incorporate safeguards to avoid wrongful denials, improve alignment with medical standards, and enhance explainability.

Ai’s exploding involvement, or interference in our lives will only increase. That is inevitable.

There is the potential that Ai can make health insurance claims processing faster, fairer, and more efficient—but only if deployed responsibly. It must address not only human fallibility but also the systemic distrust stemming from the reality that insurers prioritize profits over patients. Lessons from Wit v. UBH remind us that financial influence over clinical decisions can have devastating consequences, a cautionary tale for Ai implementation.

As courts, lawmakers, and the public demand accountability, the health insurance industry faces a pivotal choice: embrace Ai as a tool to support—not supplant—human expertise, or risk eroding trust and facing costly legal consequences.

The future of Ai in health insurance is not just a technological issue—it is a legal, ethical, and societal issue. Right now, the live of your loved one may very well depend on a machine. On Ai. A lifeless, soulless computer program devoid of all emotion, mercy and humanity.

That is our reality right now. Allow yourself to contemplate that reality and perhaps yes, be afraid. For our future depends on wisdom far greater than humanity has ever demonstrated. Our health depends on it. Our very lives depend on it.

COLLABORATE OR PERISH

June 2, 2025, was World Eating Disorders Action Day. (“WEDAD”) According to the organizers, “… over 300 organizations … stepped up—hosting events, launching social media campaigns and podcasts, conducting interviews, and working across borders and disciplines to make an impact on this one crucial day.”

Dra. Eva Trujillo, (whom I like and respect) was one of the drivers of WEDAD. Her quotes included:

“When we act together, our impact is stronger. We are looking for new voices, perspectives, and passionate professionals ready to serve.”

“Are we, as a field, ready to begin healing the divides within our own community? Or are we too overwhelmed trying to survive?”

“It’s a question that haunts many of us, and it’s time we face it with courage and honesty. We can’t build meaningful change externally if we remain fragmented internally. This is a moment for us—clinicians, educators, researchers, advocates, sufferers, and caregivers—to come together—not in perfect agreement but in shared purpose.”

“We must start connecting. Not by taking sides, but by building bridges, amplifying what unites us, listening more than speaking, and doing the hard work of healing, both within and beyond our professional circles.”

An officer from another organization stated:

“So, how do we begin to heal our community?”

“As organizations, we begin by reaching out to one another, recognizing each other’s strengths, sharing our own, and uniting our efforts to broaden services and support.”

“Together, we are stronger.”

Fine words. Grand words. But … just words. So, how do we put into action the concept behind those words and turn them into reality?

A few weeks ago, I attended ICED 2025 in San Antonio. [As an aside, ICED 2026 is scheduled for June 3 – 5 at … The Hague. And by wonderful coincidence, the Formula 1 Grand Prix in Monaco is scheduled for June 5 – 7! Can you say Bucket List? Super yachts in Monaco Bay. Black tie casino gambling. Incredible parties. But … I digress.]

Most of my time at ICED 2025 was spent darkening the Exhibit Booths, listening to a few presentations, swilling whiskey and having my tail handed to me playing chess in the hotel lobby. But, in my wanderings, I noticed the following organizations did not have a booth, or for that matter, any presence: NEDA, iaedp.

They were not listed as sponsors. They were not listed as exhibitors. Their CEOs were not there. (or if they were, they kept out of sight).

Perhaps that is where we must start. Or does it go deeper than that?

Let us pose some questions which surely must be asked:

Does the eating disorder community really need three (3) independent organizations, AED, iaedp and NEDA?
If so, why? Especially since all three appear to be flailing if not failing.
Isn’t it in the best interest of the families suffering from this illness that one unified, strong entity comprised of the best of those organizations be formed?

The problems and issues at each of the organizations are alarming.

iaedp is engulfed in a lawsuit which, if successful, will result in its demise and possibly the end of board certification. Iaedp also has a very large financial burden for past due taxes, penalties and interest. On its last F0rm 990, it showed a loss of $284,806.00. Since membership is no longer required to maintain board certification, its membership is dwindling. A number of iaedp individual chapters have dissolved. Its next symposium is being held in Baltimore … in the middle of winter. Iaedp’s “Members at Large” a/k/a Board of Directors is comprised of persons with no outside corporate or legal experience.

The issues at AED are also troubling. From 2020 through 2023, AED reported a total combined loss of -$658,156.00. The cancellation of billions of dollars in NIH grant funding resulted in many university professionals unwilling and unable to attend AED’s ICED and not renewing their membership. A contentious relationship with international chapters plagues AED.

NEDA, unlike AED and iaedp, showed a profit on its last Form 990. On its 2023 Form 990, it showed net revenue of $1,836,601. However, in the three prior years, it showed three consecutive losses in a combined amount of $1,913,492.00. NEDA sold its telephone helpline to the National Alliance. But, besides conducting its fun walks and awarding some grants, (for which it should be commended), has time eroded NEDA’s impact in the community?

Therapists are intimidated by research professionals. Research professionals do not have the wisdom gained from being on the front lines, that is, in the actual therapy rooms. Medical clinicians are frustrated waiting for research findings to be released. Uninformed and misguided fat activists are just causing chaos. And the wheel turns round and round with little, if any progress being made.

Dra. Trujillo acknowledged the divides which exist in the community. So, where does progress start?

Perhaps we begin with transparency. An element so missing in the eating disorder community. No organization or person in the community is inventing a cure for cancer or devising the next generation of Ai/Robotics technology. Certainly, private organizations and companies generally do not disclose financial information or voluntarily broadcast future expansion or retraction plans. But we are dealing with a mental health illness with a high mortality rate. Families are severely impacted every day. It seems as if eating disorder organizations and entities have lost sight of that reality.

And so, transparency and collaboration must start at the organizational leadership level. To start to accomplish this, accommodation and grace must be given.

Starting with iaedp’s next Symposium to be held in Baltimore in February 2026, iaedp must allow NEDA, AED, FEAST to have exhibit booths and have at least their three highest ranking officers to attend … at no cost. During the Symposium, the leaders from all organizations must meet to discuss all issues they have in common. Issues unique to each organization. The future is discussed. Planning is shared. Finally, at the end of the meeting, an open forum is convened both in person and via zoom. A forum that any concerned person can attend and ask questions, live or via the internet. The leaders share with everyone the topics of discussion and the plan of moving forward.

In 2027, at AED’s ICED to be held in Phoenix, Arizona, it is AED’s turn to host the other organizations utilizing the same format.

In 2028, these collaborative meetings may not be necessary. That is because by 2028, hopefully all major organizations will have realized that the tribal way they have done business in the past is not effective and does not work. In fact, the piecemeal, isolationist way each organization currently attempts to operate has failed. The six figure financial losses every year. Membership dwindling. As has been noted, people leading organizations have admitted that division exists in the community and needs to be healed. But these divisions cannot be healed singularly.

The old way of doing business has failed. The mortality rate worsens. The number of loved ones and families suffering continually increases. Each organization in their own way has failed and contributed to worsening the situation. So, how can we possibly proceed in the future?

The best way, the path which provides the greatest likelihood of success is to have these organizations merge into one entity. One large, collaborative organization. Therapists, medical doctors, research professionals, advocates all under one tent. Talking together in the spirit of professionalism and respect. Combining the greatest minds of different tracts to share knowledge, wisdom and ideas. Casting individual egos aside for the greater good. Bringing in corporate and legal experts to assist in reorganizing and providing many additional outlets for fundraising.

One large, all-encompassing yet diverse organization. An organization which would be able to lobby more effectively to address the true needs of the community. An organization which would be able to approach large corporations and foundations to engage their substantial resources for the purpose of working toward true breakthroughs in our understanding and treatment of eating disorders.

Now make no mistake. The obstacles are many and the challenges are great. There are those who will oppose this collaborative entity merely because it threatens their self-importance. There is a faction in the eating disorder community which actively fights against progress unless that progress exclusively involves their own pedantic points of view.

Nonetheless, the handwriting is on the wall. The commendable accomplishments of individual organizations in the past have been relegated to the past. The old way of doing business no longer works. It is not effective. That is shown by the deteriorating financial condition of these organizations, the deep divisions which exist in the community and most importantly, the number of our loved ones who continue to be taken.

Our loved ones who continue to die in ever increasing numbers.

That should be the first, middle, last and only concern of these organizations. The time is now. The future awaits. Collaboration beckons.

THE VICTIMS … THEIR FACES

I was recently advised that articles about IAEDP and Acadia were getting redundant.

So, why continue ?

Regarding Acadia, the answer is quite simple. Because its systemic corruption continues seemingly unabated and its vapid denials and inane posturing have reached an absurd level.

But before going into the most recent damning New York Times investigative article on Acadia, let’s look into the eyes of some of their victims:

Christopher Gardner

Five year old Christopher was left for 8 hours in a transport van at a West Memphis, Arkansas daycare facility owned by Acadia. Workers tried to cover up their gross negligence by signing documents showing that Christopher was taken inside the West Memphis day care center, even though he remained on the van. At least one media outlet reported the temperature in that van rose as high as 141 degrees. Christopher died in that van.

Deborah Cobbs

In May 2024, 20-year-old Deborah Cobbs, died after she threw herself down a staircase. At Timberline Knolls. Police reports indicate that she attempted to run away from the campus twice that very day. Which makes it quite curious as to why she was not being closely supervised.

Tiley McQuern

In January 2023, Tiley McQuern, 50, was found dead in her bed at Timberline Knolls after swallowing too many pills.

Those are just three of the many Acadia victims. Look at their faces. Never forget their faces. Because the faces in those photos are all that is left for their loved ones.

On April 22, 2025, the New York Times published an article about Acadia’s now shuttered and infamous facility, Timberline Knolls. It is entitled, “Suicides and Rape at a Prized Mental Health Center. Timberline Knolls, a mental health center owned by Acadia Healthcare, skimped on staff. Then came a series of tragedies.”

Although behind the New York Times paywall, the good people at the Salt Lake Tribune published the article in its entirety here:

https://www.sltrib.com/news/nation-world/2025/04/22/timberline-knolls-owned-by-acadia/

Some of the statements in the article include:

“But dangerous conditions persisted for years at Timberline Knolls, an investigation by The New York Times found, in part because of pressure to enroll more patients without hiring enough employees.”

“Two former residents sued Timberline Knolls last year, claiming that an aide had raped them. Acadia had hired the aide despite a criminal record that included domestic violence and gun charges.” [emphasis added]

“Another resident — a child who was a ward of the state — nearly died after she overdosed on medication that had been left out in a common area, according to former staff members. And two other women died by suicide after being left unsupervised, a rare occurrence at mental health facilities.”

“We were extremely understaffed,” said Cecilia Del Angel, who worked as a behavioral health aide at Timberline Knolls until last July. Several other former employees echoed that sentiment. The patient deaths, Ms. Del Angel said, were “entirely preventable.”

“Illinois regulators had not looked into the suicides. A spokesman for the state’s health department said it did not regulate Timberline Knolls, and the state’s Division of Substance Use Prevention and Recovery had not visited the property since 2019.”

“The problems at Timberline Knolls were part of a nationwide pattern of lapses at Acadia, one of the country’s largest for-profit providers of mental health services, with more than 260 facilities in 39 states, The Times found.”

“Acadia has closed facilities over the past decade after reports of sexual abuse. More than a dozen patients reported sexual assaults at an Acadia psychiatric facility in Utah. At a youth treatment center in New Mexico, patients claimed that staff had sex with them and pushed them to participate in “fight clubs.” And in Michigan, three women said they had been sexually abused by a supervisor at a youth treatment center.”

“In the summer of 2018, patients complained to Timberline Knolls employees that a therapist, Michael Jacksa, had sexually abused them on Timberline’s campus. The facility waited more than three weeks to call the police, doing so only after the patients complained to the state’s substance abuse agency, court records show.”

“Timberline’s leader at the time, Sari Abromovich, said an Acadia executive had told her not to alert the authorities, according to a deposition she gave in a lawsuit later filed by one of the women who was raped.”

“Ms. Abromovich, who was fired in 2018, said she was under daily pressure from corporate managers to fill beds and keep expenses low by skimping on staff.”

“Patient enrollment fell with the news of Mr. Jacksa’s arrest. In the ensuing years, Acadia pressured staff to find new ways to fill beds, according to eight former employees, who spoke on the condition that The Times not publish their names because they still work in the mental health industry.”

“Staff struggled to prevent patients from fighting, harming themselves and escaping the facility. In 2020, the Lemont police were called to Timberline Knolls 222 times, police said. By 2023, that number had soared to 519. No one else in Lemont made more emergency calls.”

“In a brief telephone call with The Times, Eiliana Silva, the director of J.P.’s [rape victim] residential unit, acknowledged that she had heard concerns from staff about Mr. Hampton [the rapist/employee] but said she could not properly supervise him because she was one of only two directors overseeing five lodges. As soon as she heard about J.P.’s complaint, she said, she relayed it to Timberline Knolls’ leadership.”

“At the time Timberline Knolls’ leadership heard the accusations against Mr. Hampton, the staff was still reeling from three other disasters.”

“In January 2023, Tiley McQuern, 50, was found dead in her bed after swallowing too many pills. A staff member told police that although employees were supposed to check on patients, those checks were “not thorough,” police records show.”

“Seven months later, a child, who had been placed at Timberline Knolls by the state’s child welfare agency, was rushed to the hospital after overdosing on medication that a staff member had left in a common area.”

“Then, in May 2024, another resident, 20-year-old Deborah Cobbs, threw herself down a staircase while no one was supervising her and died. She had tried to escape Timberline twice that day, police records show. Ms. Cobbs had also told several people that she was feeling suicidal, according to former employees who worked there at the time.”

So, what was Acadia’s response to this legion of corruption and harm to those entrusted to their care?

“Tim Blair, a spokesman for Acadia, said in a statement that the company had a zero-tolerance policy for behavior that could put staff or patients in danger. “We reject any notion that we put profits over patients,” he said, adding that “complaints and incidents are investigated and addressed.”

“Mr. Blair denied that Timberline Knolls had dangerous conditions and said it had adequate staffing levels.”

Another unidentified Acadia spokesperson said, “The recent New York Times story about Timberline Knolls, a closed Acadia facility, includes material inaccuracies and cherry-picks and conflates historical incidents to paint a false and inaccurate picture of the safety and quality of the care our facilities provide.”

Acadia’s corruption is vast. A report by the National Disability Rights Network detailed allegations of inappropriate physical restraints, sexual abuse, and emotional abuse at for-profit treatment centers, citing examples at Acadia facilities including an incident where a 9-year-old was injected with antihistamines as punishment at an Acadia facility in Montana.

In March 2025, three adolescents filed a lawsuit against Detroit Behavioral Institute, LLC and its owner, Acadia. The plaintiffs allege widespread sexual, physical, and psychological abuse inflicted on dozens of children. In fact, more than 35 people have come forward after they were reportedly abused as children at the Detroit Behavioral Institute between 2005-2022. The lawsuit alleges that the children were groomed, sexually assaulted and those that spoke out were retaliated against.

Naturally, Acadia closed the facility in 2022.

https://www.clickondetroit.com/news/local/2025/03/11/trapped-in-a-jail-of-horrors-juvenile-detroit-facility-accused-of-abuse-cover-ups/

Acadia’s response to that lawsuit? “The well-being of all patients is of the utmost importance to Acadia Healthcare and its affiliated facilities. We take these allegations seriously. While we can’t comment on specific allegations and patient situations due to privacy regulations, the picture being painted of Acadia and the quality of care provided by our facilities is inaccurate. We intend to defend this case vigorously.”

It is enlightening that Acadia’s public response to both the Timberline Knolls scandals and the horrific allegations against Acadia’s Detroit facility utilize almost identical language … “the picture being painted of Acadia and the quality of care provided by our facilities is inaccurate.

In addition, the same day the New York Times published its story, Acadia released its own statement entitled, “Setting the Record Straight: Acadia is A Leader in Quality, Safe Behavioral Healthcare.”

That statement can be found here:

https://quality.acadiahealthcare.com/setting-the-record-straight-acadias-a-leader-in-quality-safe-behavioral-healthcare/

It should come as no surprise that Acadia once again uses its old stand by line, “Regrettably, a recent media report cherry picked and conflated historical incidents at a closed Acadia facility to paint a false and inaccurate picture of the safety and quality of the care our facilities provide.”

So apparently, medication overdoses causing death while under the watchful eyes of Acadia, two suicides in the facility within a year, a minor taken to a local hospital because of a drug overdose, numerous young women being sexually assaulted and raped, five hundred nineteen (519) 9-1-1 calls within one year all fall into the category of “false and inaccurate picture of the safety and quality of the care our facilities provide.”

So, painting an inaccurate picture? Like this?

Or is the painting inaccurate because it does not nearly portray the numerous additional instances of abuse, misconduct and neglect perpetrated by Acadia?

It seems as if Acadia anticipates these lawsuits and issues the same trite defensive language dripping in lawyer ick. For Acadia, it is merely the cost of doing business with our loved ones being nothing more than corporate commodities.

Acadia’s profiteering at the expense of its patients results in the dirtiest kind of money. And yet, our eating disorder organizations continue to close their eyes and continue to accept Acadia’s dirty money. In February, it was iaedp at its annual symposium.

Next month in San Antonio, it is AED’s turn to turn a blind eye and accept Acadia’s dirty money. In doing so, AED arguably becomes complicit in the following odious, reprehensible acts perpetrated by Acadia and its feckless employees:

Multiple rapes in their treatment facilities located in a number of states;
Multiple sexual assaults in their treatment facilities located in a number of states;
Multiple attempted suicides in their treatment facilities located in a number of states;
Multiple successful suicides in their treatment facilities located in a number of states;
Having your lack of oversight result in the death of a 5 year old child left under your care;
Acadia’s officers and Board of Directors engaged in a scheme to defraud and mislead investors concerning patient care, staffing levels and legal compliance issues;
Acadia and its employees submitting false claims for payment to Medicare, Medicaid and TRICARE for inpatient behavioral health services that were not reasonable nor medically necessary;

There are many other woeful, reprehensible, unethical, illegal and criminal acts being perpetrated by this rogue organization. But even all of this is not enough to make eating disorder organizations take notice, stand up, and say enough, no more, no longer will we permit you to abuse the most helpless, vulnerable people in society. We refuse to be part of your misconduct.

Instead, like a common street walker, these organizations stand by with their hand extended willing to participate in any act no matter how vile, demeaning or degrading for its 30 pieces of silver.

MEDICALLY INDUCED COMA FOR ANOREXIA?

There are numerous quotes about being in a “coma” scattered throughout Hollywood movies.

“Paralyzes him, puts him in a coma, then keeps him alive. Now what the hell is that?

Alien

“Her heart. Can you give her something? – She’ll go into a coma.”

Exorcist

“Unless they’re completely supplied with lysine by us, they slip into a coma and die.”

Jurassic Park

“He’s in a coma. – Then bring him out of it. I want to talk. Now, doctor.”

Green Hornet

“When he arrived here, he was very ill, in a coma, not likely to live. And yet in a matter of ten days, his body is fully recovered.”

36^th Chamber of Shaolin

“We don’t know what the hell to do at this point. So, let’s put her in a medically induced coma and tube feed until she gains 20 pounds. That should fix things right up!”

The Marx Brothers in Medical School [Ok, not a real movie.]

Apparently, in the UK, a recent Telegraph investigation revealed that NHS hospitals authorized at least six young women with anorexia to be placed into comas in order to restore their weight.

https://www.dailymail.co.uk/news/article-14503651/Anorexic-girls-coma-NHS-hospitals-force-feed.html

Doctors attempt to argue that this hair-brained plan … err, I mean, that intervention is necessary to prevent death. However, reputable professionals and specialists caution it is a high-risk intervention with no medical precedent and that safer, evidence-based alternatives exist.

Before jumping into this fray, I should note that about three years ago when a previously untested and untried end of life option which shall not be named (thank you Harry Potter) [but, it rhymes with “Perminal Plannoplexia!]

was brought into the public consciousness, I went full blown nuclear from day one, filed ethics and board complaints and was considered (by some) very ugly in published articles.

Well, I learned my lesson. This time I am going to be more measured. More reasoned. More compassionate. Kinder, Gentler …

Before we delve into this latest Marx Brothers like Clown Show, let’s review the numerous criticisms of NHS hospitals in the UK.

A health ombudsman in the UK made the following remarks about the treatment of eating disorders in NHS facilities:

“Urgent action is needed to prevent people dying from eating disorders, the parliamentary and health service ombudsman for England has warned, as he said those affected are being “repeatedly failed”.

“The NHS needs a “complete culture change” in how it approaches the condition, while ministers must make it a “key priority.”

“Little progress has been made since the publication of a devastating report in 2017, which highlighted “serious failings” in eating disorder services.”

“Lives continue to be lost because of “the lack of parity between child and adult services”, and “poor coordination” between NHS staff involved in treating patients. There remain issues with the training of medical professionals.”

“Eating disorders are enormously complex, and those on the frontline treating people have a tremendously difficult job to do. This [is] not helped by a lack of a sense of urgency to address the scale of the problem. Clinicians need better support to do their job of protecting patients.”

“It is heartbreaking to see repeated mistakes and tragedies happening again and again. We need to see a complete culture change within the NHS, where there is a willingness to learn from mistakes.”

“The government also needs to fulfil its promise to treat eating disorders as a key priority so that we can see meaningful change in this area and make sure patients receive the quality of care they deserve.”

Tom Quinn, the director of external affairs at Beat, an eating disorders charity, said it was “appalling” that vulnerable patients were not getting the treatment that they desperately need.

NHS figures evidence the number of children being treated for eating disorders more than doubled from 5,240 in 2016-17 to 11,800 in 2022-23.

Doctors and charities warn limited access to community services means both children and adult patients are not able to access treatment quickly enough, which has led to many becoming so ill that they need urgent hospital care.

Ok, I think we got it.

A lack of urgency. Governmental ambivalence. Not learning from past mistakes. Repeated tragedies. Lack of support. Poor coordination. Insufficient training of professionals. Little progress addressing past serious failings. Exploding number of eating disorder patients. Limited access to care.

And the NHS’ solution is … let’s put “em in a coma!” Blimey! And Bob’s your Uncle!

Cue the Benny Hill yakety sax music …

Let’s put the patients “on ice,” tube feed them until they gain 20 pounds, have Prince Charming come along to give them “love’s first kiss to wake them up,” [No wait… Prince Charming was a creepy stalker!]. Ok, A rebellious, hoody wearing bandit named Jonathon comes along, kisses Snow Woke, she wakes up from her coma and along with his bandit friends, they storm the Bastille and live happily ever after. Back to reality now.

A medically induced coma …

Being placed in a coma and hopefully waking up with no resulting physical harm is wrought with peril. There is the increased risk of lung infection. The possibility of damaged lung tissue. Blood clots could develop in the legs possibly leading to a pulmonary embolism. Muscle breakdown and nerve damage. Possible memory loss and seizures. Weakened immune system. Dangerously low blood pressure. And of course… death.

Medically induced comas are too high risk for psychiatric treatment and are reserved for brain protection in life-threatening cases.

One can’t help but wonder if the NHS doctors in the UK first attempted rTMS. Or a ketamine regiment. Or Deep brain stimulation. Or responsive neurostimulation. The facts indicate otherwise.

In 2024, the NIHR Maudsley Biomedical Research Centre reported that it completed its first clinical trial of repetitive transcranial magnetic stimulation to the prefrontal cortex in patients with severe enduring anorexia nervosa.

Last year. The first clinical trial of rTMS… 2024.

Ketamine? Yeah… No.

On April 4, 2024, it was reported that King’s College researchers were awarded £1.45 million from the MRC Developmental Pathway Funding Scheme to run a randomised controlled feasibility trial of oral ketamine vs placebo in people with both anorexia nervosa and treatment resistant depression, marking the first time that ketamine has been used in a trial of this kind.

Last year. The first clinical trial of ketamine … 2024.

Seeing how according to the literature, rTMS and ketamine were not clinically trialed until 2024, it is very unlikely that these treatment regiments were first attempted.

And so instead, the NHS solution was to put these young women into a coma and then tube feed them. One can’t help but wonder if they first at least tried leeches or attempted to bleed the bad humours out of their blood. Trepanation? Tobacco smoke enemas?

There is certainly enough medical literature detailing the use of forward thinking medical treatment for anorexia nervosa. Were these treatments even first considered? Were they utilized? [from the UK literature, that would be highly unlikely.] I think we all know the answers to those questions.

Instead, we are left once again with the reality that universally we do not know nearly enough about eating disorders. Globally, medical providers have not found a way, nor the ability to collaborate, share knowledge, consult with professionals from different backgrounds and countries and to come to the realization that collective knowledge exceeds individual knowledge.

Which results in medieval type, untested and untried experimentation on guinea pigs. Except they aren’t guinea pigs. They are our loved ones.

Loved ones being treated by Groucho, Chico and Harpo.

We deserve better.

BMI … Barely Medically Important

In the past few years, the State of Colorado and the American Medical Association reviewed the use of BMI, (Body Mass Index, or perhaps it should be known as Barely Medically Important) as a tool to measure health.

The Colorado legislature implemented a new law.

The AMA adopted a new policy on how BMI should be used as a measure in medicine.

Both instances represent a more thorough understanding of health, eating disorders and medical and mental health issues. And they are both good starts. But as in all things, there are issues.

American Medical Association

In June 2023, the AMA adopted a new policy clarifying the role of BMI as a measure of medicine. Aspects of the policy can be found here:

https://www.ama-assn.org/delivering-care/public-health/ama-use-bmi-alone-imperfect-clinical-measure#

In short, the policy states, “Under the newly adopted policy, the AMA recognizes issues with using BMI as a measurement due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations. Due to significant limitations associated with the widespread use of BMI in clinical settings, the AMA suggests that it be used in conjunction with other valid measures of risk such as, but not limited to, measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors. The policy noted that BMI is significantly correlated with the amount of fat mass in the general population but loses predictability when applied on the individual level.”

The AMA also modified existing policy on eating disorders calling on the AMA to:

Encourage training of all school-based physicians, counselors, coaches, trainers, teachers and nurses to recognize abnormal eating behaviors, dieting and weight-restrictive behaviors in children and adolescents and to offer education and appropriate referral of adolescents and their families for evidence-based and culturally informed interventional counseling, and;

Consulting with appropriate, culturally informed educational and counseling materials pertaining to abnormal eating behaviors, dieting and weight-restrictive behaviors.

Interesting and somewhat forward-thinking policies which have been debated for quite some time in the eating disorder community.

The Colorado Law

According to data sourced from the Center for Disease Control, Colorado ranks as the second healthiest state in the United States. Its high ranking is attributed to its active lifestyle culture, abundant outdoor recreational opportunities, and a strong focus on healthy eating. It is also known for having a number of tree hugging, Birkenstock wearing, pot smoking, hippie libruls. [I kind of respect that last aspect.]

With its liberal politics and lifestyle and focus on health, it should come as no surprise that Colorado politicians wanted to do away with the much criticized BMI as an indicator of health. And so, the Colorado legislature passed a bill which greatly limited the use of BMI

This bill can be found here:

Click to access 2023a_176_signed.pdf

If you can work your way through this bill and then reach a place of partial understanding, there is much to embrace. And much which provides confusion.

On the one hand, the some of the substance of the bill states, “… SHALL NOT UTILIZE THE BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD REQUIRING AN ACHIEVED WEIGHT WHEN DETERMINING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH AN EATING DISORDER, INCLUDING BUT NOT LIMITED TO BULIMIA NERVOSA, ATYPICAL ANOREXIA NERVOSA, BINGE-EATING DISORDER, AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER, AND OTHER SPECIFIED FEEDING AND EATING DISORDERS AS DEFINED IN THE MOST RECENT EDITION OF THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS.

But then, the next part of the bill states, “SUBSECTION (1)(a) OF THIS SECTION DOES NOT APPLY WHEN DETERMINING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA, RESTRICTING SUBTYPE, OR BINGE-EATING/PURGING SUBTYPE; HOWEVER, BODY MASS INDEX, IDEAL BODY WEIGHT, OR ANY OTHER STANDARD REQUIRING AN ACHIEVED BODY WEIGHT MUST NOT BE THE DETERMINING FACTOR WHEN ASSESSING MEDICAL NECESSITY OR THE APPROPRIATE LEVEL OF CARE FOR AN INDIVIDUAL DIAGNOSED WITH ANOREXIA NERVOSA, RESTRICTING SUBTYPE, OR BINGE-EATING/PURGING SUBTYPE.”

Ok, so I am a reasonably intelligent human being. But, what in the blue hell does the language of the bill mean? On the one hand, BMI, ideal body weight or any other standard requiring an achieved weight can only be applied to anorexia nervosa – restricting subtype and binge-eating/purging subtype so long as they are not the determining factor? Well, that doesn’t seem too vague, confusing and subject to interpretation!

It would also appear as if the bill, albeit well intentioned is having adverse effects. Dr. Elizabeth Wassenaar, the Regional Medical Director for the Mountain and West regions at Eating Recovery Center and Pathlight Mood & Anxiety Center was interviewed by an NBC news local affiliate. This interview can be found here:

https://www.9news.com/article/news/health/doctor-warns-law-designed-to-expand-eating-disorder-treatments-creating-barrier-to-care/73-9ac527d4-9d38-4d67-b212-6067fe53d714

In the interview, Dr. Wassenaar stated:

“On face value, I 100% agree with this legislation,” Wassenaar said. “I absolutely want to see every person who needs eating disorder treatment be able to access it. And I never want to see someone be discriminated against because of the size of their body, especially when it comes to receiving care for their eating disorder.”

“Unfortunately, what we are seeing is that patients who are in small bodies who are malnourished are actually being excluded from care or being asked to step down before they are ready because we can’t consider their degree of malnutrition as a part of their degree of severity of illness.”

“And the reality is when you have a statute that makes this sort of determination, then it takes the decision out of the hands of the medical providers who are taking care of people with these patients.”

Indeed.

Which brings up the seminal question …

The Question

With BMI being an incredibly troubling issue regarding its use (or non-use) with eating disorders, why hasn’t a definitive policy or statement been released from experts in the eating disorder community? A unified, collaborative statement so strong, so authoritative, that legislatures, organizations and health insurance providers alike adopt it as THE definitive word on BMI.

After all, the research, study and treatment of eating disorders are the raison d’être for our experts’ existence.

Shouldn’t the continued existence of BMI, or the genesis of its demise lie with the recognized experts in the eating disorder community? Those who study it and either use it or decry it as a diagnostic tool.

Envision if you will, some of the most renowned experts worldwide in the field of eating disorders coming together to brainstorm, to share research and ideas. And then issuing a comprehensive study supported by all of the eating disorder organizations and treatment entities. Including representatives from the health insurance industry.

If ever a time existed for this wisdom, this type of collaboration, this coming together as one, that time is now.

And so, the last question is … who is going to step to the plate and turn this into a reality?

AWARENESS WITHOUT ACTION EQUATES TO FAILURE

Awareness.

Have you ever wondered what comes after awareness?

In any event, once again it is Eating Disorder Awareness Week 2025. Almost all eating disorder organizations and treatment providers will be mentioning this on their social media outlets.

Some buildings will be lit in the blue and green colors adopted by NEDA. This is the St. Louis Planetarium complete with statue in the shape of what society deems an anorexic body type:

Did I just body shame a statue?

Some therapists and advocates, treatment centers and organizations will hold special “virtual” sessions highlighting their pet eating disorder interest. People self-identifying as experts will pontificate on many and varyed aspects of eating disorders. The same radical tired voices will repeat the same radical tired messages to the same radical tired crowd measuring in the tens of people.

As in year’s past, the eating disorder community will feel good about itself for the week, will pat itself on the back and then … will slink back to its customary irrelevancy in the medical and mental health fields. Next year will be rinse and repeat. Or as Herman’s Hermits once sang, “Second verse same as the first.”

However, this year is different. For a number of reasons. These reasons threaten to not just shake but could very well crumble the very foundation of the eating disorder community. Not surprisingly, these reasons and issues will not be discussed this week and the community will ignore its awareness of these issues.

These issues will not be discussed in part because the issues are just too difficult. They are uncomfortable. In addition, the firmly entrenched corruption and rot in the community will mandate that some of the issues be ignored. When for a price, even the most reprehensible predator can buy a place at the table. Regardless, the issues are incredibly serious and require serious people with serious IQs to ponder and then take rational, serious action.

Let’s review some of these serious issues.

NIH funding collapsing

On Friday, February 7, 2025, the National Institute of Health (“NIH”) announced it was pausing all grant funding pending review and placing a 15% cap on funding “indirect research costs.” Indirect costs, also known as facilities and administrative (F&A) costs, are used to cover research expenses such as equipment and facilities maintenance, IT services, and administrative support.

The freeze has impacted the funding of all continuing grants at NIH. These grants fund ongoing research, including many studies involving human subjects in clinical trials. Universities are already reacting in a manner consistent with believing that those funding grants will not be reinstated. Some universities have already frozen hiring and taken other budgetary measures. These measures include a spending freeze on travel, procurement, capital projects and events.

So, how will this impact the eating disorder community? University based eating disorder professionals are likely to have their budgets slashed making travel to conferences unlikely. This includes travel to San Antonio for the ICED conference. This could also include a reduction in membership in AED. With AED’s financial woes already being very deep, a steep decrease in membership and low attendance at its ICED event could be the death knell for that organization.

But more importantly, this issue means that there will be significantly less research conducted into our understanding of the biological and genetic aspects of eating disorders. Possible state of the art treatment requiring a research basis will not be experimented upon and implemented. “Evidence-based” will become an even greater cartoon slogan.

Which will result in the mortality rate continuing to climb.

At least we now have awareness on that issue.

Iaedp

Iaedp’s many issues and problems have been highlighted for over a year. Tax fraud. Forgery on official documents. An overall lack of transparency. Possible violations of antitrust laws regarding the certification process. I understand that attendance at the recently concluded Symposium was disappointing.

A class action lawsuit hanging over its head.

A number of chapters have dissolved.

Rumors that the 2026 Symposium will be virtual. Perhaps because of a lack of funds? After hosting an in-person conference for a number of years, a virtual conference means virtually nothing.

All of which makes iaedp’s continued survival problematic. And if iaedp does not survive, what of the certification process? Would that mean we are left with another certification process which starts out with an idiotic Indigenous Persons land use acknowledgement? Because nothing says “eating disorders and the highest quality certification process” like an Indigenous Persons Land Use Acknowledgement!

At least we have awareness on these issues now.

Residential Treatment Center issues

The great eating disorder residential treatment center experiment appears to be floundering.

Recently, Castlewood (Make no mistake, it was Castlewood all along. Alsana was merely its pasteboard mask.) closed its operations in the State of Missouri … where it all began. Now, Alsana may find itself having issues with the California Medical Board for the unauthorized practice of medicine in that state.

Acadia shuttered Timberline Knolls after numerous issues and abuse came to light.

Cielo House. Shoreline Center. Fairhaven. Evolve. All closed.

Some of the residential treatment centers which remain open seem to be exploring adopting an addiction treatment model.

Accanto Health’s CEO, Dr. Tom Britton is the former CEO of American Addiction Centers. Accanto Health owns the Emily Program. Information has been circulating that medical doctors at Accanto Health/Emily Program have been laid off or asked to take lesser roles.

Virtual treatment programs, with no independent, third-party studies supporting their efficiency have sprung up and their growing presence cannot be denied. They are less expensive to operate. Purportedly, the growing influence of virtual programs is impacting attendance at residential treatment centers.

At least we have awareness of these issues now.

Acadia Healthcare

Then, there is Acadia Healthcare. I once wondered why treatment centers and organizations were not incensed at the harm being perpetrated by Acadia. Why they did not stand up for the vulnerable and hold Acadia accountable. Of course, the answer is obvious.

They have accepted money from Acadia Healthcare. They are bought and paid for consorts for Acadia.

Since iaedp did not have enough troubles, at its recent symposium, one of its primary sponsors was Acadia Healthcare.

The National Alliance on Eating Disorders lists Acadia Healthcare as one of its “Diamond Supporters.” [its highest level]

Montecatini, McCallum Place and Carolina House are not going to stand up. They live on their knees subservient to the whims of its overlord and master, Acadia.

Acadia, knowing the eating disorder community is long on radicalism and short on common sense, embedded itself by throwing money around. It was an effective strategy. And it still is.

And to think at one time, AED would not accept money from any pharmaceutical company or health and wellness company because of concerns about conflicting interests.

Sadly, when an organization accepts dirty money, it acquiesces to whatever heinous acts are being perpetrated by the predator.

And so, we have that awareness now too!

Many other issues about which we need to be aware

Many other serious issues exist which plague the eating disorder community.

No generally accepted standards of care.

No collaboration with any medical or mental health communities to speak of.

No collaboration within the eating disorder community.

When was the last time NEDA, iaedp, AED and the other entities got together and stated, “Enough is enough. We are going to hold a joint conference. We are going to collaborate. We cannot have true progress if we remain separate and instead, we must collaborate. But, egos prevent that.

Ai is to be feared and cancelled.

Eating disorder legislative bills to increase research funding? Nope.

Then there is the beating of the drums by the Militant Fat Activists who have been allowed to poison the community with their own unique brand of craziness.

How many times have we read or heard that pediatricians, medical doctors and other medical professionals do not understand eating disorders and do not know what to look for? That lack of awareness falls on the shoulders of the eating disorder community.

The eating disorder community has had over ten (10) plus years to accomplish that! Instead? They failed. Completely. Miserably.

So, we go back to awareness? Awareness of what? Our own failures?

A focus on awareness has only resulted in failure. And this failure is measured by the lives of more children, adolescents and loved ones being taken.

The next step in awareness is … taking action. Since awareness without action is only cowardice and ignorance.

Ordinarily I would hope that at this time next year, we will be embracing Eating Disorder Action Week. But when as a community you instead embrace the known predators in the community, you have destroyed the hope which must exist within families.

So, ring in the new year. I am sure Eating Disorder Awareness Week 2026 will be the same vacuous song and dance.

The same radical tired voices will repeat the same radical tired messages to the same radical tired crowd measuring in the tens of people.

As the predators increase their profit margin, our children will continue to die.

Happy Eating Disorder Awareness Week 2025.

WE … DO … NOT … CARE

The 2025 iaedp symposium has started in Palm Desert, California. Its first symposium since parting ways with Bonnie Harken.

I have been a very open critic of iaedp. I have also been a very open, and apparently, sole critic of Acadia Healthcare. I have set forth the corruption and fraud perpetrated by Acadia. I have highlighted the reprehensible acts perpetrated under the non-watchful eyes of Acadia… rape, sexual abuse, physical abuse, mental abuse, emotional abuse, fraud against the Veteran’s Administration, fraud involving Medicare and Medicaid, fraud against their very own shareholders. Children and adolescents being abused. Paying hundreds of millions of dollars to satisfy judgments rendered against it and its subsidiaries. Closing Timberline Knolls.

Therefore, it should come as no surprise that the eating disorder community has risen as one and in a clear, unmistakable, loud voice shouted … “We don’t care. So long as you keep paying us money … We do not care!”

Iaedp had the opportunity to conduct a due diligence investigation into Acadia’s misconduct. It would not have taken long. The horrific conduct perpetrated by Acadia is readily found on the internet. In addition, I have sent articles detailing Acadia’s bad faith conduct to iaedp chapters.

As such, iaedp can no longer say, “we did not know.” It does not even have implausible deniability.

Therefore, I was not at all surprised to see, on iaedp’s Facebook page, the day before its symposium began, the following:

iaedp Foundation

It’s #ThankfulThursday! We are highlighting #iaedp2025 bronze partner Acadia Healthcare.

Acadia Healthcare’s comprehensive eating disorder treatment network provides specialized care across four premier facilities offering Residential, Partial Hospitalization, and Intensive Outpatient levels of care. Carolina House (NC) offers a tranquil, homelike setting for individuals 17+ seeking ED and MH care. McCallum Place (MO) combines medical and psychiatric expertise with personalized care for ages 10+ featuring the Victory Program for athletes and performance-driven individuals. Montecatini (CA), provides tailored programming and ocean-side healing for female-identifying and nonbinary individuals ages 12+. The Refuge (FL) integrates trauma-focused therapy with ED recovery for adults in a serene environment.

Strangely, nothing is said about the closure of Timberline Knolls. Nothing is said about the numerous young women at Timberline Knolls who have been so scarred by Acadia/Timberline Knolls. Nothing is said about the corruption.

Instead, the only sounds you will hear are … iaedp ringing its cash register with Acadia’s dirty money … and the anguished cries of the victims of Acadia’s greed and callous, criminal conduct.

A DAD'S JOURNEY WITH EATING DISORDERS

Musings on Mental Health and the Eating Disorder Industry

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Tag Archives: health

RIGHTEOUS INDIGNATION ?

When Maladjusted Masquerades as Activism … Weight Stigma Awareness Suffers

When Social Justice Therapists Go Too Far …

LIVE OR DIES … Ai DECIDES

COLLABORATE OR PERISH

THE VICTIMS … THEIR FACES

MEDICALLY INDUCED COMA FOR ANOREXIA?

BMI … Barely Medically Important

AWARENESS WITHOUT ACTION EQUATES TO FAILURE

WE … DO … NOT … CARE

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