Treatment for eating disorders

Seriously this year sucks. Im kind of ready for it to get just a little bit better :--p

Oooohhhh and throwing something in there about without proper treatment it can cause more severe medical problems. Which in turn can lead to more medical costs and possible inpatient stays. Talking money doesn't affect my company they don't approve things just on financial issues, but you never know. I don't know the inner workings of Kaiser so I don't have a clue if they are for profit or make decision based off money. If they are for profit and have stock then money will talk.

This idea sounds bad and is unfortunate, but there are companies out there that this will work on. Just a thought.

Thats a good idea - i think i'll see if I can see my bariatric surgeon this week since its prettty much time for my two year follow up. Im sure he'd be able to weigh in on the medical consequences of eating disoders post wls ( id hope anyways). 

My real hope is that they just recognize the potential legal conseqences/actions I * could* take.,,,and maybe they will just try to keep things quiet but who knows. I dont know any lawyers who work for HMOs so id love to know their perspective on things like this. 

I really know nothing about HMOs. I only work with PPOs and I have a PPO myself. I hope you get what you need. I will keep you in my thoughts.

Good luck, sweetie!  This is one of many reasons I will never have an HMO, especially Kaiser. I'm appalled to hear about what happened with the Mel therapist. In my book he shoukfn't have a job anymore. Just disgusting. So . . .  I'm actually a clinical social worker FWIW and I think the medical necessity angle is a really good one -- and absolutely true. Eating disorders require specialized treatment and I can't imagine a legitimate reason for not authorizing the treatment you need. Letter from doc is good. As far as the professional credentials of the therapist, I would just say that the field really doesn't matter as much as the expertise and that has to do with having gotten additional training and experience on top of their original professional credential. 

I'm holding you in a big hug, sorry tat you're having to go through all this and here to PM if you want. ((((((hugs)))))

Just wanted to say good luck, and give hugs!  I just know you can fight this and can appeal, etc. and get the therapy you need.  

I have had a sort of opposite experience than you it seems in finding the right therapist. Over the past 3 years I have been to about 5 "eating disorder specialists", and I disliked them all!  I just thought the message of moderation was a flippin' joke. I live in a major metro area and even went to our "Center for Eating Disorders" outpatient therapy, and they had candy at the checkout station....I stood there paying my bill, unwrapping the mini chocolate candies, shoving them in my mouth, and then drove straight to a gas station for a few full-sized candy bars. They were trying to teach moderation....didn't work on me, well, at least before the Sleeve, 'moderation' was truly a laughable concept to me. I currently have a new therapist who is a Ph.D. in Cognitive Behavioral Therapy and and is the top in the city, and I really like him. And, having the Sleeve really does help.  I also did a lot of work in and out of 12-Step programs since I was in my early 20s, and have gained a lot of insight.

Keep us posted!

My thoughts are that you are awesome, the way you advocate for yourself and stand up for yourself. Good for you!

Does your employer have anything?  I know the City has something for employees and it's not through our specific insurance.  We get several free visits.

Loving you...

Hello, my courageous friend!!

You've gotten great ideas here...!

I  agree that this should be, in a rational and moral world, a slam-dunk -- you have a health/mental health need that your HMO does not have facilities (ie., the specialty) for in your local area...PLUS, there is the very significant issue that you have, with very strong reason, that you decline to enter their mental-health services building...the next logical step would be, I would certainly think, would be to help you locate and fund an alternate service provider who is equipped to meet your specialized needs.

You might have to go into LA to find someone, I am thinking...

There are probably lots of ways to find someone. I recently discovered goodtherapy.com -- there are lots of psychologists who are members, and many of them do specialize in eating disorders and Cognitive Behavorial Therapy (CBT).

Another thought ...it might be very interesting to call the Lindstrom Law practice (as I recall, the web address is obesitylaw.com) -- as you know, their specialty is helping people get approval for surgery from their insurances...but they are of course very familiar with the ins and outs of HMOs, etc. They give brief, no-cost consultations by phone. They were of great help to me thru their phone consultation when I had a problem with my  HMO and approval for surgery. If you tell them that you are very active on the OH boards and that you are an attorney, you might have a helpful chat...

There is lots of support and love for you here.

I send you lots and lots of sugar free, high-fiber hugs. :)

Love, Swizzlequeen

On May 13, 2013 at 9:10 AM Pacific Time, swizzlequeen wrote:

I  agree that this should be, in a rational and moral world, a slam-dunk --

I say on a daily basis at work, "What makes sense to me and how I think things should be versus how things actually are; are two separate things". Heck, I probably say that at least 5 times a day.