Questions and answers: Bringing treatment for eating disorders at home

Eating disorders have a High death rate compared to other mental states, but many people fight to access treatment. According to report from STRIPED, the Academy of Eating Disorders and Deloitte Access Economics, 28.8 million Americans living in 2018 and 2019 will have an eating disorder at some point in their lives.

Equip, a virtual company for the treatment of eating disorders, aims to improve access to and effectiveness of care through family treatment, which works with patients in their homes along with their family members during recovery. Founded in 2019, the startup has announced that it has grown $ 58 million in Series B funding earlier this year.

Christina Safran, CEO and co-founder of Equip, sat down with MobiHealthNews to discuss the company’s expansion across the country, how the COVID-19 pandemic affected the spread of eating disorders and why the region needs more research and investment. This transcript has been edited for clarity and length.

MobiHealthNews: You are currently focused on children, adolescents and young adults at the moment. Is it because this is a population in which eating disorders are more common? Or do you plan to expand?

Christina Saffron: We are planning to expand. In the early spring of 2023, we will expand to adults over the age of 24. This is a great question. I’ve been working on this since I was 15 and I’ve recovered. The mission of my life was to ensure that other people could recover.

The honest answer is to start anything, I think you have to start with focus and really kill it from the park. And most of the evidence has been made on children and adolescents with family treatment. It is easier to conduct family treatment when the children live at home and you are financially responsible for them.

However, nothing changes in your brain on the day you turn 18. And obviously we have adults in our program, 23-year-olds, 24-year-olds. It’s just getting a little harder and we’re expanding our definition of what a family is. Even in adolescents we have foster parents, we have teachers who can play this role. But with adults even more, we really rely on partners, friends, college roommates, spouses.

For those who do not come with a support person, the first month of treatment is really focused on, how do we find at least one support person to help you recover? These are brain disorders and it is really, really, very difficult to fight with your brain many times a day.

The other thing about adults is that we also treat concomitant diseases. There is even more concomitant diseasesand the population is even more heterogeneous.

MHN: In the midst of the COVID-19 pandemic, there were many discussions about mental health, as well as concerns about elevated levels of eating disorders. Have you noticed an increase? Do you think this is improving or is it something we still have to deal with?

Saffron: No. I think we will continue to see the lasting effects of the pandemic over the next few years. We certainly saw a jump. Inpatient hospitalizations, especially for adolescents doubled in the course of the pandemic. Anecdotally, our clinical partners told us that children come to treatment sicker than ever.

I think a few things about the pandemic exacerbated it. First, eating disorders thrive on social exclusion. These are a lot of kids who have been to school and used those temperament traits that make you vulnerable to an eating disorder – this type A, the pursuit of perfectionism – to focus on school work, or hobbies, or extracurricular activities. activities. Now they have all this time at home, just focusing on themselves and their bodies.

Besides, social media obviously doesn’t help. We know that on average children spend around seven hours [per day] on their phone. And with the harmful algorithms we see on social media, they are constantly being bombarded unrealistic imagesand even frankly thrown awful, awful content for eating disorder.

Finally, we know that with increasing food insecurity in a community, eating disorders directly it also rises. We have certainly seen more than that during the pandemic.

MHN: There were many investing in the digital space for mental health, especially in conditions such as depression and anxiety. Why do you think the treatment of eating disorders is not so innovative?

Saffron: Honestly, there are so many reasons, but I think they are all due to the stigma surrounding eating disorders. People do not understand eating disorders. Most people think this is a problem with white, rich girls when we know it can’t be further from the truth. Eating disorders affect people of race, class and ethnicity equally. You really can’t tell if someone has an eating disorder just by looking at it. And besides, they are not a choice; they are not vain problems. These have strong ones genetic and neurobiological basesbut we still have a lot of stigma towards eating disorders. We still blame the patient.

I think this leads to an area that is severely underfunded. The study of eating disorders gets around $ 9 per person affected unlike Alzheimer’s disease, which receives about $ 200 per person affected or more. When there is not a lot of funding, you can’t innovate a lot in this space.

And then, unfortunately, in this kind of vacuum of good care and landscape stigma, we saw in 2008, when the Mental Health Parity Act was passed, that private capital poured a lot of money in hospital care. These privately supported housing centers have, frankly, the most money in the district to really run the district and the direction they want.

MHN: So, in connection with this funding note, you announced a $ 58 million B-Series in February. How has your expansion gone since then and what are some of your goals for the future?

Saffron: I’m excited to say that one of my biggest goals from the beginning was to get into all 50 states, plus [Washington] DC We’ve been there a few weeks ago. We have not even made the official announcement yet.

Since we started a year ago, we’ve been to four states. And we started moving families across the state to get care of us, which was flattering, but obviously heartbreaking – the opposite of why we wanted to start this company, to stay home with our family. So expanding to 50 states plus DC was absolutely huge for us and huge for our mission.

I don’t want families to have to pay out of pocket. I believe that we have completed 2021 with 86% of families using their benefits online. We have made great progress in terms of negotiation. But there is obviously so much more to do. In particular, with Medicaid, with Medicare when it comes to older people, and with TRICARE. I want everyone to be covered by their payers.

And then, finally, you come across a big one that extends to adults, so this treatment is really affordable for anyone with an eating disorder. So, we are working as hard as we can on these initiatives.

Then, the last thing I say is that the reason we chose Chernin Group to lead our Serie B was because we really wanted someone who would help us change that cultural narrative about eating disorders. We cannot reach everyone with an eating disorder and give them access to good treatment if the majority of the population still thinks that eating disorders have a view and do not understand the breadth of who they are affecting. We need to make sure that everyone has access to a diagnosis, and this starts with a lot of psycho-education about changing the face of eating disorders.

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