It isn’t easily identifiable. A person with an eating disorder isn’t always waif-like or with a gaunt look to his face, say health officials, who add that the affliction is a burden carried by people from all walks of life.

“A lot of times people think that eating disorders are visible,” said Briana McElfish, a predoctoral psychology intern at the West Virginia University Disordered Eating Center of Charleston.

“That’s not always true,” she said. “Sometimes a person can become extremely emaciated as a result of their disorder, but most times you can’t see it. There’s an inaccurate belief that you can.”

The WVU-DECC facility provides treatment for people with various eating disorders, and includes family-based therapy.

Millions suffer with the disorder, McElfish said, adding, “If you know 10 people, chances are you know someone with or who has suffered an eating disorder.”

Not only is the stereotype of physical traits misleading, but so are the demographics of those afflicted.

“There’s a myth that it is a rich, young white girl disease,” McElfish said. “That’s not true. Eating disorders are brain-based diseases.

“There’s a chemical brain base for these diseases, much like other diseases we see more of, like diabetes and heart disease.”

Treatment expanding

The WVU Disordered Eating Center of Charleston opened in 2010. But it wasn’t long before that when care for those with disordered eating conditions was difficult to acquire.

As an undergraduate at Marshall University, McElfish, a Scott Depot native, was organizing National Disordered Eating Association activities in 2006.

She was well ahead of the curve, evidenced by the fact that she instantly became somewhat of a source on the topic.

“When I was an undergrad, before DECC began, I remember clinicians and M.D.s emailing me and saying, ‘I have this patient that has an eating disorder. What do I do?’ I remember thinking, ‘Dude, I’m 19 (years old). Why are you asking me?’” McElfish recalled.

“But I think that speaks to the dearth of clinicians that we have in this state,” she added. “Before DECC opened, you could count on one hand the number that were proficient in treating people with eating disorders.”

McElfish later received her masters degree at WVU, went back to MU for her doctorate and back to WVU for her internship.

“It has been something I’ve wanted to do for a long time,” she said. “When you become an advocate for something, people kind of come out of the woodwork (looking for information).

“I’ve seen people’s lives that have grown through this, and worked so hard to get the treatment that they need. It’s had a profound impact on me, to see that.”

McElfish said treatments need to be evidence-based.

“That’s what we offer (at DECC.) These disorders kill people,” she said. “We don’t need to mess around with treatments that don’t have evidence behind them.”

National attention

The WVU-DECC is located at the Robert C. Byrd Clinical Teaching Center at Charleston Area Medical Center Memorial Hospital. Most patients at WVU-DECC are treated as outpatients.

As an intern, McElfish works as a supervised psychologist under Dr. Jessica Luzier.

“This center is a place for hope,” said McElfish. “Not only for the people that come here for treatment, but for those like me that want to get the training to be able to disseminate and provide for others.”

WVU-DECC is described as an interdisciplinary, outpatient treatment center that provides evidence-based interventions to children and adults who struggle with eating disorders. It conducts research and provides outreach to hundreds of providers across the state in an effort to improve prevention, access, and treatments offered to families.

The need for more awareness for disordered eating has reached Washington, D.C.

Sen. Shelley Moore Capito, R-W.Va., led the introduction of bipartisan, bicameral eating disorders-specific legislation — the Anna Westin Act of 2015. Capito introduced the bill along with Sen. Amy Klobuchar, D-Minn., Sen. Kelly Ayotte, R-N.H. and Sen. Tammy Baldwin, D-Wis.

If passed and signed into law, the Anna Westin Act would provide training to health professionals and school personnel on how to identify the early warning signs of an eating disorder and to intervene. It also would clarify existing law to ensure families and individuals are able to receive full health insurance coverage for their eating disorder treatment, including intermediate level residential treatment.

Capito visited WVU-DECC Feb. 22, during the National Eating Disorders Awareness Week.

“It was perfect timing for her to come and visit,” said McElfish. “The (Anna Westin Act) bill has been a long time in the works.”

Capito toured the facility and spoke with doctors and students at WVU-DECC. The affiliation between CAMC and WVU is broad and deep, Capito said, adding that she is impressed with a diverse team that is dealing with all areas of treatment.

“DECC is doing great things with nutrition, psychology and with medical physicians to treat what is a pervasive problem in West Virginia,” said Capito.

Covering treatment

Families need insurance coverage for treatment, Capito added. That’s part of the reason she is leading the bill.

“It will help with the insurance piece,” Capito said of the bill. “It will also help to make sure we have the proper education for our nutritionists, dieticians, psychologists, school counselors and teachers to make sure that people understand that disordered eating can impact your physical health, your mental health and ultimately your future.”

“Most of the people we treat are either uninsured or under-insured,” McElfish said of the care at WVU-DECC.

The training happening in Charleston is a “gem” not only in West Virginia, but also nationwide, McElfish said.

“There are not a lot of clinicians here,” she said. “Hopefully with the bill passage it will allow for more grant block funding for training. That will allow for more providers in the state.

“The bill is important for people across the nation that suffer with eating disorders, that have the highest rates of death of all mental illness,” McElfish added. 

There is a lot of suffering, pain and death related to these disorders. Families experience this, too.

“With the bill, we hope that more people can have access to treatment. It’s important for us to address this in West Virginia,” said McElfish.