Eating disorders, more fragile treatment network: Budget bill cancels $25 million fund

Negotiate a truce. Stop before it’s too late. It’s complicated when the theater of battle is one’s own body, which, pound by pound, identifies with the disease that is consuming it. A wild path that empties or sediments too much. More girls and boys are walking this tightrope than ever before eating disorders trying to get out. A collective scream that emanates from the silent bodies whose trail evaporates in front of the mirror. Reflecting the image of the epidemic: Eating disorders are the second leading cause of death among young people after traffic accidents. More than 3 million people are currently being cared for in Italy.

“Today, the predominant disorder is bulimia nervosa. Disorders change rapidly as they are linked to the cultural and social contexts of our times. They are deep sufferings, there is a desire for death inside.’ Laura Dalla Ragione, Director of the Eating Disorders Network USL 1 of Umbria, tells us that in recent years the situation has changed, and not only because of the increase in cases, which from 680,456 in 2019 increased by one million in 2023 to 1,680,456, “what is changing is the psychopathology: at the moment the cases pure eating disorders are 40%, while 60% are cases of comorbidity with other pathologies. For example, self-harm, a phenomenon that has become very widespread.’

Susan Sontag he wrote that “it is almost impossible to inhabit the kingdom of the sick without being affected by the ominous metaphors created to describe the landscape”. This also applies to the diseases of our time: anorexia, bulimia nervosa AND binge eatingthey are increasingly present in the collective imagination, but clinical connotations still struggle to find a stable residence and a concrete “land”.

He canceled the fund

However, the amendment voted by the Senate on December 21, 2021 sanctified a step forward by creating the so-called A fund at the Ministry of Health in the amount of 25 million euros (15 million euros for 2022 and 10 million for 2023) dedicated to opening specialized centers and creating a support network for patients and families. But the 2024 budget bill cuts funding and assistance centers, which are already few and fragmented at the regional level, are threatened with closure on October 31.

According to the latest census in 2023, there are 126 structures in the state, of which 112 are public, 14 belong to the accredited private sector. 63 centers al North (20 in Emilia-Romagna and 15 in Lombardy), 23 per Center (of which 8 in Lazio and 6 in Umbria), 40 distributed between South AND islands (12 in Campania and 7 in Sicily). “There are regions that activated clinics with these funds because they had nothing: PrayL’Abruzzo, March, Campaign, Puglia. Temporary staff have been hired who cannot be renewed,” he comments From Reason.

But what does stopping treatment mean for an eating disorder sufferer? “Discontinuing treatment worsens the situation and leaves patients to fend for themselves. When you start treatment, a relationship of trust is created. You can’t tell a patient after trying to convince them that this is the way to go that the clinic is now closing. They are delicate patients who can also have a rapid negative development.”

Stefano Tavilla, co-founder of the Fiocchetto Lilla Foundation, explains: “Waiting lists will get longer and unfortunately we will start thinking about a step-down treatment solution. At the same time, the disease progresses. At that moment, the patient’s health deteriorates, and when the disease is finally cured, it is no longer confirmed by the treatment process, but by the achievement of minimum goals, which may be a specific weight or the disappearance of symptoms. This means that we are creating a generation of long-term patients.”

Basic levels of assistance

Meanwhile, the LEA (basic level of assistance) is being revised until 2017, and scientific societies and family associations have put forward proposals to include tied and permanent funding for eating and nutrition disorders and to expand the free services necessary to monitor pathologies, given the complexity and duration of pathologies.

“Our request was already born during a street demonstration in October 2021, in the middle of Covid – he continues Tavilla – Currently the complete network has only 9 out of 21 regions. We end up wandering around Italy looking for a treatment system and creating very long waiting lists. Inclusion in Lea would allow all regions to have dedicated resources to create a minimum network of care that extends from detention to clinic, residential community or hospital.

From Reason adds: “There needs to be funding for eating disorders as well as autism. These are pathological conditions where mortality is very high and where, because there is a psychological and medical component, mortality is not only linked to suicide (as is the case with mental health) but also to organic consequences”.

However, eating disorders can be cured. But as he concludes From Reason: “There is no case in the literature of spontaneous remission of these pathologies: you cannot recover without treatment”.

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