Q&A: Bringing eating disorder treatments into the home

Eating disorders have a high death rate compared with other mental health conditions, but many people fight for access to treatment. Based on a report of STRIPED, Deloitte Institute of Eating Disorders and Approaching Economics, 28.8 million Americans alive in 2018 and 2019 will have an eating disorder at some point in their lives.

Equip, a virtual eating disorder treatment company, aims to improve the accessibility and effectiveness of care through home treatment, working with patients in their homes together with their family members during their recovery. Founded in 2019, the startup claims it has raised capital $58 million in Series B funding this early year.

Kristina Saffran, CEO and Co-Founder of Equip, sat down with MobiHealthNews to discuss the company’s nationwide expansion, how the COVID-19 pandemic is affecting eating disorder rates, and why the area needs more research and investment. This transcript has been edited for clarity and length.

MobiHealthNews: Currently, you are focusing on children, adolescents, and young adults. Is it because that is the population where eating disorders are more common? Or do you have plans to expand?

Kristina Saffran: We have expansion plans. We’ll be expanding to adults beyond 24 in early spring 2023. That’s a great question. Basically, I’ve been working in this field since I was 15 years old and have recovered. My life’s mission is to make sure that others can recover too.

The honest answer is to start with anything, I think you should start with focus and really knock it out of the park. And most of the evidence has been done in children and adolescents treated at home. Family-based treatment is easier when children live at home and you are financially responsible for them.

That said, nothing really changes about your brain the day you turn 18. And obviously we have adults in our program who are 23 years old, 24 years old. age. It’s just a little more difficult, and we broaden our definition of what family is. Even with teenagers, we have foster parents, we have teachers who can play that role. But with people more mature than that, we really rely on partners, on friends, on college roommates, on spouses.

For those who don’t come with a support person, the first month of treatment really focuses on, how are we going to find at least one support person for you to help you through your recovery? These are brain disorders and it’s really hard to fight your brain several times a day.

What’s different from adults is that we also treat comorbidities. There are many more comorbiditiesand the population is not even homogeneous.

MHN: There has been a lot of discussion at the height of the COVID-19 pandemic about mental health and concerns about increased rates of eating disorders. Did you notice an increase? Do you think that is getting better or is it something we still need to work on?

Saffran: No. I think we will continue to see the lingering effects of the pandemic over the next few years. We definitely saw a spike. Inpatient hospitalization for adolescents in particular double during the pandemic. Often, our clinical partners have told us that the children who are coming in for treatment are more sick than they have ever been.

I think it’s something about the pandemic that has exacerbated it. One, eating disorders thrive in social isolation. These are kids who went to school and used the temperamental traits that make you susceptible to an eating disorder — type A, perfectionism — to focus on schoolwork or on hobbies. , or foreign language. Now, they have all the time at home just to focus attention on themselves and their bodies.

Other than that, obviously, social media doesn’t help with that. We know that, on average, children spend about seven o’clock [per day] on their phone. And with the harmful algorithms we see on social media, they are constantly being attacked with Unrealistic pictureand even frankly thrown out in a terrible, terrible way eating disorder content advocates.

And then, finally, we know that as food insecurity in the community increases, eating disorders directly Also increased. We’ve certainly seen a lot of that over the course of the pandemic.

MHN: There have been many invest in the digital mental health space, especially for conditions like depression and anxiety. Why do you think the treatment of eating disorders hasn’t changed much?

Saffran: Honestly, there are a lot of reasons, but I think they all stem from the stigma surrounding eating disorders. People don’t understand eating disorders. Most people think it’s a matter of frivolous, rich white girls, when we know that couldn’t be further from the truth. Eating disorders affect people equally across races, classes, and ethnicities. You really can’t tell that someone has an eating disorder just by looking at them. And then, they’re not choices; they are not frivolous matters. These things have power genetic basis and neurobiology, but we still have a lot of stigma against eating disorders. We still blame the patient.

I think that leads to a very undercapitalized sector. Research on eating disorders received about $9 per affected individual as opposed to Alzheimer’s, receive an amount like $200 for each affected individual or more. Without a lot of funding, you can’t drive much innovation in this space.

And then, unfortunately, in the good care vacuum and stigma context we saw in 2008, when the Mental Health Equality Act was passed, private equity pour a lot of money into facility care. Honestly, these private equity-backed residential centers have the most money in the field to really steer the field and the direction they want to go.

MHN: So on that funding note, you announced a $58 million Series B in February. Since then, how has your expansion gone and what are some of your goals for the future?

Saffran: I’m happy to say that one of my biggest goals since I started has been to get into all 50 states, plus [Washington] DC Since a few weeks ago we were there. We haven’t even really made an official announcement yet.

Right when we started a year ago, we were in four states. And we’re starting to have families move across the states to be cared for with us, which is great, but obviously heartbreaking – the opposite of why we want to start a business. this company, to stay at home with your family. So expanding to 50 states plus DC is absolutely huge for us and huge for our mission.

I don’t want any family to pay out of pocket. I believe we have ended 2021 with 86% of families using their in-network benefits. We have made a lot of progress on the contract side. But obviously, there’s still a lot of work to be done. Especially, with Medicaid, with Medicare as we get older, and with TRICARE, as well. I want everyone to have this covered by their payers.

And then, finally, you’ve got a big, adult-expanding solution that makes this treatment truly available to everyone with an eating disorder. So we’re working as hard as we can on those initiatives.

Then the last thing I’ll say is that the reason we chose the Chernin Group to lead our Series B is because we really wanted someone who would help us change the cultural narrative around the disorder. eating disorder. 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 are just a sight and don’t understand the scope. their influence. We have to make sure everyone has access to a diagnosis, and that starts with the plethora of psychological treatments around changing the face of eating disorders.

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