Woman starts treatment option for eating disorders

LAWRENCE, Kan. (AP) - Brooke Wesley remembers watching an "Oprah Winfrey" show about anorexia as an adolescent. The guest was Rudine Howard who weighed 58 pounds at age 29.

"All of a sudden that was my idol. I wanted to be like her," Wesley said. "That woman died and she looked horrific, but for somebody who struggles with anorexia that's like the gold star."

Wesley saw that show when she, too, was struggling with anorexia. She was very ill, and it's a reason she never tells her lowest weight. She doesn't want to provide fuel for others who might be struggling like she was.

Wesley was hospitalized four times over a year and a half as a teenager. One of those hospitalizations lasted six months.

She used to compare herself to every person she encountered in a treatment center. "The goals was always to be the thinnest or sickest," she said.

"The process of recovery is so challenging and it takes a long time. I continued to struggle with significant body image issues and really tampered with several eating disorder behaviors until I was about 21," she said.

Today, Wesley is 34, married, and has three children, ages 7, 6 and 4. The Olathe resident considers herself lucky. Eating disorders have the highest mortality rate of any mental illness.

A study by the National Association of Anorexia Nervosa and Associated Disorders reported that about 10 percent of anorexics die within 10 years after contracting the disease; about 20 percent of anorexics will die after 20 years; and only about 40 percent fully recover.

Wesley credits her parents for her recovery. Initially, she said they listened to her when she promised she would do better, and so they wouldn't make her stay in a hospital. But, they reached a point where they had had enough. Wesley's heart rate and blood pressure were very low and she had lost almost all of her hair.

"There was no wiggle room and they were not going to screw around with it," she said. "They wanted me better and they didn't want to trust that I was going to make good decisions if I clearly wasn't able to. I felt like their persistence was huge."

Wesley went on to earn a bachelor's degree in psychology and a master's degree in social work and now helps others with eating disorders through a private practice in Overland Park. She also co-founded an assisted living facility for women with eating disorders called Thalia House, which opened one year ago in Fairway. There are few treatment facilities like it in the country and it's the only one in the region.

Thalia - which in Greek means to flourish - helps women transition from 24-hour inpatient or residential treatment to their homes. Wesley said the goal is to prevent women from relapsing, which is common with eating disorders.

"We tried to create some sort of middle ground to help women start to get their feet wet in their regular lives but also continue to have the support around meals and some group support," she said.

The Thalia House looks like any other house along the block. Inside, it's ordinary, too, with several bedrooms and bathrooms, a kitchen, dining room, laundry room, living room, office, deck and meditation area. It is licensed as a residential care facility and can accommodate up to seven women. Wesley said they only take women, ages 18 and older, who are motivated to get well. They won't accept women whose weight is less than 80 percent of their ideal body weight, and they won't accept women who have made a suicide attempt in the past 30 days.

"It's not a locked facility and it's not a treatment center, so you have the ability to come and go and we aren't going to make you do anything," Wesley said. "If somebody doesn't want to get well, then it's not really going to work for them."

There is staff support in the house 24/7, and every day, they attend a group therapy session with a master's level professional. A registered dietitian helps each resident with meal planning, meal preparation, grocery shopping and eating at a restaurant. The residents also eat together and provide support for one another.

Women can stay for as long or as little as needed. Wesley said most women stay for about 60 days. The house doesn't accept health insurance because the founders do not want that to be a barrier to treatment, which often is. Wesley said most health insurance doesn't cover mental health illness beyond 30 days. Additionally, there's certain weight or behavior criteria to get coverage.

"They typically will cover someone when they are in crisis and through when they are stable," Wesley said. "When they are stable, they are just starting to be cognitively aware enough to learn and actually implement some of the healthier coping skills."

During the past year, 40 women, ages 18 to 52, have stayed in Thalia House. Among them was Heather St. Clair, 37, a teacher from Raytown, Mo. She lived there from June through September.

St. Clair said she began purging at age 6 and has struggled with bulimia and anorexia since. She was hospitalized twice in her early 20s. During the past three years, she tried to get into treatment centers using her health insurance but was denied.

"I wasn't sick enough or severe enough. I was too healthy," she said. She had almost given up hope and then her therapist recommended Thalia House. She said the founders worked out a payment plan and she now believes that she's on the mend.

"My problem was that I wanted to do it myself and I thought I was going to be OK and that I could get better on my own, but I learned it's OK to reach out to others," she said.

St. Clair said the toughest part of the Thalia House program was the weekly restaurant outings. She said she suffered a lot of anxiety when eating out and would spend a lot of time scoping the menu for something "safe" to eat. "I probably almost had to send the dietitian to therapy herself because that was a big struggle for me," she said.

St. Clair continues to attend group therapy sessions on the weekends and also does volunteer work there.

"It helps me stay positive and it's very encouraging for my recovery," she said.

Wesley said they are considering opening a house for men.

"I treat a lot of men with eating disorders in my private practice," she said. "Eating disorders don't discriminate. I think fortunately there have been some really courageous men who have said they've struggled."

She said men struggle for the same reasons that women do, and they have for years. "It's really the same cycle - the shame and guilt. It's the hyper focus on body image to avoid other things," she said.

She currently has a male client who has been binging and purging for four years. She said he's about 6-foot-2 and extremely thin.

"He would love to stay in the Thalia House," she said.

Ann Chapman, registered dietitian at Kansas University Watkins Memorial Health Center, works with students who have eating disorders, and also has a private practice in town.

"Eating disorders are very common on university campuses," she said. "It's a time in life when disordered eating often manifests itself. It often begins even younger - junior high and high school - but then with the transition to college there's a lot of times additional stress."

At Watkins, students will see a physician, counselor and dietitian. Often, they meet with the counselor and dietitian on a weekly basis. Chapman said the longer a student has had an eating disorder, the longer it will take to heal.

If students need to be hospitalized, they are referred to Research Medical Center in Kansas City, Mo., or Laureate Psychiatric Clinic and Hospital in Tulsa, Okla., where they have inpatient programs specifically for eating disorders. Chapman said while Lawrence has some outpatient programs, there are none like the Thalia House that provide an integrated approach. She's also glad that it provides treatment regardless of insurance.

"It's a real problem because oftentimes 30-day coverage isn't enough," she said. "They just need more time in a supervised setting before they are ready to have the freedom to go back into the real world."

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