The rise in eating disorders is prompting state legislative action

DENVER (AP) — Housebound amid pandemic lockdowns in the spring of 2020, Emma Warford went down a social media rabbit hole to get in shape. Viral 28 Day Fitness Challenges. YouTubers promise an “hourglass pill.” Diet videos featuring skinny stomach influencers launching calorie tracking apps.

Warford, then a 15-year-old aspiring volleyball player, bought a food scale and began replacing meals with energy drinks handed out by social media stars.

Soon, he was forced to cut back on his calories. The thought of eating cake on her 16th birthday caused her intense anxiety. At the end of the season, she started playing volleyball on the bench, too weak to begin with. A year into the pandemic, his heart rate slowed and he was rushed to the hospital.

Stories like Warford’s are why lawmakers in Colorado, California, Texas, New York and elsewhere are pushing for major legislative changes to address the eating disorder crisis. On Thursday, Colorado lawmakers introduced a bill that would create a state Office of Eating Disorder Prevention, aimed in part at plugging the gap in care, funding research and raising awareness.

The bill passed the committee on a 6-3 vote, with Republicans rejecting it, in part concerned about creating a new government office and skeptical of its effectiveness.

Warford, now in recovery after two years of treatment, is among the nearly 30 million Americans — roughly the population of Texas — who struggle with an eating disorder in their lifetime. More than 10,000 people die from eating disorders each year, according to the National Association for Anorexia Nervosa and Related Disorders.

Proposals in the US include restricting social media algorithms from promoting potentially harmful content; banning the sale of weight loss pills to minors; and adding eating disorder prevention to middle and high school curricula.

The spate of legislation follows a rise in eating disorder cases as pandemic lockdowns have forced young people into long periods of isolation. Hospital beds were filling up and waiting lists were swelling as many struggled To find a treatment for a disease that already had several treatments. Only one hospital in Colorado was equipped to provide inpatient care for Warford, who was diagnosed with anorexia.

Anorexia typically involves restricted eating habits and can cause abnormally low blood pressure and organ damage. Binge eating disorder is a compulsion in the other direction. Still, having an eating disorder doesn’t always mean someone is overweight or underweight — and that leaves many who suffer from mental illness undiagnosed, experts say.

Colorado’s bill creates a state office primarily responsible for closing treatment gaps, offering research grants and educating students, teachers and parents. Bills in New York and Texas similarly seek to educate students about mental illness, including eating disorders.

Katrina Velasquez, chief policy officer of the National Eating Disorders Coalition, said the policy would give students the tools to catch early signs of disordered eating habits in themselves or their peers — potentially giving them a critical head start on treatment.

Colorado is also opting out of using body mass index, or BMI, even though it remains the industry standard. The measurement is often used to determine the level of care needed for those with eating disorders, but mental illness is not invariably linked to body weight or BMI, said Claire Engels, program coordinator for the Eating Disorder Foundation. This means that those who are not outside the BMI target are often refused treatment or leave treatment prematurely.

“Eating disorders are not necessarily about food. It’s about mental illness, anxiety, depression, trauma,” and control, Engels said.

When Riley Judd was about 12 years old, she saw a photo of herself on vacation in a bathing suit. He turned to his mother and said: “I look like a whale.” It was the first time she remembered the voice in her head mercilessly comparing her to the shiny, thin celebrities on the covers of Seventeen Magazine and Girls’ Life. “If I lose this weight, people will like it,” his voice whispered. He tried to commit suicide at the age of 13.

“It was an overwhelming vote,” said Judd, now a legislative intern and student at the University of Denver.

California lawmakers are taking aim at social media with a bill that would ban social media platforms from having algorithms or features that encourage children to be exposed to diet products or develop eating disorders. Platforms that violate the law can be fined up to $250,000.

Another California bill would expand the list of approved facilities that can provide inpatient treatment for people with eating disorders — similar to a Texas proposal that would expand Medicaid coverage for mental health services to include eating disorders.

Texas state representative Shelby Slawson, a Republican, also introduced a bill to protect minors who use digital platforms.

Kathy Johnson, a 24-year-old school counselor who testified about the Texas proposal, said “one of the biggest issues” she’s seen from social media is the rise of eating disorders.

“We have kids having panic attacks at school because their anxiety is so high, they’re comparing themselves, thinking they’re going to be one of those TikTok influencers,” Johnson said. ___ Associated Press reporters Sophie Austin contributed from California, Acacia Coronado contributed from Texas and Michael Hill contributed from New York. Jesse Bedine is a member of the Associated Press/Report for America Statehouse News Initiative corps. Reporting for America is a nonprofit national service program that places journalists in local newsrooms to cover undercover issues.