Kitty Westin lost her daughter to anorexia, but she won the battle that led to better mental health insurance coverage and treatment options
Anna Westin was a gregarious, outgoing, and cheerful 16-year-old according to her mother Kitty. So when the Chaska teen began to withdraw from friends and family, the change was stark. Anna became secretive, made excuses to escape mealtime, and noticeably restricted her food intake.
“People ask me all the time, ‘When did you first notice? When did she get treatment?’” says Kitty Westin of Anna’s anorexia nervosa. “I think the better thing for people to understand is that people with eating disorders are really good at hiding it.” The Westins got Anna into a nine-month outpatient treatment program in which she excelled, and it seemed the eating disorder was beaten. But four years later, when Anna came home after her sophomore year at the University of Oregon, Kitty saw that the anorexia was back. What she didn’t realize was that it would change her family and the state of Minnesota forever.
“It was a pretty quick bobsled ride into hell from there.”
Understanding anorexia
According to Park Nicollet’s Eating Disorders Clinic, 11 million people in the United States alone struggle with an eating disorder. Forty percent of newly identified cases of anorexia are in girls ages 15–19, and the illness has one of the highest morbidity rates of any psychiatric disorder: According to a study in the International Journal of Eating Disorders, roughly 6 percent of sufferers die from related causes. While information like this is now readily available to everyone from Google surfers to doctors, in 2000, Kitty found herself struggling to understand. “At that time, there wasn’t family therapy offered to us, so we were still pretty ignorant about the whole illness and our part in it,” explains Kitty. “I didn’t understand that the course of treatment could go on for years and that the average time from diagnosis to recovery is seven years.”
Anna’s doctor recommended what Kitty describes as “long-term, intensive, structured care,” a course of treatment that the family’s insurer, Blue Cross Blue Shield of Minnesota, wouldn’t fully cover. The combination of feeling like a financial burden to her family and a loss of hope in her recovery led Anna to commit suicide.
“I am so proud of Anna and the fight she put up against anorexia. The more I read and understand what she was dealing with the more proud I am. I’ve truly never been angry with her for the suicide,” explains Kitty. “How could I be angry at her? I would not be angry at her if she had terminal cancer and had such extreme pain and made that choice. It’s not the choice I would have made, and I had to accept that.”
What the Westins didn’t accept was the poor access to treatment for Anna, and they joined then-Attorney General Mike Hatch in filing suit against Blue Cross Blue Shield of Minnesota for delaying and denying coverage for eating disorders, chemical dependency, and a variety of other mental health problems. By the following summer, Blue Cross agreed to separate settlements with Minnesota and the Westins.
“We were at the funeral home working on the obituary when I was asked if we wanted it to say the cause of death,” explains Kitty. “I said ‘Yes, why wouldn’t we?’ She died from anorexia, and there’s no shame or stigma in that. That’s when I knew I wanted donations to the Anna Westin Foundation.” Money poured in immediately, and Kitty knew the foundation’s goal would be to create the kind of residential treatment program that had been unavailable to Anna.
Getting treatment today
Since the lawsuit, anorexia and bulimia treatment in Minnesota has “done a 180,” says Kitty. Her dream of in-state residential treatment was realized when the eight-bed Anna Westin House opened in Chaska with funds from the settlement, and Park Nicollet will open a nine-bed facility called the Melrose Institute. Dr. Jillian Croll, director of education, research, and program development with The Emily Program, a treatment program that specializes solely in eating disorders, calls the Westin case a catalyst for change. “It used to be an automatic ‘No’ whenever we called about benefits for anyone with an eating disorder,” Dr. Croll says. “Things are dramatically different now in Minnesota because of the lawsuit, which changed the whole
landscape and made people flexible in terms of accessing mental health benefits.”
MaryAnn Stump, chief innovation officer for Blue Cross, says the lawsuit was a chance for her company to work with local experts to redesign and expand care for eating disorders. “I think opportunities come in strange packages, and through the adversity, we’ve created a real legacy,” says Stump. Today, experts agree that treatment can take many forms, and programs use a comprehensive evaluation process to build individual treatment plans, including residential treatment, intensive day programs, support groups, and nutritional counseling. Blue Cross is also working with state experts to fund a five-year study on residential outcomes. Health plans around the country now look to Minnesota for how eating disorder treatment can and should be done. “In our own state, we’ve set the mark and other health plans have followed,” said Stump.
Kitty Westin herself says the work done in Minnesota has exceeded her expectations. So, last March Westin passed control of the Anna Westin House to the Emily Program and essentially folded her foundation into theirs. While Westin will remain on the board of directors for the Emily Program, she plans to focus more on her national work as president of the Eating Disorders Coalition, knowing that other families won’t have to suffer for lack of treatment the way hers did. “If I had known that [Anna’s] decision to go on a diet at 15 would be fatal, you bet I would have done something about it,” says Kitty. “Nowadays when a 15-year-old who is healthy and slender goes on a diet, that is a red flag and families can get help.”
Warning signs–Bulimia nervosa
Eating very rapidly
Weight fluctuations
Eating alone due to shame and embarrassment
Hiding food, secret stashes of food, or secret disposal of food wrappers
Warning signs–Anorexia nervosa
Elimination of certain foods or food groups
Isolation, often from activities that involve food
Loss of menstrual cycle
Preoccupation with food, dieting, weight
Monica Wright is Minnesota Parent’s assistant editor.
