Jane is a highly respected professional in her 30s. She’s smart, successful, and driven.

She also deprives herself of food for days at a time. Twice a week or so when Jane gets home from work, she binge-eats uncooked, frozen TV dinners.

Jane layers her clothing, both to keep warm and to hide her troublesome thinness. She avoids any work or social gatherings involving food.

It’s all part of Jane’s anorexia, an eating disorder she’s strived to keep secret since she was 14.

“When she first came to me, she was desperate and distraught,” said Suzanne I. Eyer, a Chambersburg-based licensed professional counselor specializing in eating disorders. “Most of the first session was crying. She knew full well she had a problem, but she had no idea how to begin controlling it.”

When Jane began visiting Eyer in 2017, she carried a cocktail of common factors that lead to eating disorders: self-loathing; a distorted self-image, stemming in part from sexual and physical childhood abuse; a Type A – or perfectionist – personality; and an impossible-to-please mother.

“In fact, she initially started dieting to receive positive messages from her mother,” Eyer said.

‘Highest Mortality Rate’

The final week of February is National Eating Disorders Awareness Week, a time to cast a spotlight on these serious psychological illnesses. Anorexia, specifically, is the deadliest mental health disease in America, according to the National Association of Anorexia Nervosa and Associated Disorders (ANAD) .

While 15% of U.S. women will have an eating disorder by their 40s or 50s, only about one-fourth of those women will receive treatment.

“That’s a big reason they have the highest mortality rate,” Eyer said. “For so many, an eating disorder is a dirty little secret they want covered up, even in death.”

Anorexia, bulimia and binge-eating disorders can hurt the heart and kidneys, cause osteoporosis, disrupt menstrual cycles, and toss electrolytes off-balance – to the point where the heart can stop.

Because so many people hide their eating disorders, statistics almost certainly underestimate their harm. But existing data is still distressing: About 9% of the U.S. population -- nearly 30 million – will have an eating disorder during their lives, according to ANAD. Most, 85% to 90%, are women.

The Cost and Coverage for Disordered Eating

Eating disorders cost America’s economy at least $64.7 billion in treatments and lost wages/productivity in 2018-19, according to a study published in the International Journal of Eating Disorders. The authors said the price tag likely is steeper due to reduced physical and mental well-being.

Employers can help through educational initiatives and by providing healthcare plans with access to behavioral health and nutritional counseling.

Capital Blue Cross offers a VirtualCare telehealth option and a behavioral health toolkit for certain employers, and Capital can connect you to a behavioral health professional online or by calling 866.322.1657. Some companies, including Capital, offer employee assistance programs that make it easy for employees to access mental health professionals for any issue.

Capital’s registered dietitians offer free nutritional consultations – in person and virtual, to members and nonmembers – and offer members covered follow-up medical nutrition therapy and health coaching at Capital Blue Cross Connect health and wellness centers.

Coping through Counseling

Eyer says eating disorders like Jane’s can only be contained, not cured.

“It’s an addiction,” Eyer said, “and like any other addiction, you need healthcare support through counseling, as well as inpatient and outpatient treatment programs.”

She said Jane will always have to fight hard to control her condition.

“She is improving, and doing well,” Eyer said. “But eating disorders are an ongoing struggle, and for Jane, as with most any eating disorder client, continued counseling and monitoring of her disorder are critical.”