
CMScript 11 of 2024: Focus on Anorexia Nervosa
The new year is a time for fresh starts and setting health goals, but it is important to approach these resolutions with care. Many health-focused goals may make us feel the pressure to focus on weight loss and appearance, which can unintentionally lead to conditions like anorexia nervosa. This month, CMS is raising awareness about eating disorders, starting with this CMScript issue on anorexia. Our next mailer will focus on Bulimia and prioritising mental health as you pursue your 2025 wellness goals.
What is Anorexia Nervosa?
Anorexia Nervosa is a serious eating disorder where individuals severely limit their food intake due to an intense fear of gaining weight and a distorted body image. Eating disorders like anorexia are not about vanity; they are complex mental health conditions that can have long-term effects on physical and emotional health.
The long-term effects of anorexia include infertility, organ damage, bone density loss, and increased risk of heart failure. With a mortality rate as high as 20%, anorexia is the deadliest mental health disorder, affecting people of all genders, ages, and backgrounds.
Types of Anorexia Nervosa
- Restrictive Anorexia Nervosa is characterised by skipping meals, eating very small portions, and focusing on calorie counting, often resulting in severe malnutrition. Self-induced purging is rare, but excessive exercise for weight control and the use of appetite suppressants are common.
- Purgative Anorexia Nervosa involves purging behaviours like vomiting and misuse of diuretics or laxatives, even after a small food intake. It may also include binge-eating episodes followed by purging, often combined with appetite suppressants.
Signs and Symptoms of Anorexia Nervosa:
Recognising the signs and symptoms of anorexia is critical for early intervention. These include:
- Physical signs: Extreme weight loss, dizziness, low energy, digestive issues, and weakened immunity.
- Behavioural signs: Restricting food intake, compulsive exercise, avoiding meals, or purging behaviours such as self-induced vomiting.
- Psychological symptoms: Intense fear of weight gain, distorted body image, and denial of the seriousness of low body weight.
What is covered as PMB level of care?
Prescribed Minimum Benefit (PMB) regulations prescribe that your medical scheme is required to cover the diagnosis, treatment, and care of eating disorders, such as anorexia, in full. This includes:
- Hospital-based care for up to 3 weeks per year or 15 outpatient consultations annually.
- Coverage for medications (e.g., antidepressants) and consultations with specialists like psychiatrists, psychologists, occupational therapists, and social workers.
It is important to note that treatment is typically provided through Designated Service Providers (DSPs) appointed by the medical scheme. Choosing a non-DSP may result in co-payments. Additionally, medication coverage is based on the scheme’s formulary, so consulting your medical scheme and doctor is essential to avoid extra costs.
Focus on holistic well-being and download the full CMScript to learn how your medical scheme can support you in navigating eating disorders like anorexia nervosa. Download the full CMScript here.