By Ashley Hackett

More than 20 years ago, a young girl wrote in her diary: “I am scared to death about what’s going on right now. I can’t have any control over my own mind. As much as I know what I need to do it’s so hard to. My moods are very extreme. One minute I’ll be depressed, then another, something will make me happy again.”

That girl was Anna Westin from Chaska, who was diagnosed with anorexia at 16 years old. After completing her sophomore year at the University of Oregon, Anna’s health was deteriorating quickly. The 20-year-old was facing dangerously low body temperatures and blood pressure, as well as liver malfunction.

Her anorexia had become so severe that her doctor urged she be hospitalized. Anna’s parents were on board — they wanted to do whatever they could to save their child. But in the late ’90s and early 2000s, anorexia was not an illness commonly recognized by health insurance companies.

Despite the urgency of her condition, Anna’s family learned that they had to wait until their insurance company “certified” her treatment, which ultimately delayed and limited the care she received.

After struggling with the disease for five years, Anna died by suicide on Feb. 17, 2000, at the age of 21.

After Anna’s death, her mother, Kitty Westin, began to channel her grief into action. She began to advocate for better mental health care for people with eating disorders and went on to open Minnesota’s first residential treatment center for eating disorders in Chaska. They called it the Anna Westin House. Kitty Westin also helped found the National Eating Disorders Coalition, and began to work with lawmakers to make changes nationwide.

That’s how she got connected with Sen. Amy Klobuchar (D-MN), who ultimately passed legislation that would make major changes to the way health insurance companies treat those with eating disorders.

That was back in 2016. Now, Klobuchar has introduced a new piece of legislation, the Anna Westin Legacy Act, that would make funding for some of the programs created in 2016 permanent.

The Anna Westin Act

The Anna Westin Act passed in December 2016, marking the first time in history that Congress passed legislation specifically written to help people affected by eating disorders. The original act increased training and education on eating disorders and set rules for insurance companies that meant residential eating disorder treatment would be covered under most health insurance plans. It was enacted as part of the 21st Century CURES Act.

The bill also contained funding for the Center of Excellence for Eating Disorders, a treatment and research facility in North Carolina.

Kitty Westin and the Westin family were overjoyed when the legislation eventually passed.

“We had the ultimate outcome. For us it was making sure that people don’t suffer like our daughter did or like we have,” Kitty Westin told the Chaska Herald shortly after the bill was passed. “It’s really helped us cope with the death of our daughter knowing there’s some good that came from that. It’s helped us all heal.”

Klobuchar’s new push for funding

The number of emergency department visits from those dealing with eating disorders has doubled among adolescent women since the pandemic began.

The Centers for Disease Control and Prevention reported that eating disorders can be triggered by pandemic-related risk factors, like lack of structure in daily routine, emotional distress and changes in food availability. They can also be exacerbated by reduced access to mental health care during the pandemic. Eating disorders also have the second highest mortality rates of any mental illness, second only to opioid addiction. But only one in three people affected by eating disorders will receive treatment.

Klobuchar hasn’t let up on her push for legislation to help those with eating disorders and other mental health diseases. And with many mental health conditions becoming more widespread during the pandemic, Klobuchar decided that now was the time to introduce legislation for more funding.

Along with Sens. Shelly Moore Capito (R-WV), Tammy Baldwin (D-WI) and Thom Tillis (R-NC), Klobuchar introduced the Anna Westin Legacy Act. The bill would authorize $5 million for each fiscal year from 2023 to 2027 to fund the Center of Excellence for Eating Disorders. The previously adopted act authorized $3.75 million.

The funding will be dedicated to adapting screening, brief intervention and referral to treatment models for pediatric patients, expanding in-person and online training modules on eating disorders for physicians, consult with the Department of Defense and the Department of Veteran Affairs on treatment of eating disorders for veterans and military service members and integrate screening, intervention and referral to treatment models into electronic health record systems.

“In memory of Anna Westin, a Minnesotan who tragically died of an eating disorder at the young age of 21, I was proud to successfully lead bipartisan legislation to increase education and training on eating disorders through the creation of the Center of Excellence for Eating Disorders,” Klobuchar said. “Now, I’ve joined with a bipartisan group of my colleagues once again to support the Center and help countless families affected by eating disorders receive the care and services they need.”

Christine Peat, director of the Center of Excellence for Eating Disorders, said Klobuchar’s bill is an important next step in continuing to provide research and technical assistance to health care providers.

“This legislation will ensure that education and training on eating disorders is an integral component of the health  care landscape and thereby increase our ability to detect and appropriately manage these life-threatening conditions,” Peat said.