Insurance and Education & Workforce Development

Local facility first to offer overnight help for anorexia: Lotus House fills void for those with eating disorders

April 10, 2006

A spacious home near Stony Creek in Noblesville once known as the Hare estate has been transformed into an intensive treatment facility for young women struggling with severe eating disorders.

Dubbed Lotus House, the three-story residence began hosting patients in October. Partners Patrick Hall, 40, and Misty Rees, 33, founded the facility to provide an inpatient alternative to standard care.

The facility, which offers therapies for anorexia nervosa and bulimia, is just the second in the Indianapolis area to treat eating disorders and the first to do so in an overnight setting where patients spend a minimum of six weeks trying to get healthy.

The Charis Center in Indianapolis, operated by Clarian Health Services, offers an eating-disorder program on an outpatient basis. Lotus House offers more in-depth treatment.

"The type of resident here is someone who physically is in serious danger of losing their life," Hall said. "That is the level of care we're dealing with."

Hall is a licensed marriage and family therapist who handles the business side of the arrangement while Rees, the only certified eating-disorder specialist in the state, is the program director who tends to patient needs.

The home can accommodate up to seven guests at a time and so far has treated roughly 20 patients-all from the Midwest-in the six months since it opened.

Lotus House is among the few live-in facilities in the Midwest and the only one of its kind in the state. Women who seek its type of intensive treatment, usually as a last resort, must meet medical criteria. They must be at least 18 years of age as well, due to state regulations that require adolescents to be housed separately from adults.

Stigma of illness

Lotus House patients typically will have related health issues. They may have heart or blood-pressure problems, low bone density, or they may be struggling with depression.

Their days are full, beginning at 7 a.m. and ending at 10 p.m. In between, they attend individual behavioral meetings with a staff psychiatrist. They also visit with a dietitian and a physician to monitor nutritional restoration. That process begins with a "very gentle" diet, Rees said.

Other forms of therapy might include art, dance, writing and yoga sessions. The residents even travel off site to receive equine therapy, in which they ride or interact with horses. Hall and Rees eventually want to have horses on the premises of the 10-acre property.

The treatment is expensive. The minimum six-week stay can run nearly $50,000, which is the average cost for an inpatient program, Hall said. Many insurance companies, however, don't recognize eating disorders as a psychiatric problem and won't pay for treatment.

And coverage provided by carriers that do offer it often is inadequate, said Dr. Doug Bunnell, clinical director of the Renfrew Center of Connecticut and past president of the Seattle-based National Eating Disorders Association.

Caregivers often are forced to discharge patients prematurely when benefits expire, Bunnell said. If proper care was widely available, he is convinced recovery rates would skyrocket. While intensive treatment may last a matter of weeks, a person can be in recovery from four to seven years.

On a positive note, eating disorders are being recognized more as a serious illness, Bunnell said.

"But most families and patients still struggle with the stigma," he said. "When you get down to the person with the illness, it's still very hard to talk openly about it."

Thin is in

Anorexia is a psychological disorder that causes young women-or men in rare cases-to lose their appetite. No matter how much weight they lose, they still think they are overweight.

Bulimia is a condition in which the subject eats regularly or engages in binge eating and then vomits or uses laxatives, enemas or diuretics to avoid gaining weight.

It is estimated that up to 10 million females battle an eating disorder every year, according to the NEDA. Yet research funding pales in comparison with that for other illnesses.

The National Institutes of Health devoted $12 million in research funding last year to anorexia. That compares with $350 million to schizophrenia, which affects 2.2 million people, and $647 million to Alzheimer's disease, which affects 4.5 million.

Eating disorders are most prevalent among young women between the ages of 15 and 24. The mortality rate for anorexia is about 10 percent, which is one of the highest premature death rates among psychological disorders, said Dr. Kathleen Kling of Clarian's Charis Center. The center has existed since 2001 and treats patients thrice a week for eight weeks.

The number of cases has steadily increased since the 1980s as expectations to become thin increased, Kling said.

"In high school these days, everybody wants to be a size 1 or size zero," she said. "There is tremendous stress on young girls' bodies."

Bunnell of the NEDA cited several contributing factors. Vulnerability can be inherited from another family member, and psychiatric illnesses such as depression or anxiety can contribute to the cause, he said.

Magazines, the modeling world and even Hollywood, which glamorize thinness, send the strongest message, Bunnell said.

Eating-disorder experts point out that the average U.S. woman weighs about 140 and is 5-foot-4. The average fashion model, however, is about 5-foot-11 and weighs 117. Such disparities create unrealistic expectations.

Rewarding but difficult

Hall, an Anderson native, earned his master's degree in marriage and family therapy in 1993 from Butler University. He practiced independently in several hospitals and private practices in Anderson, Carmel and Indianapolis and met Rees at Community Hospital Anderson.

She received a bachelor's degree in art therapy from the University of Evansville and completed her education at the Eating Disorders Institute at Saddleback Community College in California.

The curriculum is approved by the Pekin, Ill.-based International Association of Eating Disorders Professionals, which lists Rees as the only IAEDP-certified eating-disorder specialist in Indiana.

Two years ago, she proposed the pair open an eating-disorder treatment facility, but Hall said he wasn't interested in working in that particular field. After much thought and prayer, though, Hall said he relented.

Hall, who lives with his wife in Noblesville, purchased the former Hare estate in August. The 4,200-square-foot home, built in 1949, had for years belonged to the Hare family that operates the nearby Hare Chevrolet Olds on Stony Creek Road, as well as other automobile dealerships.

Lotus House staff includes five licensed clinical social workers, two psychiatrists and a dietitian.

Kling of the Charis Center welcomed the competition, noting a variety of treatments are necessary to combat the illness.

Hall and Rees said the work is rewarding but can be difficult. Two of 20 patients who have entered Lotus House left before completing the program.

Said Rees: "We constantly see people get their lives back."
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