BILL ANALYSIS
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Date of Hearing: March 24, 2009
ASSEMBLY COMMITTEE ON HEALTH
Dave Jones, Chair
ACR 28 (Ma) - As Introduced: February 19, 2009
SUBJECT : Eating Disorders Awareness Week.
SUMMARY : Declares February 22 through 28, 2009 as Eating
Disorders Awareness Week and urges the California Department of
Public Health (DPH) to undertake a study on eating disorders in
California. Specifically, this resolution :
1)Declares February 22 through 28, 2009 as Eating Disorders
Awareness Week.
2)Encourages citizens and policymakers to learn more about
eating disorders and the obstacles to treatment, and to help
people overcome and prevent these life-threatening diseases.
3)Urges DPH to undertake a study of the public health impact of
eating disorders in California, and the need for programs or
policies to enhance education, awareness, detection, and
prevention of these diseases in the general population.
4)Urges DPH to undertake a study of the conditions, needs,
issues, and problems relating to eating disorders and make
necessary or appropriate recommendations for legislation.
5)Makes various declarations and findings related to eating
disorders, including the following:
a) Ten million women and one million men across the country
are battling illnesses such as anorexia and bulimia, and
millions more are suffering from binge eating disorder;
b) Anorexia, bulimia, and compulsive overeating are
problems that are misunderstood, stigmatized, underfunded,
and untreated;
c) Eating disorders can lead to major medical
complications, including cardiac arrhythmia, cognitive
impairment, certain cancers, osteoporosis, infertility,
kidney failure, and death;
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d) Eating disorders affect persons of every race, color,
gender, and socioeconomic category;
e) Media pressures and genetic, social, and familial
factors are all known to be related to eating disorders;
and,
f) Eating disorders are treatable when diagnosed early and
treated sufficiently.
EXISTING LAW :
1)Permits DPH to do all of the following in order to protect,
preserve, and advance public health: a) studies; b)
demonstrations of innovative methods; c) evaluations of
existing projects; d) provisions of training programs; and, e)
dissemination of information.
2)Permits DPH in performing activities listed in #1 above, to do
all of the following: a) perform the activity directly; b)
enter into contracts, cooperative agreements, or other
agreements for the performance of the activity; and, d) award
grants for the performance of the activity.
FISCAL EFFECT : This bill has not been analyzed by a fiscal
committee.
COMMENTS :
1)PURPOSE OF THIS RESOLUTION . According to the author, in
California more than 4.1 million people suffer from anorexia,
bulimia, binging or some other unclassified eating disorder.
The author maintains that anorexia is the third most common
disorder amongst teens, behind obesity and asthma. The
National Eating Disorders Association (NEDA), the sponsor of
this resolution, argues that eating disorders among young
women are increasing at an alarming rate in California and
across the nation. The purpose of this resolution is to raise
public awareness about the challenges in accessing adequate
medical care to battle eating disorders and to advocate for
prevention programs to combat this growing and deadly
epidemic.
2)BACKGROUND . According to the National Institute of Mental
Health (NIMH), an eating disorder is marked by extremes. It
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is present when a person experiences severe disturbances in
eating behavior, such as extreme reduction of food intake or
extreme overeating, or feelings of extreme distress or concern
about body weight or shape. Eating disorders are very
complex, and despite scientific research to understand them,
the biological, behavioral and social underpinnings of these
illnesses remain elusive. The two main types of eating
disorders are anorexia nervosa and bulimia nervosa. A third
category is "eating disorders not otherwise specified
(EDNOS)," which includes several variations of eating
disorders. Most of these disorders are similar to anorexia or
bulimia but with slightly different characteristics.
Binge-eating disorder, which has received increasing research
and media attention in recent years, is one type of EDNOS.
The NIMH maintains that eating disorders frequently appear
during adolescence or young adulthood, but some reports
indicate that they can develop during childhood or later in
adulthood. Women and girls are much more likely than males to
develop an eating disorder. Men and boys account for an
estimated 5 -15 % of patients with anorexia or bulimia and an
estimated 35 % of those with binge-eating disorder. Eating
disorders are treatable medical illnesses with complex
underlying psychological and biological causes. They
frequently co-exist with other psychiatric disorders such as
depression, substance abuse, or anxiety disorders. People
with eating disorders also can suffer from numerous other
physical health complications, such as heart conditions or
kidney failure, which can lead to death.
Researchers are unsure of the underlying causes and nature of
eating disorders. Unlike a neurological disorder, which
generally can be pinpointed to a specific lesion on the brain,
an eating disorder likely involves abnormal activity
distributed across brain systems. With increased recognition
that mental disorders are brain disorders, more researchers
are using tools from both modern neuroscience and modern
psychology to better understand eating disorders.
3)STATE PROGRAMS . According to DPH, the state currently does
not have a specific initiative aimed at eating disorders.
However, some of the related youth-focused studies such as the
California Teen Eating, Exercise, and Nutrition Survey
(CalTEENS) and the Youth Risk Behavior Survey (YRBS) look at
areas related to eating disorders.
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The CalTEENS survey is administered by the Network for a Healthy
California and is conducted every other year, in even years.
CalTEENS is administered to a random telephone sample of
California teenagers, age 12-17. The majority of the
questions on CalTEENS address typical eating and physical
activity behaviors, attitudes, and knowledge, as well as
perceptions of the school and neighborhood environments as
they pertain to these activities. Questions about body weight
include the following: self-reported height and weight, used
to calculate body weight status (obesity, underweight, etc.);
perceived ideal weight; whether the respondent is trying to
lose/gain/maintain weight; strategies the respondent has used
in the past 30 days to lose weight (diet, fast 24 hours or
more, exercise, smoke, other - provide further information);
if the respondent dieted, the type of diet used; and, if the
respondent is currently dieting at the time of the interview.
The main goal of the CalTEENS survey is to inform the Network
for a Healthy California programming, other local nutrition
and physical activity projects, as well as policy makers and
researchers of youth behavior, knowledge and attitudes about
diet, physical activity, and body weight.
The YRBS is administered by DPH. The major difference between
the YRBS and CalTEENS is that questions related to diet,
physical activity and body image make up only a small part of
YRBS. Many questions are about other risk behaviors such as
drugs, alcohol, violence, guns, etc. YRBS is a biennial
survey conducted in schools, with students in grades 9 through
12.
4)SUPPORT . Supporters of this resolution, NEDA, the California
School Nurses Organization and the American Federation of
State, County and Municipal Employees, are in favor of
recognizing Eating Disorders Week in order to encourage
citizens and policymakers to learn more about eating disorders
and the obstacles to treatment, and to help prevent these
life-threatening diseases.
5)PREVIOUS LEGISLATION . AB 88 (Thomson), Chapter 534, Statutes
of 1999, referred to as the Mental Health Parity Law, requires
a health care service plan contract or disability insurance
policy to provide coverage for severe mental illnesses, and
for the serious emotional disturbances of a child.
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REGISTERED SUPPORT / OPPOSITION :
Support
National Eating Disorder Association (sponsor)
American Federation of State, County and Municipal Employees,
AFL-CIO
California School Nurses Organization
Opposition
None on file.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097