During the pandemic, eating disorders skyrocketed among teens. Now, investors are putting their money behind a relatively new startup that hopes to help kids and young adults work with their families to recover from this ailment. The company, Equip, has raised $58 million led by The Chernin Group, bringing its total funding to $75 million. It plans to use the money to push its service nationwide by mid-year.
CEO Kristina Saffran, who is in recovery from anorexia, co-founded Equip in 2019 with COO and clinical psychologist Erin Parks. The online platform practices family-based treatment, an outpatient framework where families work with their children to help them recover at home. Parents take on menu planning, portion control, scheduling meals, monitoring physical activity, and ensuring their child is actually eating. To support parents in this endeavor, Equip connects patients and their families with a therapist, a dietician, a doctor, and peer and family mentors who can validate their experiences and offer advice.
So far, Equip is available in 40 states with 10 insurers including, Aetna, Anthem, Cigna, Horizon BCBS, Magellan, Moda, Optum, PacificSource, and Partnership HealthPlan of California, through which it will treat Medicaid patients. To date, the company is treating hundreds of families. The goal is to go nationwide.
While family-based treatment (FBT) has gained popularity as a treatment for eating disorders, it’s not always easily accessible. “The old thinking was, ‘Let’s talk to you, let’s motivate you to want to eat,'” says Saffran. “But it’s not that they’re choosing not to eat.” One of the tenets of FBT is that children are not in control of their eating disorder. FBT also doesn’t dwell on the cause of the eating disorder, asserting that they arise from a complex set of factors that are part biological and part environmental. Instead, it focuses on getting the patient back to a normal weight and then on addressing the thought processes that lead to disordered eating.
“A lot of the symptoms of eating disorders are symptoms of starvation, so you really can’t do anything,” says Saffran. “Step one needs to be full weight restoration.”
Eating disorders are about feeling in control, something you will often hear people who are in recovery talk about. Perfectionism is heavily associated with eating disorders, as is anxiety. They can also arise when children feel no authority over their own circumstances. The body becomes a thing that can be controlled. The body is also a natural target for control when a teen’s feelings of inadequacy stem from their perceived inability to keep up with the kinds of beauty standards that are served to them on social platforms such Instagram.
A lot of the narrative that was out there was, ‘Things will get better,’ but they’ll always be hard.”
When Degener was 14, she was checked into a hospital with blood pressure so low she could have died. Her anorexia had taken complete control of her. In the film, she makes a stunning observation about her stay in the eating disorder ward: “Everybody is competing to be the most disordered person. Because you’re in this hospital where they’re trying to take away the one thing that gives you a sense of control, and you almost want to prove that they’re not doing it.”
Degener now manages peer mentors at Equip. She says that she also did FBT, but neither she nor her parents had peer mentors, or people who have been through the experience and can help to define what constitutes “normal” within the context of an eating disorder. She says her own parents were totally shocked by her behavior when she in active recovery.
“An eating disorder can take your very quiet, kind of goody-two-shoes, perfectionist kid to now they’re throwing plates across the room and you’re arguing over eating bread,” she told me. “I think there’s times where my parents were scared away from challenging the eating disorder as much as they needed to because they didn’t have a network of parents around them saying, ‘Oh yeah, no, my kid did that too.'”
Peer mentorship is also valuable to the patients, says Degener. “A lot of the narrative that was out there was, ‘Things will get better,’ but they’ll always be hard,” she says. “It was a while until I found voices that were saying, ‘I’ve been there and now look at what I’m doing with this part of my life or this volunteer work I’m doing.'” In the years since her eating disorder first emerged, Degener has become a yoga instructor and graduated college.
Equip is hoping to provide long-term support for patients. The most critical time to watch for relapse is in the first year of recovery, though as the pandemic has shown, unforeseen circumstances can always trigger a flareup. For now, insurers are paying Equip a monthly fee for all care on an ongoing basis.