DENVER — Two weeks after a routine trip to a health clinic turned into a psychiatric hospitalization, Emma Troughton was on a plane to Denver.

The intervention had been building: By early 2017, Troughton had struggled with body image and eating for years, first as a high schooler in Indiana piecing through their gender identity (Troughton is nonbinary) and then as a college student in California processing personal trauma. School-issued laptops sent Troughton down social media rabbit holes of unhealthy weight loss strategies. A password-protected blog became a repository for body measurements and bad information.

Troughton crashed their car because of the brain fog and cognitive decline caused by their malnourishment. Providers at a campus health clinic were so alarmed they wouldn’t allow Troughton to return to class. After two weeks in a psychiatric unit, Troughton left for Denver. The city, they had learned, was a national hub for eating disorder treatment.

“I felt this existential detachment from my body,” said Troughton, who now works for Mental Health Colorado. “Any attempt I had at re-integrating (with my body), I felt flooded with anger and a sense of helplessness. I re-acquainted strongly with my eating disorder going into college.”

Troughton spent the next three years in and out of Denver facilities, navigating treatment they considered to be both traumatic and life-saving. The city is home to Denver Health’s ACUTE, considered one of the highest-level eating disorder facilities in the country. The Eating Recovery Center, a national for-profit treatment provider, is based here, too. That’s where Troughton was treated, and their last time there — in 2020 — came as COVID-19 arrived in Colorado.

The pandemic would ignite a series of societal disruptions that have led to an explosion of eating disorder diagnoses among youth in Colorado and across the United States. Providers here say demands for their services have increased and that the pandemic’s impact on eating disorders will endure for years.

“The severity of kids that we saw during the worst part of the pandemic was really intense,” said Jennifer Hagman, the director of the disorder eating program at Children’s Hospital Colorado. “Almost every kid, to a person, talked about the impact of being isolated at home and being on social media and starting to get even more body focused than they already were.”

The surge in cases — coupled with concerns about treatment raised by patients like Troughton — have gained the attention of Colorado lawmakers and mental health advocates. A leading Democrat in the state Senate has introduced legislation in recent weeks that seeks both to prevent eating disorders from developing and to regulate the treatment that’s provided when that prevention fails. The two bills — one to establish a statewide office of disordered eating prevention, the other to limit the availability of diet pills and to better oversee medical practices — are unique in the country, several local and national experts told the Denver Post. Their introduction, those experts said, signal an increased focus on a long-neglected and stigmatized disease that is among the deadliest mental illnesses.

The diseases — like anorexia and bulimia — are often portrayed as physical diseases affecting teen girls and models. While women and LGBT people are more commonly affected, men and boys are vulnerable, too, and often go undiagnosed. Six former patients who spoke to the Denver Post described their condition as psychologically torturous and all-consuming, often born of a desire for control, a response to trauma or a trigger point around weight or healthy eating. Hagman said the diseases can be enduring and as severe as schizophrenia, and they often develop hand-in-hand with anxiety and depression.

“It’s like being held hostage,” said Sarah Staron, who struggled with an eating disorder for a decade. She’s now the policy coordinator for the advocacy group Young Invincibles, which is supporting the legislation. “By yourself, by society or by the plate of food that’s in front of you.”

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