Colorado bans sale of diet pills in push to address eating disorders

Colorado insurers will soon be barred from using an antiquated weight calculation to block a patient from accessing eating disorder care, under a new law signed Tuesday that also bans the sale of certain diet pills to minors.

The new law, which passed the legislature in early May, is part of a two-pronged approach undertaken by legislators this year to better address eating disorders in Colorado. A second bill, also signed into law Tuesday by Lt. Gov. Dianne Primavera, will create a program within the state health department that seeks to better prevent Coloradans from developing the diseases in the first place.

The two bills had been pushed by mental health advocates and by the Colorado Youth Advisory Council. Eating disorder diagnoses have erupted in the wake of the pandemic, and Colorado is a hub for eating disorder treatment nationally.

Aimee Resnick, a college student who helped champion the prevention bill (SB23-014), said she was proud of the work undertaken by advocates to pass the bill and said it was part of a national movement to address eating disorders. The new prevention program will coordinate prevention strategies, launch a grant program and provide resources on the diseases. The bill was sponsored by Sen. Dominick Moreno, of Commerce City, and Rep. Mandy Lindsay, of Aurora.

Resnick said she hopes Colorado's law can serve as a template for other states interested in combatting the illnesses.

"This (is) the first time a state's lawmakers have taken a serious look at quality of care and access to care issues associated with disordered eating," Vincent Atchity, the president and CEO of Mental Health Colorado, said in a statement. "Disordered eating is rampant and deadly — as the second most fatal of mental health conditions (exceeded only by the opioid crisis). Too little is known or practiced on the prevention side. And the quality of health care for disordered eating, when it can be accessed, ranges from excellent to harmful and destructive."

SB23-176 prevents insurers and providers from using the body-mass index in determining a patient's need for treatment. BMI, which uses a person's height and weight to determine their body mass, was developed nearly 200 years ago by a Belgian mathematician. It's often used, patients and advocates say, in assessing whether an eating disorder patient needs treatment but statistics show that fewer than 6% of eating disorder patients are underweight, and BMI has been criticized for being an outdated and incomplete method of assessing a patient's health status.

The law also prohibits retail establishments from selling over-the-counter diet pills to residents under the age of 18. That prohibition becomes effective July 1, 2024.

Initially, the bill also would’ve instituted prescribed regulations for eating disorder treatment providers to address what lawmakers have described as "bizarre" practices in treatment facilities. Former patients have accused treatment providers of using feeding tubes and restrictive care as threats to ensure compliance, and several have said that the treatment environments often felt punitive.

But those provisions would’ve cost money, and they were stripped from the bill in April as legislators parceled out limited funds to various priority legislation. That drew frustration from advocates and former patients. Atchity, of Mental Health Colorado, said Tuesday that there was more work to be done on the issue but that SB23-176, even pared down, was an important step forward.

Sen. Lisa Cutter, a Jefferson County Democrat and one of the bill's co-sponsors, said it was "heartbreaking" to strip the regulatory provisions from the bill, and she said some treatment providers engaged in "barbaric" and "punitive" practices. But she said the new law was progress and that she was interested in doing more in the years to come.

Resnick said she was already working on legislation for next year that would ban various forms of weight discrimination in the state.

"Progress is progress," Cutter said. "So you take that and you figure out something else to chip away at and come back again."

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