There has been very little legislative activity on eating disorders in the history of Congress. The first bill addressing eating disorders was introduced in 1987 in both the House and Senate, and was a resolution designating a week as the National Eating Disorders Awareness Week for that year. Only one bill was ever passed into public law. In total there have been 17 freestanding bills that have dealt with eating disorders . Of those, 12 bills are specifically about eating disorders and the remaining 5 bills are more omnibus women's health or education bills which include the language of an eating disorders bill in it. Although there are 17 bills that have addressed eating disorders until this Congress (the 106th) all the bills have simply been a recycling of the following 2 bills:

Awareness Week/Day: A popular idea for a legislative initiative to address eating disorders is to establish an eating disorders awareness week or day. This idea was the first eating disorder initiative ever introduced in 1987 and a version of this idea was introduced as a resolution in the 100th, 101st, 102nd and 105th Congress. It was only passed into Public Law once in 1989, which designated October 23 through October 29, 1989 as Eating Disorders Awareness Week.

Information and Education: The second popular idea first introduced by Representative Schroeder in the 103rd Congress (1993) was to require the Secretary to carry out a program to provide information and education to the public on the prevention and treatment of eating disorders, including the operation of toll-free 24-hour telephone communications. A version of this bill was introduced every year until the language was partly included in the 1998 Committee Report of DEPARTMENTS OF LABOR, HEALTH AND HUMAN SERVICES, AND EDUCATION, AND RELATED AGENCIES APPROPRIATION BILL. Once the goals of this bill were included in the report language the Office of Women's Health in the Secretary's Office responded by creating the BodyWise project and including eating disorders in their women's health hotline.

New Ideas

In the 106th Congress, two new eating disorders initiatives were introduced.

Effect of eating disorders on learning: This bill was introduced in the House to work within the school system (by amending title VI of the Elementary and Secondary Education Act of 1965) to raise awareness of eating disorders and to create educational programs concerning the same.

Relationship between eating disorders and the media: The second bill is a congressional resolution expressing the sense of the Congress with respect to the relationship between eating disorders in adolescents and young adults and certain practices of the advertising industry. This bill was written in response to a Constituent's concern. There are no Cosponsors and it hasn't received any since it's introduction. This means that the Member introduced it but is not creating any activity around it.

Congress Mandating Federal Agencies to Address Eating Disorders

Perhaps the most activity has come from Congress mandating agencies to address the problem of eating disorders through appropriations report language. Eating disorders were first addressed through appropriations language in 1997. The agencies targeted were NIMH, NICHD, and the Secretaries Office. This may be why we see very little activity from federal agencies on eating disorders until recently. In fact, one person contacted at NICHD stated explicitly that they now do have eating disorders activity because Congress mandated them to address this concern through report language.

The report language focused on the need for more research and education to better understand eating disorders. Examples include:

In 1997 - The Committee urges NICHD to further investigate behavioral, social, and cultural factors that affect adolescent girls' eating habits, with the goal of learning how to prevent and treat eating disorders.

In 1997 - The Committee encourages the Secretary to develop a national media campaign targeting, but not limited to, adolescent girls and women to educate them about healthy eating behaviors. The program should educate the public about the risks of restrictive dieting and the prevention of eating disorders. The Secretary may consult with other agencies as appropriate, including the Centers for Disease Control and Prevention and other public health agencies. Such program may include development of a toll-free number and information clearinghouse on eating disorders.

Report language typically inspires the named federal agency to respond to Congress's concerns. The response of the report language to NICHD is that they included research in their Endocrinology, Nutrition and Growth Branch, which address eating disorders. Again, as mentioned earlier as a result of the report language quoted in the second example (which is language from the Eating Disorders Information and Education Act) the Office of Women's Health created the BodyWise project.

Activity in Federal Agencies

The activity of federal agencies on eating disorders can be summarized as follows:

1. Most of the activity on eating disorders has occurred in the last few years.
2. For the majority of agencies that address eating disorders they do so by offering a fact sheet or other information on their web site.
3. NIMH is the most active agency. They have hosted workshops, created educational materials, created task forces, and offered research funding.
4. Other agencies have investigated eating disorders as they relate to the diseases and populations that are of concern to that particular agency. For example the National Institute of Allergy and Infectious Diseases is conducting a study with patients who have HIV-wasting syndrome, which is characterized by severely debilitating anorexia and weight loss.
5. A number of federal agencies have not addressed eating disorders at all such as the Department of Defense, Center for Disease Control, Indian Health Services, and the Department of Education.

Conclusions and Recommendations:

1. The time is ripe for promoting policies that address the range of concerns in the eating disorders field/arena. Congress and federal agencies have increased their activity in this area, yet there is clearly much more that needs to be done in order to better understand the dynamics of eating disorders and to prevent the incidence rate from increasing.
2. There is an interrelationship between the actions of Congress and the activity of federal agencies.
3. Now that a number of agencies are addressing eating disorders it is recommended to work directly with the federal agency to promote further attention to eating disorders.
4. Report language on eating disorders first appeared in 1997 as a result of advocates working with Members of Congress. This is clearly an important route toward promoting further eating disorders policies.