I wish someone had told me how few economic resources existed for eating disorder research and philanthropy. The eating disorder field receives $28 million of annual federal funding, which translates to less than a dollar per affected individual. Meanwhile, the national eating disorder philanthropic space receives less than $10 million a year. Government-supported research and funds for other mental health conditions outpace eating disorders tenfold.
As part of my series about “individuals and organizations making an important social impact”, I had the pleasure of interviewing Sam Menaged, Founder and President of The Renfrew Center.
Samuel E. Menaged, JD, is the founder and president of The Renfrew Center and The Renfrew Center Foundation. Mr. Menaged opened The Renfrew Center 38 years ago as the country’s first residential treatment facility specializing in eating disorders. He is the past president of the board of the Eating Disorders Coalition for Research, Policy and Action, an advocacy group based in Washington, D.C. Mr. Menaged is a former healthcare attorney.
Thank you so much for joining us in this interview series! Can you tell us a story about what brought you to this specific career path?
Thank you for this opportunity! Absolutely, I can. In 1983, Karen Carpenter, who was one of the country’s top recording artists at that time, died from the ravages of Anorexia Nervosa. Due to the media coverage of her death, eating disorders finally came out of the closet. Although I was a healthcare attorney, not a clinician, I felt compelled to find a way to help. I began by learning as much as possible about this disorder. Shortly thereafter, I set a plan in motion to develop a residential treatment center for girls and women, like no other, based on respect, community and the power of connection. Located on a 27-acre estate in Philadelphia, The Renfrew Center, the nation’s first eating disorders treatment facility, offers the serenity and beauty of nature to exponentially enhance the healing milieu.
Today, The Renfrew Center is the pioneer of eating disorder treatment. We have 19 locations nationwide as well as a virtual platform, Renfrew@Home, offering treatment to those who are not able to travel to a physical site. We have helped more than 100,000 adolescent girls, women, and transgender and nonbinary individuals with eating disorders. I carry with me the same passion and enthusiasm I did when we first opened in 1985, and I have chosen to maintain Renfrew’s presence in the eating disorders field as a family-run business. Over the course of the past decade, my daughter, Vanessa Menaged, has joined me, bringing her dedication, intelligence and creativity to our corporate and clinical structure. She is an essential element in Renfrew’s continued advancement in the field.
Can you describe how you or your organization is making a significant social impact?
The Renfrew Center uses a proprietary Unified Treatment Model (also known as the UT), which was first implemented in 2015. The UT is an emotion-focused, transdiagnostic approach that emphasizes the building of emotional awareness and tolerance, while carefully integrating and honoring our feminist-relational roots.
As the first residential eating disorder treatment program to publish treatment outcomes in peer-reviewed journals, we have been able to demonstrate that our patients show greater improvement with the UT than they do with “treatment as usual” — which is no small feat. We spend a substantial amount of time and resources on training, supervision and research to ensure that we maintain this high level of quality across all 19 of our locations and through our Renfrew@Home virtual programming. Our latest analysis of five years of treatment outcome data demonstrates that our treatment continues to provide the same level of clinically significant change now as it did when we first implemented this evidence-based treatment over five years ago. So we can continue to feel good about the fact that our treatment produces sustainable change in our patients year after year.
Most recently, in 2021, Oxford University Press published the Unified Treatment Model for Eating Disorders as part of their Treatments That Work series. There is now a patient workbook and a clinician’s guide to practicing the model. These treatment manuals are designed to be user-friendly and accessible to both clinicians and patients, and are available at all major booksellers.
It is incredibly gratifying that we have been able to stay true to and vastly benefit from the feminist-relational model we initiated those 38 years ago, while also providing cutting-edge evidence-based treatment.
Are there three things the community/society/politicians can do to help you address the root of the problem you are trying to solve?
Eating disorder research often points to the longevity of eating disorder symptoms being a result of a lack of access to treatment. The most important thing we can do is work to eliminate these barriers. To do this, we need to:
- Improve access to care for marginalized communities and those who cannot obtain in-person treatment for any reason.
- Raise funds for scholarship treatment for those who cannot afford care themselves.
- Ensure the federal government mandates telehealth coverage to ensure people in rural communities and others throughout the country can access treatment.
How do you define “Leadership”? Can you explain what you mean or give an example?
When I opened The Renfrew Center in 1985, eating disorders were a well-kept secret, and specialized treatment facilities were nonexistent. In my work as a practicing healthcare attorney, I consulted frequently with mental health professionals as well as women who were struggling to recover from the physical and emotional toll of anorexia nervosa and bulimia nervosa. From those conversations, I recognized a need for a treatment facility that addressed the complexities of the underlying issues that lead to an eating disorder, not just the symptoms.
We were once just a local site in Philadelphia, and now we have expanded to 19 locations across the country, while continuing to operate as a family-owned business. Through our work, we have dispelled the notion that eating disorders affect just a small demographic of the population. We continue to adapt our treatments, using research findings to provide more expansive and inclusive care. I am particularly proud that we were able to open our doors to treat adolescent girls, women, and transgender and nonbinary individuals.
Through advocacy, awareness and the seminars we provide, we work within our local communities and beyond to build support systems that will lead to more evidence-based, inclusive and empathetic treatment. A good leader defines a problem and guides a group of people in creating a solution.
What are your “5 things I wish someone told me when I first started” and why. Please share a story or example for each.
- I wish someone had told me how few training opportunities there were for professionals to specialize in eating disorders. In 1985, and even now, graduate students in social work, counseling, nutrition and medicine receive a handful of hours at best on treating patients with eating disorders. While taking on an acute patient population from the get-go, we have also sought to robustly train clinicians in eating disorder best practices, so they have the comfort, skills and efficacy to treat our patients.
- I wish someone had told me about the need for a continuum of care. When I set out to start The Renfrew Center, the limited existing treatments focused on medical stabilization in a hospital setting. Part of my goal in founding a residential treatment center was to provide a bucolic, home-like space for healing. However, what would happen after patients left our campus after their stay? Over the years, the need to create outpatient programs, specifically a partial hospitalization program — or day program — followed by an intensive outpatient program, became essential. The introduction of these programs required conceptualization of how to provide appropriate clinical care and how to plan for the days and evenings that patients wouldn’t be in treatment. These programs are now an integral part of the treatment continuum, with patients gaining autonomy, agency and necessary support over the course of their outpatient stay.
- I wish someone had told me about the complexities of working with insurance companies. Before the advent of managed care in the mid-1990s, we determined the course of treatment by progress and ability to pay. However, as managed care became the prevailing model, lengths of stay became shortened. The Renfrew Center had to grow a strong team of admissions professionals whose role would include communicating with insurance companies to pre-certify patients and increase their length of stay when needed. Today, we have contracts nationally with over 400 insurance companies. In fact, expansion into day treatment and intensive outpatient services has been more enticing for insurance companies that appreciate providers who offer different levels of care.
- I wish someone had told me not to believe the harmful, limited stereotypes about those who suffer from eating disorders or their etiology. Since Renfrew’s inception, we have seen a diverse array of people come through our doors with hopes of recovery. Over the decades, we have worked to dismantle stigmas around eating disorders, body size and mental health, and engage in advocacy for treatment for people of all races, religions, genders and sizes.
- I wish someone had told me how few economic resources existed for eating disorder research and philanthropy. The eating disorder field receives $28 million of annual federal funding, which translates to less than a dollar per affected individual. Meanwhile, the national eating disorder philanthropic space receives less than $10 million a year. Government-supported research and funds for other mental health conditions outpace eating disorders tenfold.
Five years after opening The Renfrew Center, we launched The Renfrew Center Foundation, which has conducted research, advocacy and training while also establishing treatment scholarships to increase access to care. There is much more work to be done in all these areas in order to advance the field.
You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
One of the things we see at The Renfrew Center and through research is that eating disorders thrive in isolation. Individuals who struggle experience intense feelings of guilt and shame that ultimately prevent them from coming forward to ask for the help they so desperately need. My feeling is that if more people who survived these issues felt comfortable enough to come forward and tell their story, it could vastly change another person’s life. I would be excited to see a media campaign that shows recovery is possible. Any funds made from the campaign could also be allocated to treatment scholarships or eating disorder research.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Hard times don’t create heroes. It is during the hard times when the hero within us emerges.”
There are many heroes who have emerged at The Renfrew Center over its 38 years, from our clinicians, practitioners and staff to our patients. There is one word that truly describes all of them, and that is “committed.” Our staff members deserve admiration for their commitment to helping our patients in times of great need, while our patients deserve admiration for their bravery in committing to receive treatment to recover from these insidious mental illnesses.
How can our readers further follow your work online?
They can visit renfrewcenter.com or follow us on Facebook, Twitter and Instagram @Renfrewcenter.
This was very meaningful, thank you so much. We wish you only continued success on your great work!
Thank you!
Social Impact Heroes: Why & How Sam Menaged of The Renfrew Center Is Helping To Change Our World was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.