Besides not being covered by insurance, there is the whole burden factor. For many, it is quite troubling. Individuals don't want to burden their families with the treatment of costs. This just makes the guilt even worse. At least for me it did.
Here's a vague conversation I had with my father in my mid-teens when the eating disorder had really taken force. He was very frustrated with me for not getting better/recovered. He said things like, "do you want to be emaciated looking, have a tube down your nose?" I replied with that I did not want that. And then he said, (this is jest of what he said, I can't remember it exactly word for word) "because you know, treatment costs a lot of money. I'd have to take money out of my savings. Do you want that?"
Talk about a major guilt trip. Of course, I answered with that I did not want that. The underlying factor of what I heard here is that I really wasn't worth it. Maybe it's one reason why I never got incredibly thin but remained just under the radar all the time. Even with my therapists, they'd ask something like "do you think you need to go inpatient?" I'd say I did not know, but what I really wanted them to say was, "yes, you need to go." At that time, I wanted the choice out of my hands. I thought if I was inpatient, maybe it would convince me that I was truly sick. That maybe if someone really advocated on my behalf, it would show me that I really was ill.
Inpatient never happened, at least not for the eating disorder (inpatient one time when I was 16 for suicidal tendencies which was a horrible experience other than finding coloring to be relaxing), but I'm beginning to realize that I really don't have to be inpatient to be better. Most of the time, the real healing only begins afterwards anyway.