Tuesday, November 24, 2009

Drawing back the curtain on binge eating - LA Times

With psychiatrists mulling whether to classify binge eating as a bona fide eating disorder -- laid out in a package of stories in today's Health section -- the blog Jezebel launches a more personal discussion of the problem.

That post notes: "As someone who has been fortunate enough to receive proper treatment for an eating disorder, I find it somewhat troublesome that the concern over including binge eating disorder in the DSM comes back to worrying about doctors over prescribing medication or patients who rely on the diagnosis as some excuse to continue engaging in unhealthy behavior. ... I was able to get proper treatment because my eating disorder was clearly defined in the DSM."

People who have struggled with binge eating then weigh in. Others opine about the merits of the DSM classification.

Here's the L.A. Times' story, by staff writer Melissa Healy: Is binge eating a psychiatric disorder?

It begins: "Rina Silverman's refrigerator is almost always empty. She keeps it that way to avert episodes of frantic food consumption, often at night after a full meal, in which she tastes nothing and feels nothing but can polish off a party-sized bag of chips or a container of ice cream, maybe a whole box of cereal. The food she's eating at these moments hardly matters."

And here are the related stories in the package:
Trying to define binge eating disorder
Binge eating: Is it a form of addiction?
Holidays can feed binge eaters' problems

And for more on binge eating, check out this collection of information, tips and resources from helpguide.org.

— Tami Dennis

Friday, November 20, 2009

How to execute dietary management in eating disorder patients

Eating disorders (ED) patients display a high prevalence of gastrointestinal symptoms and functional gastrointestinal disorders such as irritable bowel syndrome. These symptoms may interfere with their nutritional management. Ingestion of fructose-sorbitol (F-S) is an established means of gastrointestinal symptom provocation in irritable bowel syndrome patients. Surprisingly, although ED patients are known to consume "diet" products containing fructose and sorbitol, their gastrointestinal symptom responses to F-S provocation have not been studied.

A research article published on November 14, 2009 in the World Journal of Gastroenterology describes the responses of 26 ED patients to F-S provocation. The research team, including Professors Kellow, Abraham and Hansen from the University of Sydney, Australia, monitored gastrointestinal symptoms and breath hydrogen concentration (a marker of small bowel absorption) for 3 h following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day. Responses to F-S were compared to those of 20 asymptomatic healthy females.

F-S provoked gastrointestinal symptoms in 15 ED patients but only in one healthy control. In contrast, only one ED patient displayed symptom provocation to glucose, which does not usually provoke gastrointestinal symptoms; this shows specificity of the F-S response. A greater symptom response was observed in the most underweight ED patients (BMI ≤ 17.5 kg/m2) compared to those with a BMI >17.5 kg/m2. There were no differences in psychological scores, prevalence of functional gastrointestinal disorders or breath hydrogen responses between patients with and without an F-S response.

The key findings of this study are that F-S provoked gastrointestinal symptoms in more than half of the female ED patients, a significantly greater proportion than that found in healthy individuals; the response was specific for F-S ingestion; and there was a greater symptom response in patients at lower BMI values. Consistent with this last finding, symptom provocation was more common in anorexia nervosa patients. Hence negative energy balance appears to play a role in F-S sensitivity in these patients. As fructose and sorbitol are likely to be commonly ingested by ED patients, representing a potential source of gastrointestinal distress that would impact negatively on their nutritional management, F-S provocative testing could prove valuable in identifying those patients with symptom sensitivity to these substances.

Reference: Friesen N, Hansen RD, Abraham SF, Kellow JE. Fructosesorbitol ingestion provokes gastrointestinal symptoms in patients with eating disorders. World J Gastroenterol 2009; 15(42): 5295-5299


Correspondence to: Dr. John E Kellow, Department of Gastroenterology, Royal North Shore Hospital, St. Leonards, Sydney 2065, Australia. johnk@med.usyd.edu.au

Telephone: +61-2-99267355 Fax: +61-2-94363719

About World Journal of Gastroenterology
World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H. pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

About The WJG Press
The WJG Press mainly publishes World Journal of Gastroenterology.

Athletes and Eating Disorders: Discussing the unique issues surrounding athletes with eating disorders.

When we think of athletes, typically we envision individuals who strive to maintain a healthy body. However, there are those athletes who take weight control and physical appearance to extremes and develop eating disorders as a result. It is important that we as parents, coaches, teachers and teammates are able to recognize the issue and provide support for the athlete as they work to overcome their eating disorder.

A variety of factors put an athlete at risk for developing an eating disorder, including: outside pressure to keep up athletic abilities, maintaining a healthy weight for optimal performance, and the type of sport (individual vs. team, and whether or not it focuses on physical appearance). The National Eating Disorders Association (NEDA) lists some risk factors here.

Coaches and parents should be aware of symptoms of eating disorders, such as having an intense fear of gaining weight, refusal to maintain a minimally healthy weight, believing that simply weighing less results in improved athletic performance, and increased exercise or obsession with exercise. More symptoms can be found on the NEDA's Web site. Anytime an athlete exhibits these signs, it is important to take immediate action before any severe physical damage occurs.

When assisting an athlete with an eating disorder, start by addressing the athlete's feelings first. These emotions can range from feeling lonely, isolated, and depressed, to feeling overly pressured to excel in athletic performance and setting unrealistic expectations for themselves. Athletes should have a safe environment in which they feel comfortable talking about pressures related to weight and performance, their self-image, and their self-esteem or perceived ability to perform well.

Being proactive in the prevention of disorders is essential, as it can help reduce their occurrence. Remember that talking about eating disorders does not necessarily mean an athlete will develop one. Take time to educate your athlete about the risks of an eating disorder and emphasize the importance of maintaining a healthy body for athletic competition. With these steps, hopefully the athletes you work with will develop a well-grounded view of what it means to be a healthy athlete.

Thursday, November 19, 2009

Eating Disorders Information Packet

I've been sending out a few school and sorority information packets each month.  If you would like a packet, I will send you one FREE OF CHARGE!  Just comment with your e-mail address, and I will be in touch.

Included in the packet are:
- ED related newletter or magazine (subject to availability)
- Introductory letter and contact card
- Can you eat too healthy?
- Harriet Brown's I-Love-My-Body Pledge
- Spanish language info sheet
- How to help your overweight child
- The truth about laxative abuse
- Exercise Prescription and eating disorders
- At Risk:  All cultural and ethnic groups
- Confront:  The plan for confronting someone you feel has an eating disorder
- Boys and eating disorders
- Book list
- Do's and don't's of helping someone recover from Binge Eating Disorder
- ANAD BMI testing in schools position statement
- FEAST press release
- Healthcare myths
- FEAST pamphlet
- Eating disorders ignored
- ANAD facts
- Physical consequences of eating disorders
- Symptoms lists and charts
- School program information
- ANAD pamphet

Kate Moss criticised over 'skinny is best' motto

Model Kate Moss has been criticised by campaigners after saying she lives by a slogan which encourages people with anorexia not to eat.

In an interview with fashion news website WWD, Moss said one of her mottoes was: "Nothing tastes as good as skinny feels."

The saying is widely used by anorexia and bulimia sufferers on websites.

Eating disorder charity Beat described the comments as "dangerous" and "very unhelpful" for sufferers.

In the interview Moss adds: "That's one of them. You try and remember, but it never works."

A spokeswoman for Beat said it was "a very unfortunate phrase" particularly as it was widely used on pro-anorexia websites.

"She probably doesn't realise how dangerous such comments can be. It's difficult enough for young people who are struggling to beat eating disorders, without comments like this which are very unhelpful," she said.

Katie Green, a former Ultimo underwear model, who has launched a Say No To Size Zero campaign with Liberal Democrat MP Lembit Opik, said the comments were "irresponsible".

She said: "I think Kate Moss should really have thought before she spoke like most of us do before giving interviews. Kate is a mother herself and how would parents with children suffering from eating disorders feel reading something like this?

"We are trying to get the government to put something in place to stamp out size zero models and comments like this aren't doing anything to help that."

Home for the Holidays: A FREE Webinar and Workshop for Those Recovering from an ED

Home for the Holidays:  Shine Your Light
A FREE Webinar and Workshop for Those Recovering from an Eating Disorder from the Renfrew Center

Topics include:
- Eating Challenges During the Holidays
- How to Alleviate Holiday Stress and Pressure
- Taking Responsibility for Your Own Health and Recovery
- Survival Strategies to Stay Focused on Your Recovery
- Creating and Sustaining Relationships at Home, Work, & School

Tuesday, December 15, 2009
12:00pm-1:00pm EST OR 8:00pm-9:00pm EST

Facilitated by Jennifer Nardozzi, PsyD and a Renfrew Alumna

Click here to register for the 12:00pm EST webinar.

Click here to register for the 8:00pm EST webinar.

Workshop at Non-Residential Sites
Tuesday, January 5, 2010

Workshop Locations Include:
Radnor, PA • New York • New Jersey • Connecticut • North Carolina • Tennessee • Texas • Maryland

Click here to register for the Workshop at the Non-Residential Sites (except Florida).

Workshop at Florida Site
Tuesday, January 5, 2010

Click here to register for the Workshop at the Florida site.

For more information, please call Jenna Hoskinson at 1-877-367-3383, ext. 3246 or jhoskinson@renfrewcenter.com

Tuesday, November 10, 2009

Overeaters and Drug Abusers Share Addictive Brain Chemistry

WASHINGTON (ISNS) -- Failed dieters may be pushed to over-eat not by their stomachs, but by their brains. The brain chemistry that makes it hard for alcoholics, drug users and smokers to quit their addictions also punishes us for trading sugar for salad, according to a new study of food consumption in rats.

The research supports those who believe that overeating can, in extreme cases, be considered an addiction comparable to drug abuse or gambling.

Some eating disorders, such as anorexia and bulimia, are already included in the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which psychiatrists use to diagnose their patients. Overeating is a controversial candidate for inclusion in the next version of the manual.

"For people who are eating way beyond their need and storing excess fat, there's a debate as to whether you want to call that a disorder of the brain," said Charles O'Brien, director of the Center for Studies in Addiction at the University of Pennsylvania School of Medicine and member of the task force for the new DSM.

Now Pietro Cottone and Valentina Sabino, co-directors of the Laboratory of Addictive Disorders at Boston University, have found that feeding unhealthy food to rats can alter the same region of the brain that changes when they are given alcohol, opiates or nicotine.

The scientists switched a group of rats from their normal diet of boring but nutritious rodent chow to a sugary diet of calorie-dense food. After two days of decadence, the animals were returned to a healthy diet. The pampered rats no longer cared for the healthy food; they ate less of it than their comrades who had never tried sugary food.

This change in appetite also happens in people who cycle back and forth between healthy and unhealthy foods, said Cottone. They also tend lose their desire for healthy foods enjoyed by others.

But it wasn't just that the healthy food had lost its appeal. Returning to a diet of normal food affected the amygdala of each rat, the region of the brain that produces anxiety. Brain cells in this area churned out five times the normal amount of a protein called corticotropin-releasing factor, or CRF -- the same chemical that punishes addicts who are trying to give up their drug of choice.

Relief from the anxiety-inducing chemical only came when the rats returned to a sugary diet and gorged themselves, increasing their consumption of food as compared to their first experience with it.

"This [CRF] punishment, this negative einforcement is causing anxiety and is increasing the probability that bad behavior is performed in the future to relieve anxiety," said Cottone.

The destructive eating habits of the rats improved when Cottone treated them with a substance that blocks CRF from attaching to the brain cells. They regained some of their taste for healthy foods and reduced the amount of sugar they ate.

Studies in the 1990s found that CRF blockers could help rats overcome exposure to drugs. For years, the pharmaceutical industry has been trying to develop drugs based on these chemicals for alcoholics, smokers and drug abusers.

Cottone suggests that they add compulsive eaters to their list of potential clientele.

Thursday, November 5, 2009

Downward Dog Fights Eating Disorders

Yoga for teens could be more than a spiritual and physical boost—a new randomized controlled trial suggests that it may help those with anorexia, bulimia and other eating disorders.

The study included 50 adolescents aged 11-16, the vast majority of whom were girls. They were seriously ill. Nearly half had previously been hospitalized because of their eating disorder—at the time of the study, they were being treated at an outpatient clinic at Seattle Children's hospital.

55% were suffering from anorexia, 17% had bulimia and the rest had been diagnosed with “eating disorder-not otherwise specified,” a condition in which people have some, but not all of the symptoms of anorexia or bulimia or both.

The study was led by T. Rain Carei Ph.D. of Seattle Children's Hospital and published in the Journal of Adolescent Health.

Teens were randomized to receive either usual treatment at the clinic—or that treatment plus two hours a week of yoga classes, conducted by an instructor certified in Viniyoga by the Yoga Alliance. The study period lasted eight weeks.

While controls showed improvement on tests of eating disordered behaviors and thinking during treatment, these had fallen back to their previous levels when they were followed up a month afterwards.

But in the yoga, while improvement started slowly, a month later, these teens were doing much better than they had been at the start of treatment and had lower scores on these measures as a result. Yoga had no effect on weight, which was reassuring because underweight subjects needed to gain to recover and weight loss could cause more harm.

The researchers suspect that yoga may help by reducing the obsessive concern about weight associated with eating disorders. They write, “Food preoccupation may be reduced by focusing attention on yoga poses.” Some subjects even expressed this idea directly to the researchers, saying “This is the only hour in my week when I don't think about my weight."

If a larger study confirms these findings, a prescription for the child's pose and others could be in the future for teens with eating disorders.