Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, previously responded to readers’ questions about anorexia, bulimia, binge eating and related problems. Here, she responds to a reader who developed anorexia after a severe case of strep throat.
Q.A number of years ago, several studies indicated there might be a link between strep infections and the onset of anorexia nervosa. When I was young, my own anorexia began immediately after a severe strep infection, though I was already “ripe” for a.n. beforehand. Have any further studies been done?
Tinytim, France
A.Dr. Kathryn Zerbe responds:
You are referring to a small number of case reports that linked the development of anorexia to a condition called PANDAS, or pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. Since these reports were published in the late 1990s, there have been studies that specifically link some cases of anorexia to acute strep infection.
There is also ongoing investigation of how tics and obsessive-compulsive disorder, or OCD, may worsen after a strep infection in some children up to the age of puberty. Because anorexia and obsessive-compulsive disorder often occur together, it is possible that antibodies produced by the strep bacteria could affect the brain and trigger or worsen both disorders.
At the present time, however, the National Institute of Mental Health only links the PANDAS syndrome with tics and OCD, attention-deficit hyperactivity disorder, separation anxiety, sleep problems and mood changes. Children who have have OCD and tics associated with PANDAS usually improve once the infection clears, only to get worse if they get another strep infection.
Children without PANDAS but who have tics and OCD tend to have the disorder for a long time, with good days and bad days, but they don’t necessarily get worse when they get a strep infection. The mechanism for PANDAS remains unknown.
Showing posts with label Dr. Zerbe. Show all posts
Showing posts with label Dr. Zerbe. Show all posts
Tuesday, June 29, 2010
Monday, August 31, 2009
Ask the Expert - Week 5
Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers’ questions on anorexia, bulimia, binge eating and other problems. Here, she responds to one reader’s question about growing up in a household where eating disorders were common.
Question: In recent years, an increasing number of men have been diagnosed with eating disorders, and not just compulsive overeating, but also disorders like anorexia and bulimia that have traditionally been associated with women. (Full disclosure: I am one such man.)
Does this represent men wanting to take on feminine roles, or feeling that they cannot relate at all to traditional, ultra-macho conceptions of masculinity, and want to take on a more “feminine” persona? Does it differ for homosexual and heterosexual men? To what do you attribute the recent rise in these disorders among men?
Anonymous
Dr.. Zerbe responds:
Two large studies have reported that some 10 to 11 percent of patients with an eating disorder are men, though more recent studies report that as many as 30 percent of patients with anorexia or bulimia are male, and as many as 40 percent of binge eaters are men.
Fortunately our society is moving away, albeit slowly, from stereotyping men and women. Hence, like you, more men are admitting to having anorexia, bulimia, binge eating problems and even just a preoccupation with being a particular weight.
Clinicians are learning more about the millions of men who suffer from body image conflicts, compulsive exercise, weight obsession and other accompanying psychiatric problems like obsessive-compulsive disorder and depression that can accompany a bona fide eating disorder. Men also tend to use steroids more than women to develop a desired masculine build, a condition sometimes called “reverse anorexia.”
Participating in sports like wrestling, gymnastics or running can also place certain men at risk of developing an eating disorder. Those in certain occupations, such as flight attendants, members of the armed forces or actors, may also be at increased risk compared to men in the general population.
Although a large study from 2007 found that gay men do appear to have more eating disorders than straight men, these men do not necessarily want to be feminine. Nor do they seem to have trouble with their masculine role, as they define it. They do, however, desire to be attractive to potential partners and believe that being a particular weight and shape is appealing.
There is some research that suggests that gay men with an eating disorder may be more likely to have been the victim of sexual or physical abuse as a child. You and other men should be aware that the same physical consequences that occur in women with eating disorder take their toll on men, too, including osteoporosis and osteopenia (thinning bones).
Take a look at one of these books about eating disorders in men to learn more: “Making Weight: Healing Men’s Conflicts With Food, Weight, Shape and Appearance,” by Arnold Andersen, Leigh Cohn and Tom Holbrook; or “The Invisible Man: A Self-Help Guide for Men With Eating Disorders, Compulsive Exercise and Bigorexia,” by John F. Morga
Question: In recent years, an increasing number of men have been diagnosed with eating disorders, and not just compulsive overeating, but also disorders like anorexia and bulimia that have traditionally been associated with women. (Full disclosure: I am one such man.)
Does this represent men wanting to take on feminine roles, or feeling that they cannot relate at all to traditional, ultra-macho conceptions of masculinity, and want to take on a more “feminine” persona? Does it differ for homosexual and heterosexual men? To what do you attribute the recent rise in these disorders among men?
Anonymous
Dr.. Zerbe responds:
Two large studies have reported that some 10 to 11 percent of patients with an eating disorder are men, though more recent studies report that as many as 30 percent of patients with anorexia or bulimia are male, and as many as 40 percent of binge eaters are men.
Fortunately our society is moving away, albeit slowly, from stereotyping men and women. Hence, like you, more men are admitting to having anorexia, bulimia, binge eating problems and even just a preoccupation with being a particular weight.
Clinicians are learning more about the millions of men who suffer from body image conflicts, compulsive exercise, weight obsession and other accompanying psychiatric problems like obsessive-compulsive disorder and depression that can accompany a bona fide eating disorder. Men also tend to use steroids more than women to develop a desired masculine build, a condition sometimes called “reverse anorexia.”
Participating in sports like wrestling, gymnastics or running can also place certain men at risk of developing an eating disorder. Those in certain occupations, such as flight attendants, members of the armed forces or actors, may also be at increased risk compared to men in the general population.
Although a large study from 2007 found that gay men do appear to have more eating disorders than straight men, these men do not necessarily want to be feminine. Nor do they seem to have trouble with their masculine role, as they define it. They do, however, desire to be attractive to potential partners and believe that being a particular weight and shape is appealing.
There is some research that suggests that gay men with an eating disorder may be more likely to have been the victim of sexual or physical abuse as a child. You and other men should be aware that the same physical consequences that occur in women with eating disorder take their toll on men, too, including osteoporosis and osteopenia (thinning bones).
Take a look at one of these books about eating disorders in men to learn more: “Making Weight: Healing Men’s Conflicts With Food, Weight, Shape and Appearance,” by Arnold Andersen, Leigh Cohn and Tom Holbrook; or “The Invisible Man: A Self-Help Guide for Men With Eating Disorders, Compulsive Exercise and Bigorexia,” by John F. Morga
Friday, August 21, 2009
Ask the Expert - Week 4
Dr. Kathryn Zerbe, professor of psychiatry at Oregon Health and Science University and a longtime expert on eating disorders, recently took readers’ questions on anorexia, bulimia, binge eating and other problems. Here, she responds to one reader’s question about growing up in a household where eating disorders were common.
My mother-in-law is in her 60s and has struggled with bulimia since her early 20s. Both my husband and his sister struggle with food but in different ways. She is very thin, is addicted to exercise and is obsessed with her body image. My husband overeats and is overweight. This is impacting his health. I know that there are many books and resources for adult children of alcoholics. Are there any resources for adults raised by a mother with an eating disorder?
Lisa
Dr. Zerbe responds:
There is only one book that I know of that addresses your question specifically, but I bet there will be more in the future. Take a look at Daniel Becker’s “This Mean Disease: Growing Up in the Shadow of My Mother’s Anorexia.” Mr. Becker describes his mother’s 30 year battle with anorexia in a way that is not only touching and thought provoking but shows how each family member must make changes in his or her life to really deal with the effects of such a severe problem on the life of the family.
Your problem is coming to the attention of more and more therapists because we are seeing eating disorders in older women and men. There are a number of good books and resources out there for loved ones who have a family member with an eating disorder, but nothing takes the place of having those with food issues talk with someone knowledgeable and understanding.
For example, I am thinking of one of my patients, I’ll call him Jeff, whose mother and father both had significant issues with their depression, body image and low weight. Jeff is now in recovery, but we discovered in his therapy that an obsession with thinness went back at least to both of his grandmothers, who could never be too thin and always seemed to be angry and demanding.
As Jeff’s psychiatrist, I could not give a formal diagnosis, such as depression, dysthymia (low mood) or an eating disorder, to any of his family members, since I wasn’t treating them. In fact, they refused all interventions that Jeff asked them to get. But I offered him therapy and medications, and a book I suggested he read, Judith Viorst’s classic 1986 work on adult life transitions called “Necessary Losses: The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow,” helped him come to accept what he could and could not do for his mother and father, as much as he wanted to help them.
Jeff gradually embraced more of his own life and faced down his eating problem. He is now married and raising a couple of children, and has become aware through his reading how common eating concerns are becoming in younger and younger children. And though he struggles from time to time with his body image, he is a lot better than when he started his therapy work over six years ago.
As Jeff put it, “I don’t want my parents’ problem to become the problem of my own kids. We will have a ‘no teasing’ policy at the dinner table when it comes to body image, and my wife and I plan to start media awareness of the slender body ideal even when they are in grade school.”
Another resource I recommend for those who grew up or live in a household with eating disorders is the Web site www.bulimia.com from Gurze books, which publishes a catalog of excellent books on the subject. (They can also be reached at (800) 756-7533.) You will likely find something that helps you and perhaps raises the awareness of your loved ones.
My mother-in-law is in her 60s and has struggled with bulimia since her early 20s. Both my husband and his sister struggle with food but in different ways. She is very thin, is addicted to exercise and is obsessed with her body image. My husband overeats and is overweight. This is impacting his health. I know that there are many books and resources for adult children of alcoholics. Are there any resources for adults raised by a mother with an eating disorder?
Lisa
Dr. Zerbe responds:
There is only one book that I know of that addresses your question specifically, but I bet there will be more in the future. Take a look at Daniel Becker’s “This Mean Disease: Growing Up in the Shadow of My Mother’s Anorexia.” Mr. Becker describes his mother’s 30 year battle with anorexia in a way that is not only touching and thought provoking but shows how each family member must make changes in his or her life to really deal with the effects of such a severe problem on the life of the family.
Your problem is coming to the attention of more and more therapists because we are seeing eating disorders in older women and men. There are a number of good books and resources out there for loved ones who have a family member with an eating disorder, but nothing takes the place of having those with food issues talk with someone knowledgeable and understanding.
For example, I am thinking of one of my patients, I’ll call him Jeff, whose mother and father both had significant issues with their depression, body image and low weight. Jeff is now in recovery, but we discovered in his therapy that an obsession with thinness went back at least to both of his grandmothers, who could never be too thin and always seemed to be angry and demanding.
As Jeff’s psychiatrist, I could not give a formal diagnosis, such as depression, dysthymia (low mood) or an eating disorder, to any of his family members, since I wasn’t treating them. In fact, they refused all interventions that Jeff asked them to get. But I offered him therapy and medications, and a book I suggested he read, Judith Viorst’s classic 1986 work on adult life transitions called “Necessary Losses: The Loves, Illusions, Dependencies, and Impossible Expectations That All of Us Have to Give Up in Order to Grow,” helped him come to accept what he could and could not do for his mother and father, as much as he wanted to help them.
Jeff gradually embraced more of his own life and faced down his eating problem. He is now married and raising a couple of children, and has become aware through his reading how common eating concerns are becoming in younger and younger children. And though he struggles from time to time with his body image, he is a lot better than when he started his therapy work over six years ago.
As Jeff put it, “I don’t want my parents’ problem to become the problem of my own kids. We will have a ‘no teasing’ policy at the dinner table when it comes to body image, and my wife and I plan to start media awareness of the slender body ideal even when they are in grade school.”
Another resource I recommend for those who grew up or live in a household with eating disorders is the Web site www.bulimia.com from Gurze books, which publishes a catalog of excellent books on the subject. (They can also be reached at (800) 756-7533.) You will likely find something that helps you and perhaps raises the awareness of your loved ones.
Friday, August 14, 2009
Ask The Expert: Week 4
Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Four
(Edited to correct typos/spelling in original question)
There is so little focus in our society given to binge-eating. General sentiment seems to be, “go on a diet.” Yet there are some people who’s eating disorders actually manifest themselves via binging and not purging.
Do you think this is changing/will change? Also, are there treatment programs for this? I’ve looked at a couple of web sites, but binge eating seems to be regarded as sort of an “also ran” alongside anorexia and bulimia.
Thanks for your input.
Dr. Zerbe responds:
You are certainly correct that binge eating disorder gets less attention than anorexia or bulimia, but we are learning much more about it because research is starting to focus on it a lot. Doctors are using some medications for it, such as fluoxetine (Prozac), but cognitive-behavioral therapy also can help people who suffer learn coping skills that help them avoid binging.
I certainly agree with you that “going on a diet” is not the answer. One needs to learn what might be causing the person to binge in certain circumstances and to find ways to deal with food that is “all around us” in the modern world. Many people turn to food in times of stress because in our modern society it is so readily available (think of the fast food restaurant down the street or the multitude of snacks and candies in your local grocery store) and how relatively inexpensive food is compared to 50 years ago.
We also tend to eat alone a lot more than in the past (snacking by the computer; having lunch at our desks), so we learn to eat faster and without thinking or talking to anybody. Family mealtimes slow our eating down, and we get psychological nurturance when talking with our loved ones, but so many times nowadays this just doesn’t seem to happen as often as it might.
One concrete suggestion I have for the binge eater is to never get too hungry. Try to eat protein at every meal and always have some low calorie snacks available, especially in the car or at times when you might be tempted to binge. Then, begin to look at the triggers that might cause you to binge. Journal about them, and if at all possible, seek out a professional with experience in eating disorders to discuss them with. You might also consider looking for a helpful book about binge eating that fits your needs by going to the Gurze Books Web site on Eating Disorders at http://www.gurze.com.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Four
(Edited to correct typos/spelling in original question)
There is so little focus in our society given to binge-eating. General sentiment seems to be, “go on a diet.” Yet there are some people who’s eating disorders actually manifest themselves via binging and not purging.
Do you think this is changing/will change? Also, are there treatment programs for this? I’ve looked at a couple of web sites, but binge eating seems to be regarded as sort of an “also ran” alongside anorexia and bulimia.
Thanks for your input.
Dr. Zerbe responds:
You are certainly correct that binge eating disorder gets less attention than anorexia or bulimia, but we are learning much more about it because research is starting to focus on it a lot. Doctors are using some medications for it, such as fluoxetine (Prozac), but cognitive-behavioral therapy also can help people who suffer learn coping skills that help them avoid binging.
I certainly agree with you that “going on a diet” is not the answer. One needs to learn what might be causing the person to binge in certain circumstances and to find ways to deal with food that is “all around us” in the modern world. Many people turn to food in times of stress because in our modern society it is so readily available (think of the fast food restaurant down the street or the multitude of snacks and candies in your local grocery store) and how relatively inexpensive food is compared to 50 years ago.
We also tend to eat alone a lot more than in the past (snacking by the computer; having lunch at our desks), so we learn to eat faster and without thinking or talking to anybody. Family mealtimes slow our eating down, and we get psychological nurturance when talking with our loved ones, but so many times nowadays this just doesn’t seem to happen as often as it might.
One concrete suggestion I have for the binge eater is to never get too hungry. Try to eat protein at every meal and always have some low calorie snacks available, especially in the car or at times when you might be tempted to binge. Then, begin to look at the triggers that might cause you to binge. Journal about them, and if at all possible, seek out a professional with experience in eating disorders to discuss them with. You might also consider looking for a helpful book about binge eating that fits your needs by going to the Gurze Books Web site on Eating Disorders at http://www.gurze.com.
Friday, August 7, 2009
Ask the Expert - Week 3
Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Three
I am fairly certain that my sister in law (mid-30s) suffers from bulimia–she is extremely thin and looks unhealthy, but eats a lot whenever I see her, typically at family meals/restaurant visits. She always leaves to visit the bathroom fairly obviously not long after we’ve finished eating and I’ve occasionally smelled vomit when I follow her into the bathroom. I understand she had an experience with an eating disorder about 10 years ago but I don’t know that she ever stopped having a problem. The family doesn’t speak openly about it so I don’t feel comfortable approaching her myself, and I’m also not 100% sure of course. Do you have any suggestions on how to handle this situation?
From Dr. Zerbe:
These situations in a family are always difficult to handle. It does sound to me as if your sister-in-law could have relapsed into bulimia based on your observation of her leaving to go to the bathroom after eating large amounts of food and sometimes smelling vomit.
I suggest you talk to her and express your concerns. You might also try to enlist at least one other family member who shares your observations to sit down with you. Because denial of the problem is so common in those with an eating disorder, she may not listen or tell you the truth immediately, but at least you know that you have done what you could. You might also suggest a book or looking at the Academy for Eating Disorders Web site, which has valuable information about these life threatening illnesses.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Three
I am fairly certain that my sister in law (mid-30s) suffers from bulimia–she is extremely thin and looks unhealthy, but eats a lot whenever I see her, typically at family meals/restaurant visits. She always leaves to visit the bathroom fairly obviously not long after we’ve finished eating and I’ve occasionally smelled vomit when I follow her into the bathroom. I understand she had an experience with an eating disorder about 10 years ago but I don’t know that she ever stopped having a problem. The family doesn’t speak openly about it so I don’t feel comfortable approaching her myself, and I’m also not 100% sure of course. Do you have any suggestions on how to handle this situation?
From Dr. Zerbe:
These situations in a family are always difficult to handle. It does sound to me as if your sister-in-law could have relapsed into bulimia based on your observation of her leaving to go to the bathroom after eating large amounts of food and sometimes smelling vomit.
I suggest you talk to her and express your concerns. You might also try to enlist at least one other family member who shares your observations to sit down with you. Because denial of the problem is so common in those with an eating disorder, she may not listen or tell you the truth immediately, but at least you know that you have done what you could. You might also suggest a book or looking at the Academy for Eating Disorders Web site, which has valuable information about these life threatening illnesses.
Friday, July 24, 2009
Ask the Expert - Week 2
Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Two
I recently began running (in March) and since then have had no menstrual cycle. After seeing my gynecologist, she suggested that my amenorrhea, vegetarian diet, and increased fitness program meant that I could be struggling with an eating disorder. However, I eat very healthily and my weight is well within the suggested weight for my height (I am age 18, 140 and 5′11).
It’s true that I do not like to eat fattening foods, preferring to eat healthy, nutritional alternatives (toast with cottage cheese instead of cookies as a snack, for example) but does this mean that I am anorexic? I feel that my gyn. is not seeing the bigger picture here.
From Dr. Zerbe:
It sounds to me as if your gynecologist could be onto something, although I cannot be sure because I have not met with you in person, of course. Here is how I think about a situation such as yours.
Loss of one’s menstrual cycle and eating such a low-fat diet might be signs of an eating disorder. Be aware that we all need essential fat and soluble vitamins for healthy functioning of our brains, our metabolism and our entire bodies. Because many patients with an eating disorder begin with the desire to be trim and fit, it is often hard to know, without consulting a specialist in the field, when running and a particular diet begin to shade into a full or even subclinical form of anorexia or bulimia.
The exact weight of a person is less important than the emphasis one places on looking or feeling a particular way and the amount of time and attention placed on exercise. This is why we in the field say that the first step in recovery is being very honest with oneself about how much time and attention the focus on weight, diet and exercise is taking. We also ask, “Are you really satisfied in your life with respect to your work, your relationships and your overall self image? If you gained 10 pounds, would you feel your world was falling apart?” This helps one know if one is thinking too much about the body and hinging self worth on it.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week Two
I recently began running (in March) and since then have had no menstrual cycle. After seeing my gynecologist, she suggested that my amenorrhea, vegetarian diet, and increased fitness program meant that I could be struggling with an eating disorder. However, I eat very healthily and my weight is well within the suggested weight for my height (I am age 18, 140 and 5′11).
It’s true that I do not like to eat fattening foods, preferring to eat healthy, nutritional alternatives (toast with cottage cheese instead of cookies as a snack, for example) but does this mean that I am anorexic? I feel that my gyn. is not seeing the bigger picture here.
From Dr. Zerbe:
It sounds to me as if your gynecologist could be onto something, although I cannot be sure because I have not met with you in person, of course. Here is how I think about a situation such as yours.
Loss of one’s menstrual cycle and eating such a low-fat diet might be signs of an eating disorder. Be aware that we all need essential fat and soluble vitamins for healthy functioning of our brains, our metabolism and our entire bodies. Because many patients with an eating disorder begin with the desire to be trim and fit, it is often hard to know, without consulting a specialist in the field, when running and a particular diet begin to shade into a full or even subclinical form of anorexia or bulimia.
The exact weight of a person is less important than the emphasis one places on looking or feeling a particular way and the amount of time and attention placed on exercise. This is why we in the field say that the first step in recovery is being very honest with oneself about how much time and attention the focus on weight, diet and exercise is taking. We also ask, “Are you really satisfied in your life with respect to your work, your relationships and your overall self image? If you gained 10 pounds, would you feel your world was falling apart?” This helps one know if one is thinking too much about the body and hinging self worth on it.
Friday, July 17, 2009
Ask the Expert
Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week One
I can’t believe I am actually reading something on my age group. I am 49 years old and have been suffering with bulimia/laxative abuse for more then 2 years now. After listening to a recorded talk by one of the directors at Remuda I was able to pinpoint what triggered my disorder. Sadly, that doesn’t help regarding treatment. I live in Philadelphia (home of Renfrew) but am the primary breadwinner in my family (which includes 2 daughters) which makes it impossible for me to seek intensive treatment (either outpatient or residential). Even with decent medical insurance, high copayments make it also impossible for me to seek even moderate therapy. Sometimes I can put 2 days together without suffering but more often then not it’s multiple x/day. Sorry, this is much more then a comment but I was so excited to read about my age group that I got carried away. Hope to read more in the future!
— Gayle
From Dr. Zerbe:
You might consider seeing if there is a support group for midlife women with eating disorders in your area. Be sure to also consult with your primary care doctor to make sure that a medical cause has been ruled out. There are also some excellent training programs in Philadelphia (the Beck Institute; the medical schools; and the Psychoanalytic Institute of Philadelphia) where trainees treat patients at lower cost. You might find some affordable treatment there to help you. There is also a chapter in each of my books, “The Body Betrayed” and “Beyond the Body Betrayed,” on anorexia and bulimia in middle age. Good luck!
NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.
Week One
I can’t believe I am actually reading something on my age group. I am 49 years old and have been suffering with bulimia/laxative abuse for more then 2 years now. After listening to a recorded talk by one of the directors at Remuda I was able to pinpoint what triggered my disorder. Sadly, that doesn’t help regarding treatment. I live in Philadelphia (home of Renfrew) but am the primary breadwinner in my family (which includes 2 daughters) which makes it impossible for me to seek intensive treatment (either outpatient or residential). Even with decent medical insurance, high copayments make it also impossible for me to seek even moderate therapy. Sometimes I can put 2 days together without suffering but more often then not it’s multiple x/day. Sorry, this is much more then a comment but I was so excited to read about my age group that I got carried away. Hope to read more in the future!
— Gayle
From Dr. Zerbe:
You might consider seeing if there is a support group for midlife women with eating disorders in your area. Be sure to also consult with your primary care doctor to make sure that a medical cause has been ruled out. There are also some excellent training programs in Philadelphia (the Beck Institute; the medical schools; and the Psychoanalytic Institute of Philadelphia) where trainees treat patients at lower cost. You might find some affordable treatment there to help you. There is also a chapter in each of my books, “The Body Betrayed” and “Beyond the Body Betrayed,” on anorexia and bulimia in middle age. Good luck!
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