Read the full article here
Imagine you're a relatively thin young woman who thinks she has no issues with food or dieting—certainly no eating disorder. You see a picture of a swimsuit-clad woman with chunky thighs, a noticeable belly and arms that could benefit from a regular triceps routine. Suddenly your brain starts whirring anxiously and you wonder, do I look like that?
Now imagine you're a slim guy, also with no history of eating problems. You see a picture of a man in a swimsuit who looks like he's enjoyed more than his share of fries, beer, and double cheeseburgers. Your reaction is quite different from the woman's—at least according to researchers at Brigham Young University who conducted an experiment just like this.
Neuroscientist Mark Allen and his colleagues used imaging technology to watch brain activity in 19 men and women as they looked at computer-generated pictures of fat people in swimsuits. The nine male subjects in his study didn't appear to make any comparison between a picture of a fat guy and their own bodies. But the part of the brain involved in self-reflection (the medial prefrontal cortex) jumped into action when the 10 women looked at images of fat women, Allen says.
Showing posts with label bulimia. Show all posts
Showing posts with label bulimia. Show all posts
Monday, April 26, 2010
Thursday, April 22, 2010
NTY: A Mother’s Loss, a Daughter’s Story
Read the full article here
Documentary Website
ANDREW AVRIN sits on a beige couch in a nondescript room, a fruit still-life partly visible on the wall behind him, twisting his fingers while, off-camera, an unseen interviewer prompts him to talk about his sister, Melissa, who died last year at the age of 19 after a long battle with bulimia.
“There was no food in the house,” he says, looking off to the side as his eyes fill. “If I went out with friends, I could not bring leftovers home because they would be gone by the next morning.”
Once, he explains, in the middle of a bitterly cold night, he looked out the window and saw Melissa on the curb, going through the garbage. “I went outside and I yelled her name,” he recounts in the interview, his voice breaking. “Just the way she looked back at me — it was so empty, vacant. It was a deer in the headlights, but that doesn’t even explain it.”
It is a hard scene for anyone to watch, but even more so for the film’s producer — Judy Avrin, Melissa’s mother, who decided to make a documentary about her daughter’s life and, ultimately, her death.
People deal with grief in their own ways, and those who have been spared the loss of a daughter or a son can only imagine how they would choose to try to cope. For Ms. Avrin, coping meant confronting her anguish and trying to make something good come out of it.
The idea for a film didn’t occur to her immediately. In the weeks following Melissa’s death, Ms. Avrin mostly avoided her daughter’s bedroom, and tried to resume some semblance of normalcy, going back to work three days a week as the coordinator for a consortium of academic libraries in New Jersey. But one day she sat down to read Melissa’s leather-bound journal.
Someday ...
I’ll eat breakfast.
I’ll keep a job for more than 3 weeks.
I’ll have a boyfriend for more than 10 days.
I’ll love someone.
I’ll travel wherever I want.
I’ll make my family proud.
I’ll make a movie that changes lives.
The film, called “Someday Melissa” and now in the editing stages, has become for Ms. Avrin salve, distraction and cause — a way to get the word out to other families grappling with eating disorders that they are not alone; to sound the alarm that eating disorders have the highest mortality rate of any mental illness; to help make sense of the senseless event that was losing her teenage daughter.
“I kept saying, ‘This is an amazing way for me to channel my grief,’ ” Ms. Avrin said. “But it also allowed me to put off grieving.”
Ms. Avrin, 56, got the idea for the film from one of Melissa’s therapists, Danna Markson, who introduced her to Jeffrey Cobelli, 27, a filmmaker. Over the last several months of working on the project, Ms. Avrin has come to know more than she ever intended to about eating disorders — how their seriousness has been underestimated, their treatment underinsured, their deaths underreported.
The process hasn’t been easy, and some, like her ex-husband, initially questioned the impulse to do it at all. Melissa’s best friend since first grade, Nicole Kendrick, who also suffers from an eating disorder, said she was incredulous when she first learned that Ms. Avrin was making the film. “I thought she was crazy,” Ms. Kendrick said. “I guess I didn’t realize how deep a mother’s love can run.”
But Ms. Avrin said that making the film has been easier than doing nothing at all. “I’ve never once thought this was more than I could bear,” she said, in an interview at her home in Totowa, N.J. “If anything, the more I continue, the more I know it’s the right thing to do.”
The difficulty of reliving her daughter’s decline has been mitigated by the public response. “Sometimes I think: ‘I’m a suburban mom. Who am I to think I could make a difference in the world?’ ” Ms. Avrin said. “But then I read the messages that keep coming in from people I know and people I don’t know who say Melissa’s story has motivated them to fight one more day.”
Documentary Website
ANDREW AVRIN sits on a beige couch in a nondescript room, a fruit still-life partly visible on the wall behind him, twisting his fingers while, off-camera, an unseen interviewer prompts him to talk about his sister, Melissa, who died last year at the age of 19 after a long battle with bulimia.
“There was no food in the house,” he says, looking off to the side as his eyes fill. “If I went out with friends, I could not bring leftovers home because they would be gone by the next morning.”
Once, he explains, in the middle of a bitterly cold night, he looked out the window and saw Melissa on the curb, going through the garbage. “I went outside and I yelled her name,” he recounts in the interview, his voice breaking. “Just the way she looked back at me — it was so empty, vacant. It was a deer in the headlights, but that doesn’t even explain it.”
It is a hard scene for anyone to watch, but even more so for the film’s producer — Judy Avrin, Melissa’s mother, who decided to make a documentary about her daughter’s life and, ultimately, her death.
People deal with grief in their own ways, and those who have been spared the loss of a daughter or a son can only imagine how they would choose to try to cope. For Ms. Avrin, coping meant confronting her anguish and trying to make something good come out of it.
The idea for a film didn’t occur to her immediately. In the weeks following Melissa’s death, Ms. Avrin mostly avoided her daughter’s bedroom, and tried to resume some semblance of normalcy, going back to work three days a week as the coordinator for a consortium of academic libraries in New Jersey. But one day she sat down to read Melissa’s leather-bound journal.
Someday ...
I’ll eat breakfast.
I’ll keep a job for more than 3 weeks.
I’ll have a boyfriend for more than 10 days.
I’ll love someone.
I’ll travel wherever I want.
I’ll make my family proud.
I’ll make a movie that changes lives.
The film, called “Someday Melissa” and now in the editing stages, has become for Ms. Avrin salve, distraction and cause — a way to get the word out to other families grappling with eating disorders that they are not alone; to sound the alarm that eating disorders have the highest mortality rate of any mental illness; to help make sense of the senseless event that was losing her teenage daughter.
“I kept saying, ‘This is an amazing way for me to channel my grief,’ ” Ms. Avrin said. “But it also allowed me to put off grieving.”
Ms. Avrin, 56, got the idea for the film from one of Melissa’s therapists, Danna Markson, who introduced her to Jeffrey Cobelli, 27, a filmmaker. Over the last several months of working on the project, Ms. Avrin has come to know more than she ever intended to about eating disorders — how their seriousness has been underestimated, their treatment underinsured, their deaths underreported.
The process hasn’t been easy, and some, like her ex-husband, initially questioned the impulse to do it at all. Melissa’s best friend since first grade, Nicole Kendrick, who also suffers from an eating disorder, said she was incredulous when she first learned that Ms. Avrin was making the film. “I thought she was crazy,” Ms. Kendrick said. “I guess I didn’t realize how deep a mother’s love can run.”
But Ms. Avrin said that making the film has been easier than doing nothing at all. “I’ve never once thought this was more than I could bear,” she said, in an interview at her home in Totowa, N.J. “If anything, the more I continue, the more I know it’s the right thing to do.”
The difficulty of reliving her daughter’s decline has been mitigated by the public response. “Sometimes I think: ‘I’m a suburban mom. Who am I to think I could make a difference in the world?’ ” Ms. Avrin said. “But then I read the messages that keep coming in from people I know and people I don’t know who say Melissa’s story has motivated them to fight one more day.”
Wednesday, January 20, 2010
For Bulimics and Anorexics, A Doctor Who Thinks Outside the Box by Mary Sornberger
Sornberger: I’d like to reintroduce Dr. Robert McLean a graduate of Howard University’s College of Medicine with an undergraduate degree majoring in Physics form Dartmouth College. He has been practicing complimentary and alternative medicine for the past twenty years and has formed The Preventive Medical Center in Newport News, Virginia.
Sornberger: Dr. McLean continues to answer the question: What supplements would you prescribe to the anorexic or bulimic that has been prescribed Prozac or other antidepressants?
Dr. McLean: A very recent review in The Journal of the American Medical Association (1/6/10 issue of JAMA) of an analysis of the efficacy of antidepressant medication (including the SSRI class) suggests that while these medications have significant benefit in severe depression, there is little if any benefit, compared to placebo, in mild to moderate depression. Serotonin, however, is one of several neurotransmitters that regulate our mood, behavior, and mental function.
A better approach to increasing serotonin (and other neurotransmitters) rather than interfering with its reuptake is, I think, to supply the body with the right precursor molecules to produce more of what is needed.
In the case of the neurotransmitters there are amino acids as well as other nutrients which are needed to produce the end products. Unfortunately, in anorexia and bulimia, we are cutting off the production by reducing the supply of nutrients.
Sornberger: What other supplements would you suggest for the treatment of anorexia or bulimia?
Dr. McLean: In addition to amino acids, there are B vitamins, minerals such as magnesium, zinc, and chromium, and essential fatty acids that play critical roles in glucose and carbohydrate metabolism.
Sornberger: How would you approach treating bulimia and anorexia?
Dr. McLean: My approach would be to do an analysis of nutritional deficiencies, in particular an analysis and correction of amino acid deficiencies and imbalances. There are many supplements which enhance brain, mood, and neurologic function.
In addition, toxins and food sensitivities and intolerances can have profound influences on our health and mental state.
Hormonal imbalances can also be involved.
While there is no doubt, psychological issues may need to be addressed; however, we need to do everything possible to produce good physical health.
Sornberger: Are you aware of research into the benefits of supplements as compared to drugs?
Dr. McLean: Most research in this country has been done to show the safety and efficacy of pharmaceutical medications, which are then marketed for great profit. Supplements, however, are increasingly finding their way into mainstream use as more studies have substantiated their benefit.
Fiber, probiotics, omega 3 fatty acids, and most recently vitamin D are a few examples of substances and supplements that have been embraced by mainstream medicine.
Sornberger: Would you like to add anything more about preventative medicine and the American health care system?
Dr. McLean: The American health care system is considered by many to deliver the best quality of care in the world, yet our outcomes in terms of chronic diseases and life expectancy are far from the best. In terms of cost, it is unsustainable.
We are currently in the process of reforming our health care system. Unless we can reform our personal attitudes toward health, however, and shift the paradigm from simply treating disease after it develops, our efforts will not be successful.
If individuals take more responsibility for health promotion and disease prevention, and government supports this effort instead of promoting more pharmaceutical dependence, our outcomes in terms of health and the cost of health care delivery will improve.
Sornberger: Thank you Dr. McLean for sharing your knowledge on the difficult topic of how to best treat eating disorders.
Sornberger: Dr. McLean continues to answer the question: What supplements would you prescribe to the anorexic or bulimic that has been prescribed Prozac or other antidepressants?
Dr. McLean: A very recent review in The Journal of the American Medical Association (1/6/10 issue of JAMA) of an analysis of the efficacy of antidepressant medication (including the SSRI class) suggests that while these medications have significant benefit in severe depression, there is little if any benefit, compared to placebo, in mild to moderate depression. Serotonin, however, is one of several neurotransmitters that regulate our mood, behavior, and mental function.
A better approach to increasing serotonin (and other neurotransmitters) rather than interfering with its reuptake is, I think, to supply the body with the right precursor molecules to produce more of what is needed.
In the case of the neurotransmitters there are amino acids as well as other nutrients which are needed to produce the end products. Unfortunately, in anorexia and bulimia, we are cutting off the production by reducing the supply of nutrients.
Sornberger: What other supplements would you suggest for the treatment of anorexia or bulimia?
Dr. McLean: In addition to amino acids, there are B vitamins, minerals such as magnesium, zinc, and chromium, and essential fatty acids that play critical roles in glucose and carbohydrate metabolism.
Sornberger: How would you approach treating bulimia and anorexia?
Dr. McLean: My approach would be to do an analysis of nutritional deficiencies, in particular an analysis and correction of amino acid deficiencies and imbalances. There are many supplements which enhance brain, mood, and neurologic function.
In addition, toxins and food sensitivities and intolerances can have profound influences on our health and mental state.
Hormonal imbalances can also be involved.
While there is no doubt, psychological issues may need to be addressed; however, we need to do everything possible to produce good physical health.
Sornberger: Are you aware of research into the benefits of supplements as compared to drugs?
Dr. McLean: Most research in this country has been done to show the safety and efficacy of pharmaceutical medications, which are then marketed for great profit. Supplements, however, are increasingly finding their way into mainstream use as more studies have substantiated their benefit.
Fiber, probiotics, omega 3 fatty acids, and most recently vitamin D are a few examples of substances and supplements that have been embraced by mainstream medicine.
Sornberger: Would you like to add anything more about preventative medicine and the American health care system?
Dr. McLean: The American health care system is considered by many to deliver the best quality of care in the world, yet our outcomes in terms of chronic diseases and life expectancy are far from the best. In terms of cost, it is unsustainable.
We are currently in the process of reforming our health care system. Unless we can reform our personal attitudes toward health, however, and shift the paradigm from simply treating disease after it develops, our efforts will not be successful.
If individuals take more responsibility for health promotion and disease prevention, and government supports this effort instead of promoting more pharmaceutical dependence, our outcomes in terms of health and the cost of health care delivery will improve.
Sornberger: Thank you Dr. McLean for sharing your knowledge on the difficult topic of how to best treat eating disorders.
Wednesday, December 2, 2009
High Mortality Risk for Bulimia Nervosa and Unspecified Eating Disorders
Acknowlegement about the seriousness of EDs other than AN. All EDs kill!
A large, long-term study extends the finding of high death rates in anorexia nervosa to bulimia nervosa and other eating disorders. Crow et al. (p. 1342) determined diagnoses for 1,885 outpatients with eating disorders evaluated between 1979 and 1997 and searched the National Death Index for matches through 2004. The crude mortality rates for the patients with diagnoses of anorexia nervosa, bulimia nervosa, and "eating disorder not otherwise specified" were 4.0%, 3.9%, and 5.2%, respectively. Compared to national mortality data for demographically similar groups, the rate for eating disorder not otherwise specified was significantly elevated, suggesting that this diagnosis does not indicate a less severe disorder. In addition, 13 of the 84 deaths identified were due to suicide, and eight of these were among the patients with bulimia nervosa. These findings are discussed by Dr. Walter Kaye in an editorial on p. 1309.
A large, long-term study extends the finding of high death rates in anorexia nervosa to bulimia nervosa and other eating disorders. Crow et al. (p. 1342) determined diagnoses for 1,885 outpatients with eating disorders evaluated between 1979 and 1997 and searched the National Death Index for matches through 2004. The crude mortality rates for the patients with diagnoses of anorexia nervosa, bulimia nervosa, and "eating disorder not otherwise specified" were 4.0%, 3.9%, and 5.2%, respectively. Compared to national mortality data for demographically similar groups, the rate for eating disorder not otherwise specified was significantly elevated, suggesting that this diagnosis does not indicate a less severe disorder. In addition, 13 of the 84 deaths identified were due to suicide, and eight of these were among the patients with bulimia nervosa. These findings are discussed by Dr. Walter Kaye in an editorial on p. 1309.
Tuesday, October 20, 2009
Emerging Eating Disorder: Exercise Bulimia
A little-known form of the eating disorder bulimia is getting more and more attention from medical professionals -- exercise bulimia.
As CBSNews.com's Cali Carlin reported on "The Early Show Saturday Edition," people with the disorder can't stop themselves from working out excessively and compulsively, with potentially serious health consequences.
This "startling" form of bulimia is of particular concern, Carlin says, because it happens in plain sight and doesn't involve the hidden vomiting-to-purge-calories marking the form of bulimia more people are familiar with, making exercise bulimia hard to recognize, and insidious.
In addition, she points out, eating disorders in general have the highest mortality rate of any mental illness.
Carlin spoke with Robyn Yamanaka who is, ironically, a professional trainer.
Yamanaka told Carlin her exercise bulimia "started off innocently, (with workouts) maybe like three or four times a week. ... (But) it got to a point where I was working out three hours a day, if not more. ... I didn't take a day off for about 6 years. ... I have more health problems than someone who is overweight because I was underweight."
Dr. Maryanne Rosenthal, clinical director at Casa Palmera, an in-patient treatment center in San Diego says, "I think(exercise bulimia) is becoming epidemic. ... An exercise bulimic is focused on the ritual of exercising, and that is that method of purging.... People think they get a pass because they're not vomiting, they're not taking laxatives, so (they think) they're not really purging. ... It's very hard to diagnose, because exercise is great right?"
Health woes spurred by exercise bulimia can include fatigue,reproductive problems, depression and anxiety, Rosenthal observes.
Yamanaka, says Carlin, was "exercising herself to death. Her bones had weakened to the equivalent of a 65-year-old female. She suffered from osteoporosis, a stress fracture and lost her period for eight years."
Rosenthal calls exercise bulimia "an addiction and, when people are really heavily into their addictions, they can't stop without help."
Yamanaka tearfully told Carlin that her parents forced her to get treatment, and says she's recovering and even back on the job.
"Im really lucky," she observes.
Best-selling author and dieting expert Dr. Ian Smith told "Early Show Saturday Edition" co-anchor Erica Hill signs someone you know may be an exercise bulimic include that person missing work, parties or other important appointments to work out, not taking a break from working out for days at a time, working out for hours at a time each day, working out while injured or sick, or becoming severely depressed when not being able to work out.
Smith, who's also the medical and diet expert on VH1's highly-rated "Celebrity Fit Club," said to CBS News you should approach someone you're concerned about with caution: "Discuss with them the amount of time they're spending on working out relative to where they are with the goals they want to achieve from working out. Most of these people are already low in fat and within the healthy weight range. Try to bring it to their attention that they have had great success and results from working out. The quantity of time they're spending is out of proportion to what they need to maintain their results. Suggest they see a therapist who can help them sort out what's going on.
"Softly discuss what they may be neglecting so that they can work out. Try to get them to see that they are allowing exercise to disproportionately occupy time and space in their life. Maybe they are suffering some of the consequences of exercising too much (fatigue, dehydration, osteoporosis, arthritis, reproductive problems, injuries such as stress fractures, strains, and sprains), and pointing these consequences out may help them see what they're doing."
Smith noted that, "Unlike (with) classic bulimia, exercise bulimia is almost just as common in men as it is in women. Exercise bulimia is not about the person wanting to improve their health or train for a specific event. They exercise for the sake of exercise."
If someone resists getting help or receiving consul, Smith said, "There's not much you can do, unless they are a minor. This is not a condition where you can commit someone to a psychiatric clinic or make them go get help. The best thing to do at that point is to be as supportive as possible and encourage rather than mandate they seek at least some counsel."
As CBSNews.com's Cali Carlin reported on "The Early Show Saturday Edition," people with the disorder can't stop themselves from working out excessively and compulsively, with potentially serious health consequences.
This "startling" form of bulimia is of particular concern, Carlin says, because it happens in plain sight and doesn't involve the hidden vomiting-to-purge-calories marking the form of bulimia more people are familiar with, making exercise bulimia hard to recognize, and insidious.
In addition, she points out, eating disorders in general have the highest mortality rate of any mental illness.
Carlin spoke with Robyn Yamanaka who is, ironically, a professional trainer.
Yamanaka told Carlin her exercise bulimia "started off innocently, (with workouts) maybe like three or four times a week. ... (But) it got to a point where I was working out three hours a day, if not more. ... I didn't take a day off for about 6 years. ... I have more health problems than someone who is overweight because I was underweight."
Dr. Maryanne Rosenthal, clinical director at Casa Palmera, an in-patient treatment center in San Diego says, "I think(exercise bulimia) is becoming epidemic. ... An exercise bulimic is focused on the ritual of exercising, and that is that method of purging.... People think they get a pass because they're not vomiting, they're not taking laxatives, so (they think) they're not really purging. ... It's very hard to diagnose, because exercise is great right?"
Health woes spurred by exercise bulimia can include fatigue,reproductive problems, depression and anxiety, Rosenthal observes.
Yamanaka, says Carlin, was "exercising herself to death. Her bones had weakened to the equivalent of a 65-year-old female. She suffered from osteoporosis, a stress fracture and lost her period for eight years."
Rosenthal calls exercise bulimia "an addiction and, when people are really heavily into their addictions, they can't stop without help."
Yamanaka tearfully told Carlin that her parents forced her to get treatment, and says she's recovering and even back on the job.
"Im really lucky," she observes.
Best-selling author and dieting expert Dr. Ian Smith told "Early Show Saturday Edition" co-anchor Erica Hill signs someone you know may be an exercise bulimic include that person missing work, parties or other important appointments to work out, not taking a break from working out for days at a time, working out for hours at a time each day, working out while injured or sick, or becoming severely depressed when not being able to work out.
Smith, who's also the medical and diet expert on VH1's highly-rated "Celebrity Fit Club," said to CBS News you should approach someone you're concerned about with caution: "Discuss with them the amount of time they're spending on working out relative to where they are with the goals they want to achieve from working out. Most of these people are already low in fat and within the healthy weight range. Try to bring it to their attention that they have had great success and results from working out. The quantity of time they're spending is out of proportion to what they need to maintain their results. Suggest they see a therapist who can help them sort out what's going on.
"Softly discuss what they may be neglecting so that they can work out. Try to get them to see that they are allowing exercise to disproportionately occupy time and space in their life. Maybe they are suffering some of the consequences of exercising too much (fatigue, dehydration, osteoporosis, arthritis, reproductive problems, injuries such as stress fractures, strains, and sprains), and pointing these consequences out may help them see what they're doing."
Smith noted that, "Unlike (with) classic bulimia, exercise bulimia is almost just as common in men as it is in women. Exercise bulimia is not about the person wanting to improve their health or train for a specific event. They exercise for the sake of exercise."
If someone resists getting help or receiving consul, Smith said, "There's not much you can do, unless they are a minor. This is not a condition where you can commit someone to a psychiatric clinic or make them go get help. The best thing to do at that point is to be as supportive as possible and encourage rather than mandate they seek at least some counsel."
Thursday, September 17, 2009
Critics Blast Insurers for Poor Coverage of Eating Disorders
More than 11 million people in the United States have eating disorders.
And because an eating disorder can be a life-threatening condition with serious medical consequences, you'd assume that most health insurances polices would cover it. But many people living with eating disorders are falling through the cracks when it comes to health insurance, because in most cases, their treatment is not adequately covered, according to the National Eating Disorders Association.
No one knows that better than the Gomez family. Emily Gomez, 17, is fighting for her life, and her parents are fighting with their insurance company to pay for her treatment.
Emily, who lives on the Outer Banks of North Carolina, is a trained singer who dreams of performing on Broadway one day. But a few months ago, instead of travelling to the Great White Way, she travelled instead to an eating disorder clinic called Timberline Knolls in a quiet suburb of Chicago, more than 1,000 miles from home.
"You know, I'd eat a normal dinner and then afterwards just go through my pantry and anything I could find I'd eat," Emily said. "Then I'd go upstairs to my bathroom and then I'd usually end up purging."
Emily now suffers from bulimia, but when she was first diagnosed with an eating disorder about three and a half years ago, she suffered from anorexia. She tried to hide it from her family, but it soon became obvious that Emily was starving herself.
"She would eat two slices of like deli ham and a couple of pieces of lettuce," recalled her mother, Leigh Gomez. "And she would eat some carrots and some cucumbers up to the 300 calorie level. And that would be it for the whole day."
Emily started passing out in school and several times she wound up in the hospital. Her doctor said something had to be done -- and fast. "Her doctor would look at me and say, 'You have got to do something and quick. … This child is extremely sick, and if you don't do something immediately, you're going to find her dead on the floor,'" Leigh Gomez said.
A team of pediatricians said outpatient care wasn't enough. They said Emily needed long-term residential treatment.
But that treatment is expensive, ranging from $750 to $1,000 a day. Because Emily was so sick, her parents assumed the treatment would be covered by their insurer, but they were wrong.
"Each time I called, they just said I'm sorry, there's nothing we can do for you,'" Leigh Gomez said.
Serious Health Consequences of Eating Disorders
The insurer said nothing could be done, because one section of the family's Blue Cross Blue Shield North Carolina policy -- written in fine print -- caps coverage for mental illnesses at $2,000. And because eating disorders are considered a mental illness by the insurer, that is all it would pay, even though Emily's treatment cost the Gomez family more than $50,000.
"It's not covering my family," Leigh Gomez said. "It is destroying my family."
Lynn Grefe, the CEO of the National Eating Disorders Association, said eating disorders are one of the leading causes of death among young people.
According to the association, 10 percent of people with anorexia nervosa die as a result of complications from the illness. Still, victims struggle for adequate insurance coverage.
"Everything is wrong with this situation," Grefe said. "I mean, you have young people. They're usually very young women, some men, who are just fighting for their lives."
Dr. Tom Insel, director of the National Institute of Mental Health, agrees that eating disorders have dangerous medical consequences.
"In the case of anorexia nervosa, you've got an illness with very severe disability [that] frequently ends up with a long-term hospitalization and high mortality" Insel said. "So for women between the ages of 15 and 24, there's about a 12-fold increase in mortality."
"Good Morning America" talked to the medical director of the Gomez's insurer, Dr. John Bradley.
He acknowledged that while the insurance company won't pay for the treatment of a child like Emily Gomez, it would cover complications that result from an eating disorder, such as a heart condition. He said that policy "absolutely" makes sense.
"This is true for depression, if someone attempts to commit suicide and they end up in the hospital ... we cover that," Bradley said.
When asked if he believes the coverage for eating disorders is inadequate, Bradley said, "I think the coverage of a lot of conditions is inadequate."
"The financial situation that this family finds themselves in is in no small part due to the cost of the care that was delivered," he said.
Hope for Daughter's 'Health and Well-Being'
Emily Gomez is back home now. Her family just submitted a new $20,000 claim for her recent stay at Timberline Knolls, which was also denied. So to pay for Emily's treatment, her family had to do something drastic.
"Well it's just really hard when you have to cash your child's college fund in because you can't get your insurance to help you," Leigh Gomez said.
The Gomez family has complained to the North Carolina Department of Insurance, saying its insurer failed to tell the family about treatment options for Emily when they were most needed. The Gomezes are now considering a lawsuit against their insurer for negligence, but Blue Cross Blue Shield of North Carolina says they handled the Gomez's claims properly and did in fact tell the family about their treatment options.
People suffering from eating disorders have won major settlements against their health insurers in court, after arguing in class action lawsuits that the disease is biologically based and that treatment should be adequately covered.
Forty-eight states have some form of parity laws, which force insurers to cover mental health disorders the same way they cover physical disorders, but only 25 of the states have laws that apply specifically to eating disorders, and the state parity laws don't affect all insurance plans, including the Gomez's.
However, a new bill recently introduced in the House of Representatives, called the FREED Act (Federal Response to End Eating Disorders), if it became law, would require insurers offering group health insurance to specifically cover eating disorders.
While the Gomez's insurer wouldn't pay their claims, after "GMA" called the treatment center Emily first stayed at -- Remuda Ranch -- the center offered free residential treatment to her if she ever needs it again.
Leigh Gomez still has hope for a healthy future for Emily.
"I hope she finds a peace of mind," she said. "That she lays down this burden that she has. That she finds health, well-being, and that she takes Broadway by storm."
On October 11, the National Eating Disorders Association will be holding its first New York City walk to raise awareness in Riverside Park.
Project HEAL is a not-for-profit organization that raises money for people suffering from eating disorders and cannot afford treatment. For more information on this organization CLICK HERE. And CLICK HERE to visit DoSomething.org to find out how you can get involved in Project HEAL.
And because an eating disorder can be a life-threatening condition with serious medical consequences, you'd assume that most health insurances polices would cover it. But many people living with eating disorders are falling through the cracks when it comes to health insurance, because in most cases, their treatment is not adequately covered, according to the National Eating Disorders Association.
No one knows that better than the Gomez family. Emily Gomez, 17, is fighting for her life, and her parents are fighting with their insurance company to pay for her treatment.
Emily, who lives on the Outer Banks of North Carolina, is a trained singer who dreams of performing on Broadway one day. But a few months ago, instead of travelling to the Great White Way, she travelled instead to an eating disorder clinic called Timberline Knolls in a quiet suburb of Chicago, more than 1,000 miles from home.
"You know, I'd eat a normal dinner and then afterwards just go through my pantry and anything I could find I'd eat," Emily said. "Then I'd go upstairs to my bathroom and then I'd usually end up purging."
Emily now suffers from bulimia, but when she was first diagnosed with an eating disorder about three and a half years ago, she suffered from anorexia. She tried to hide it from her family, but it soon became obvious that Emily was starving herself.
"She would eat two slices of like deli ham and a couple of pieces of lettuce," recalled her mother, Leigh Gomez. "And she would eat some carrots and some cucumbers up to the 300 calorie level. And that would be it for the whole day."
Emily started passing out in school and several times she wound up in the hospital. Her doctor said something had to be done -- and fast. "Her doctor would look at me and say, 'You have got to do something and quick. … This child is extremely sick, and if you don't do something immediately, you're going to find her dead on the floor,'" Leigh Gomez said.
A team of pediatricians said outpatient care wasn't enough. They said Emily needed long-term residential treatment.
But that treatment is expensive, ranging from $750 to $1,000 a day. Because Emily was so sick, her parents assumed the treatment would be covered by their insurer, but they were wrong.
"Each time I called, they just said I'm sorry, there's nothing we can do for you,'" Leigh Gomez said.
Serious Health Consequences of Eating Disorders
The insurer said nothing could be done, because one section of the family's Blue Cross Blue Shield North Carolina policy -- written in fine print -- caps coverage for mental illnesses at $2,000. And because eating disorders are considered a mental illness by the insurer, that is all it would pay, even though Emily's treatment cost the Gomez family more than $50,000.
"It's not covering my family," Leigh Gomez said. "It is destroying my family."
Lynn Grefe, the CEO of the National Eating Disorders Association, said eating disorders are one of the leading causes of death among young people.
According to the association, 10 percent of people with anorexia nervosa die as a result of complications from the illness. Still, victims struggle for adequate insurance coverage.
"Everything is wrong with this situation," Grefe said. "I mean, you have young people. They're usually very young women, some men, who are just fighting for their lives."
Dr. Tom Insel, director of the National Institute of Mental Health, agrees that eating disorders have dangerous medical consequences.
"In the case of anorexia nervosa, you've got an illness with very severe disability [that] frequently ends up with a long-term hospitalization and high mortality" Insel said. "So for women between the ages of 15 and 24, there's about a 12-fold increase in mortality."
"Good Morning America" talked to the medical director of the Gomez's insurer, Dr. John Bradley.
He acknowledged that while the insurance company won't pay for the treatment of a child like Emily Gomez, it would cover complications that result from an eating disorder, such as a heart condition. He said that policy "absolutely" makes sense.
"This is true for depression, if someone attempts to commit suicide and they end up in the hospital ... we cover that," Bradley said.
When asked if he believes the coverage for eating disorders is inadequate, Bradley said, "I think the coverage of a lot of conditions is inadequate."
"The financial situation that this family finds themselves in is in no small part due to the cost of the care that was delivered," he said.
Hope for Daughter's 'Health and Well-Being'
Emily Gomez is back home now. Her family just submitted a new $20,000 claim for her recent stay at Timberline Knolls, which was also denied. So to pay for Emily's treatment, her family had to do something drastic.
"Well it's just really hard when you have to cash your child's college fund in because you can't get your insurance to help you," Leigh Gomez said.
The Gomez family has complained to the North Carolina Department of Insurance, saying its insurer failed to tell the family about treatment options for Emily when they were most needed. The Gomezes are now considering a lawsuit against their insurer for negligence, but Blue Cross Blue Shield of North Carolina says they handled the Gomez's claims properly and did in fact tell the family about their treatment options.
People suffering from eating disorders have won major settlements against their health insurers in court, after arguing in class action lawsuits that the disease is biologically based and that treatment should be adequately covered.
Forty-eight states have some form of parity laws, which force insurers to cover mental health disorders the same way they cover physical disorders, but only 25 of the states have laws that apply specifically to eating disorders, and the state parity laws don't affect all insurance plans, including the Gomez's.
However, a new bill recently introduced in the House of Representatives, called the FREED Act (Federal Response to End Eating Disorders), if it became law, would require insurers offering group health insurance to specifically cover eating disorders.
While the Gomez's insurer wouldn't pay their claims, after "GMA" called the treatment center Emily first stayed at -- Remuda Ranch -- the center offered free residential treatment to her if she ever needs it again.
Leigh Gomez still has hope for a healthy future for Emily.
"I hope she finds a peace of mind," she said. "That she lays down this burden that she has. That she finds health, well-being, and that she takes Broadway by storm."
On October 11, the National Eating Disorders Association will be holding its first New York City walk to raise awareness in Riverside Park.
Project HEAL is a not-for-profit organization that raises money for people suffering from eating disorders and cannot afford treatment. For more information on this organization CLICK HERE. And CLICK HERE to visit DoSomething.org to find out how you can get involved in Project HEAL.
Monday, August 31, 2009
Ask Ester: Dispelling myths about EDs
Q: I suspect my daughter has an eating disorder. What do I look for, and what can I do to help?
A: This is a very tough one for me. Many years ago I wrote about this in one of my columns. Many readers do not know that I was battling bulimia in my late teens and early twenties — a very dark time of my life.
I will get into my own experience in a little bit, but first let's look what an eating disorder can be.
An eating disorder is a disturbance in someone's eating behavior that compromises his or her physical and psychological health. Anorexia nervosa and bulimia are chronic problems in which there is a preoccupation with food, eating and weight loss.
Anorexia nervosa is still more prevalent in young women than in young men. The disorder typically begins in "tweens" or teenage girls who are either overweight or perceive themselves that way. The interest in weight reduction becomes an obsession with severely restricted calorie intake and often excessive exercising.
People with bulimia (including men) tend to lead secretive lives, hiding their abnormal eating habits. In a single binge, they can consume 10,000-15,000 or more calories. The binge usually occurs in several stages:
- anticipation and planning
- anxiety
- urgency to begin,
- rapid and uncontrollable consumption of food,
- relief and relaxation
- disappointment
- shame
My own experience as a bulimic:
I was always very muscular and actually was called a boy, even young man, many times. I was a lot stronger and faster than many boys growing up and always had to arm wrestle or fight (yes, I won every time!). At the age of about 13, I started Judo (a martial art where you throw people, break their arms and strangle them ... although of course they can "tap out").
I had to make my weight class, which was between 61.1 kg and 66 kg (137.4 and 148 pounds). I was always 2 to 3 pounds heavier. I used many techniques and tricks to lose weight very quickly, like running in a plastic bag, not eating anything or barely anything at all, and after the weigh-in eating like there was no tomorrow.
Myth: Bulimics always purge by vomiting
Fact: Not all bulimics try to rid themselves of the calories they have consumed by vomiting. Purging can also take form of laxatives, diuretics, exercising, or fasting.
As you can tell, I was already showing signs, but I was doing it to "make my weight class."After a severe back injury that ended my Judo career, I went to the gym to strengthen my back. When I walked in, everyone thought I have been lifting weights for years. As a matter of fact, I guess I had been: the weights were human bodies. Soon after I started lifting weights, I got excited to enter a body building competition.
When you need to make a weight class for Judo, they don't care how you look. With body building, looks are what matters: your muscles, your symmetry, your body fat. I did great with my "perfect" diet: no sweets, very low fat, everything steamed or grilled. I entered my first competition and won.
Afterwards, the reward is FOOD. Oh, and I binged. It wasn't just me; it was the other bodybuilders too. Before I knew it, the body fat I lost for the competition was "packed back on." And I felt FAT. Most bodybuilders have no problem with this and get back on a normal diet, possibly getting ready for another competition. Their binge was just a couple of days, or maybe one week. Mine turned into on and off binging and purging for years. As an instructor, it was very easy to say it was my job to teach four classes in a row almost every day of the week! I was purging by over-exercising and vomiting.
Myth: You can never recover from an eating disorder
Fact: Recovery takes a long time, but with hard work and the proper treatment (or in my case, lots of prayers with God), you can fully recover from an eating disorder.
My sister at one point found out. It was very hard to be confronted with the fact that you can't hide it anymore, but also a relief. Unfortunately, neither she nor I knew what to do. You can't just stop an eating disorder — even when you want to.
Myth: People with eating disorders do this to hurt their family and friends
Fact: People with eating disorders are doing this to themselves. They are usually upset when they know the people around them are worried or hurt by their eating disorder.
I was in denial for so long, but I was also very miserable and alone during that time of my life. An eating disorder is an addiction to food. But guess what? You have to eat to live.
Telling a food addict to eat better is like telling an alcoholic to just have one drink a day or a heroin addict you can use it only once a day.
Myth: You cannot die from bulimia.
Fact: Bulimics are at high risk for dying, especially if they are purging, by vomiting, using laxatives, and over exercising. Many bulimics have died from cardiac arrest which is usually caused by low potassium or an electrolyte imbalance. Others have died from a ruptured esophagus.
Famous gymnast Kathy Johnson, Nadia Comaneci and Cathy Rigby have come forward and admitted to fighting eating disorders. In sports where athletes are judged by technical and artistic merit, the pressure to be thin is enormous. In 1988, at a meet in Budapest, an American judge told Christy Henrich — at that time one of the world's top gymnasts — that she was too fat and needed to lose weight if she wanted to be on the Olympic team. She resorted to anorexia nervosa and bulimia to control her weight. Her disorder eventually took her life.
Christy Henrich died of multiple organ failures.
We have come a long way since then.
Myth: You can always tell when someone is Anorexic.
Fact: Not all anorexics look like the extreme cases we see on talk shows and magazines, some maybe anywhere from 5-15 pounds underweight. They look thin, but don't have what society considers to be the anorexic look. That does not mean that their health is not in danger. Signs to look for from the experience of a recovering bulimic:
- Obsesses about weight, weighing numerous times a day, especially before and after eating;
- Eats very little, or eats lots of food, then immediately disappears to the bathroom and is gone a while.
- Exercises more than 3 hours or more a day most days of the week.
- Very unhappy with their appearance even when you think they look great.
- Brush their teeth many times a day.
- Knuckles have calluses, redness or teeth marks.
- Leaves the toilet a mess, or super-clean
When you suspect a problem, please talk to your doctor or her pediatrician. They will guide you and give you the appropriate steps to take. As many people know, when a loved one is having an eating disorder, the whole family suffers.
Please stand by them even when they kick and scream.
You can check out the following websites: www.teenanorexiabulimia.org, www.mirror-mirror.org/myths.htm.
Contact Ester Marsh with health and fitness questions at 704-636-0111 or emarsh@rowanymca.com.
A: This is a very tough one for me. Many years ago I wrote about this in one of my columns. Many readers do not know that I was battling bulimia in my late teens and early twenties — a very dark time of my life.
I will get into my own experience in a little bit, but first let's look what an eating disorder can be.
An eating disorder is a disturbance in someone's eating behavior that compromises his or her physical and psychological health. Anorexia nervosa and bulimia are chronic problems in which there is a preoccupation with food, eating and weight loss.
Anorexia nervosa is still more prevalent in young women than in young men. The disorder typically begins in "tweens" or teenage girls who are either overweight or perceive themselves that way. The interest in weight reduction becomes an obsession with severely restricted calorie intake and often excessive exercising.
People with bulimia (including men) tend to lead secretive lives, hiding their abnormal eating habits. In a single binge, they can consume 10,000-15,000 or more calories. The binge usually occurs in several stages:
- anticipation and planning
- anxiety
- urgency to begin,
- rapid and uncontrollable consumption of food,
- relief and relaxation
- disappointment
- shame
My own experience as a bulimic:
I was always very muscular and actually was called a boy, even young man, many times. I was a lot stronger and faster than many boys growing up and always had to arm wrestle or fight (yes, I won every time!). At the age of about 13, I started Judo (a martial art where you throw people, break their arms and strangle them ... although of course they can "tap out").
I had to make my weight class, which was between 61.1 kg and 66 kg (137.4 and 148 pounds). I was always 2 to 3 pounds heavier. I used many techniques and tricks to lose weight very quickly, like running in a plastic bag, not eating anything or barely anything at all, and after the weigh-in eating like there was no tomorrow.
Myth: Bulimics always purge by vomiting
Fact: Not all bulimics try to rid themselves of the calories they have consumed by vomiting. Purging can also take form of laxatives, diuretics, exercising, or fasting.
As you can tell, I was already showing signs, but I was doing it to "make my weight class."After a severe back injury that ended my Judo career, I went to the gym to strengthen my back. When I walked in, everyone thought I have been lifting weights for years. As a matter of fact, I guess I had been: the weights were human bodies. Soon after I started lifting weights, I got excited to enter a body building competition.
When you need to make a weight class for Judo, they don't care how you look. With body building, looks are what matters: your muscles, your symmetry, your body fat. I did great with my "perfect" diet: no sweets, very low fat, everything steamed or grilled. I entered my first competition and won.
Afterwards, the reward is FOOD. Oh, and I binged. It wasn't just me; it was the other bodybuilders too. Before I knew it, the body fat I lost for the competition was "packed back on." And I felt FAT. Most bodybuilders have no problem with this and get back on a normal diet, possibly getting ready for another competition. Their binge was just a couple of days, or maybe one week. Mine turned into on and off binging and purging for years. As an instructor, it was very easy to say it was my job to teach four classes in a row almost every day of the week! I was purging by over-exercising and vomiting.
Myth: You can never recover from an eating disorder
Fact: Recovery takes a long time, but with hard work and the proper treatment (or in my case, lots of prayers with God), you can fully recover from an eating disorder.
My sister at one point found out. It was very hard to be confronted with the fact that you can't hide it anymore, but also a relief. Unfortunately, neither she nor I knew what to do. You can't just stop an eating disorder — even when you want to.
Myth: People with eating disorders do this to hurt their family and friends
Fact: People with eating disorders are doing this to themselves. They are usually upset when they know the people around them are worried or hurt by their eating disorder.
I was in denial for so long, but I was also very miserable and alone during that time of my life. An eating disorder is an addiction to food. But guess what? You have to eat to live.
Telling a food addict to eat better is like telling an alcoholic to just have one drink a day or a heroin addict you can use it only once a day.
Myth: You cannot die from bulimia.
Fact: Bulimics are at high risk for dying, especially if they are purging, by vomiting, using laxatives, and over exercising. Many bulimics have died from cardiac arrest which is usually caused by low potassium or an electrolyte imbalance. Others have died from a ruptured esophagus.
Famous gymnast Kathy Johnson, Nadia Comaneci and Cathy Rigby have come forward and admitted to fighting eating disorders. In sports where athletes are judged by technical and artistic merit, the pressure to be thin is enormous. In 1988, at a meet in Budapest, an American judge told Christy Henrich — at that time one of the world's top gymnasts — that she was too fat and needed to lose weight if she wanted to be on the Olympic team. She resorted to anorexia nervosa and bulimia to control her weight. Her disorder eventually took her life.
Christy Henrich died of multiple organ failures.
We have come a long way since then.
Myth: You can always tell when someone is Anorexic.
Fact: Not all anorexics look like the extreme cases we see on talk shows and magazines, some maybe anywhere from 5-15 pounds underweight. They look thin, but don't have what society considers to be the anorexic look. That does not mean that their health is not in danger. Signs to look for from the experience of a recovering bulimic:
- Obsesses about weight, weighing numerous times a day, especially before and after eating;
- Eats very little, or eats lots of food, then immediately disappears to the bathroom and is gone a while.
- Exercises more than 3 hours or more a day most days of the week.
- Very unhappy with their appearance even when you think they look great.
- Brush their teeth many times a day.
- Knuckles have calluses, redness or teeth marks.
- Leaves the toilet a mess, or super-clean
When you suspect a problem, please talk to your doctor or her pediatrician. They will guide you and give you the appropriate steps to take. As many people know, when a loved one is having an eating disorder, the whole family suffers.
Please stand by them even when they kick and scream.
You can check out the following websites: www.teenanorexiabulimia.org, www.mirror-mirror.org/myths.htm.
Contact Ester Marsh with health and fitness questions at 704-636-0111 or emarsh@rowanymca.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 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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