The devastation wrought by anorexia nervosa includes severe cognitive and physical changes that researchers say kill one in 10 patients and debilitate many others. But doctors and scientists have only a weak understanding of how to repair the damage. That's why clinical trials at the Stanford University School of Medicine and Lucile Packard Children's Hospital are now recruiting anorexia nervosa patients to test disease therapies in adolescents and young adults. The two studies focus on different patient populations and aspects of anorexia treatment. One will be the largest-ever randomized clinical trial to compare therapies that use patients' families to facilitate anorexia treatment in adolescents. The second trial tests a method for helping young adult anorexia patients change their disordered thinking patterns and become more receptive to treatment. "People have trouble accepting how serious these problems really are, " said James Lock, MD, PhD, professor of psychiatry and behavioral sciences.
Timberline Knolls, one of the country's leaders in the treatment of eating disorders, is recognizing well-known tennis star, Monica Seles, for disclosing her history with an eating disorder in her new book Get a Grip. Ms. Seles' display of courage and candor has the potential to help many others who have similar struggles, especially young female athletes. It is estimated that more than 11 million Americans suffer from an eating disorder and 20 million more suffer from binge-eating disorder. And because of the secretiveness and shame associated with eating disorders, this number is likely much larger. According to Kimberly Dennis, M.D., medical director at Timberline Knolls, the prevalence eating disorders in female athletes occur at an even higher rate than the general population. "There are several features of an eating disorder illness that are particularly exacerbated in for females in athletics, " said Dr. Dennis. "And because so much attention is placed on success in athletics, the signs of these illnesses are overlooked by many parents, coaches, teachers and even physicians and therapists.
People who feel pressure to look attractive are more fearful of being rejected because of their appearance than are their peers, according to a new study by researchers at the University at Buffalo and the University of Kent. The study of appearance-based rejection sensitivity among college students was conducted by Lora Park, Ph.D., assistant professor of psychology and graduate student Ann Marie DiRaddo, of the University at Buffalo, and Rachel Calogero, Ph.D., a lecturer in psychology at the University of Kent. It was published in the spring edition of Psychology of Women Quarterly (Vo. 33, Issue 1), a publication of the American Psychological Association. The researchers found that overall women showed greater sensitivity to appearance rejection than did men. This was particularly true of women who felt they needed to look attractive in order to be accepted by their peers. The study also found that men and women who had internalized media ideals of attractiveness had higher levels of appearance-based rejection sensitivity than did their peers.
Everyone checks their body to some extent, but many people with eating disorders repeatedly check their body and often in a way that's unusual. Sometimes body and weight checking becomes second nature and many individuals with eating disorders don't even realize they're doing it, " said Dena Cabrera, PsyD, psychologist at Remuda Programs for Eating and Anxiety Disorders. "Commonly, they check to feel for fatness, bones and any physical change in their body to subconsciously or consciously motivate their eating disorder behavior." Many individuals with eating disorders weigh themselves at frequent intervals, sometimes many times a day. As a result they become obsessed with the daily weight fluctuations that are a normal part of the body and would otherwise pass unnoticed. The movements on the scale then determine their mood and eating patterns. Body checking is influential in maintaining dissatisfaction with shape and appearance. Other common behaviors associated with body checking include: looking in the mirror (or at reflective surfaces);
Eating disorder (ED) patients display a high prevalence of gastrointestinal symptoms and functional gastrointestinal disorders such as irritable bowel syndrome. These symptoms may interfere with their nutritional management. Ingestion of fructose-sorbitol (F-S) is an established means of gastrointestinal symptom provocation in irritable bowel syndrome patients. Surprisingly, although ED patients are known to consume "diet" products containing fructose and sorbitol, their gastrointestinal symptom responses to F-S provocation have not been studied. A research article published on November 14, 2009 in the World Journal of Gastroenterology describes the responses of 26 ED patients to F-S provocation. The research team, including Professors Kellow, Abraham and Hansen from the University of Sydney, Australia, monitored gastrointestinal symptoms and breath hydrogen concentration (a marker of small bowel absorption) for 3 h following ingestion of 50 g glucose on one day, and 25 g fructose/5 g sorbitol on the next day.
Doctors and other health workers should be more aware of the high risk of eating disorders among people with obsessive compulsive disorder (OCD) and other anxiety disorders. According to new research presented today at the Royal College of Psychiatrists' 2009 Annual Meeting, as many as one in five people with OCD could also have some form of disordered eating. In addition, disordered eating may occur in as many as one in three patients with other anxiety disorders. OCD is a serious anxiety-related condition that affects 2-3% of the adult population. People with severe OCD may find it difficult to work regularly, or even take part in their family or social life. Dr Lynne Drummond, a consultant psychiatrist at South West London and St George's NHS Mental Health Trust, collected data from a sample of patients with severe OCD who were referred to a specialist unit for treatment. A control group of patients with other anxiety disorders referred for treatment to the same unit was also studied.
Young heterosexual men are falling prey to eating disorders such as anorexia and bulimia just as much as women and gay men - and their numbers are increasing, a leading specialist has warned. Dr John Morgan, a consultant psychiatrist and director of the Yorkshire Centre for Eating Disorders in Leeds, told the Annual Meeting of the Royal College of Psychiatrists in Liverpool that growing numbers of young men are increasingly dissatisfied with their bodies. In addition, the gap in the numbers of gay and straight men with eating disorders is closing. Dr Morgan told Annual Meeting delegates that men are: - less likely to recognise their eating disorder - more likely to be mis-diagnosed with other mental health problems such as depression and schizophrenia - less likely to be given treatment - less likely to be referred to a special eating disorder clinic. Many men struggle to be referred to a specialist eating disorders clinic in the first instance. Furthermore, once they undergo treatment, many report being stigmatised as the only man in the clinic.
A German study published in the current issue of Psychotherapy and Psychosomatics addresses the differences between inpatient versus day clinic treatment of bulimia nervosa. In bulimia nervosa, more intense treatments are recommended if outpatient treatment fails. This is the first randomized controlled trial comparing the options of inpatient versus day clinic treatment. Patients with severe bulimia nervosa were randomly assigned to inpatient or day clinic treatment of similar length and intensity. Specific and general psychopathology was assessed at the end of treatment and a 3-month follow-up. Fifty-five patients were randomized; 22 day clinic patients and 21 inpatients started the program. At the end of treatment, a significant reduction of general and specific pathology was found in both settings. Following discharge, there was more deterioration in bulimic symptoms after inpatient treatment, but overall, results were comparable. Inpatient and day clinic programs are effective treatments for severely disturbed bulimic patients with similar results at the 3-month follow-up.
Eating disorders are frequently seen as psychological or societal diseases, but do they have an underlying biological cause? A new study shows that the levels of a brain protein differ between healthy and anorexic women. Anorexia is a serious and occasionally fatal eating disorder most commonly affecting women. Scientists do not yet understand the physical causes of anorexia, though some studies suggest a link to low levels of a brain protein called BDNF. Now, a study recommended by Cynthia Bulik, a member of Faculty of 1000 Medicine and leading expert in the field of psychiatry and eating disorders, shows that BDNF levels are higher in women who have recovered from anorexia. This suggests that low BDNF levels may be reversible. Researchers at Chiba University in Japan found that anorexic women had lower levels of BDNF in their blood than healthy women or those who had recovered from anorexia. Women with low BDNF also had the lowest self-image, suffered from anxiety and depression, and performed poorly on certain tests of cognitive ability.
Scurvy is a condition where an individual has a vitamin C (ascorbic acid) deficiency. The name scurvy comes from the Latin scorbutus, and humans have known about the disease since ancient Greek and Egyptian times. Scurvy commonly is associated with sailors in the 16th to 18th centuries who navigated long voyages without enough vitamin C and frequently perished from the condition. Modern cases of scurvy are very rare. Humans are unable to synthesize vitamin C - which is necessary for collagen production and iron absorption - and so they must obtain it from external sources (such as citrus fruits). Therefore, people must consume fruits and vegetables that contain or are fortified with vitamin C in order to avoid the vitamin C deficiency known as scurvy. Who gets scurvy? Though scurvy is a very rare disease, it still occurs in some patients - usually elderly people, alcoholics, or those that live on a diet devoid of fresh fruits and vegetables. Similarly, infants or children who are on special or poor diets for any number of economic or social reasons may be prone to scurvy.