Yearly Archives: 2010

What Role Does the Family Play in An Eating Disorder?

The family is either going to be positive or negative, there is no such thing as neutral when it comes to the impact of a family member on the eating disorder.  Therapists err when they fail to recognize the powerful role that the family plays in the recovery process.  Because many traditional therapists believe that it is a “boundary violation” to involve family members in treatment, they effectively create a situation which makes it less likely that the patient will recover.  Excluding the family creates a sense of helplessness and futility for them and isolates the patient even further.

Parents must understand what to expect in terms of the recovery process or they may inadvertently derail it and therapists must facilitate that understanding by insisting on the family’s active involvement.

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2010, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2010, Dr J Renae Norton. http://edpro.wpengine.com’

Incidence and Risk Factors of Eating Disorders

The US Dept of Health and Human Services task force reports:

  • 10 million females and 1 million males have life threatening eating disorders
  • 87 percent are children and adolescents under the age of twenty
  • By age 13, 10% of girls had reported the use of self-induced vomiting

Risk Factors for Different Groups

 

  • Teens: Early puberty is a primary risk factor for the onset of eating disorders among teens.
  • Males: The number of males with eating disorders has doubled in the past 10 years, certain sports, homosexuality
  • Women: Increasing numbers of women aged 20 – 50 seeking help for eating disorders they have harbored secretly for twenty or thirty years.

 

Health Consequences of Eating Disorders:

 

Eating disorders are the most lethal of all mental health disorders, killing or maiming between 6 and 13 percent of victims who die of:

  • Infectious diseases
  • Stroke
  • Heart attack/failure
  • Seizures
  • Liver or kidney failure
  • Diabetic Coma

Sources:

US Dept of Health and Human Services – (http://www.hhs.gov)

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2010, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2010, Dr J Renae Norton. http://edpro.wpengine.com’

Relationship Between Obesity and Eating Disorders?

eating disorder treatment cincinnati

photo used under a creative commons license

There is an epidemic of obesity in the US today. Consider the following:

  • 1 in 3 Americans is overweight
  • 1 in 5 or 129.6 million are obese
  • 70% of Americans dieted in 2007
  • 95% of all diets fail if exercise is not part of the program
  • Yo-yo dieting leads to eating disorders and may be the single most common “cause” of disordered eating
  • In a recent study, young girls were quoted as saying that they would prefer to have cancer, lose both their parents, or live through a nuclear holocaust than to be fat.
  • 80% of girls in grades 3 to 6 displayed body image concerns and dissatisfaction with their appearance
  • 81% of 10 year olds say they are afraid of being fat
  • By the time girls reached the 8th grade, 50% of them had been on diets, putting them at risk for eating disorders and obesity.
  • 25% of first graders admit to having been a diet.

In my practice, I often see patients that were overweight as children and experienced such self-hatred or shame that their eating disorder is a conscious attempt at avoiding that situation again.

For others, a family member, perhaps a father or mother or even a grandmother or an aunt with a weight problem triggers intense anxiety about weight gain.

If you are a loved one need treatment for obesity or an eating disorder in Cincinnati, I’m here to help! Schedule a consultation at 513-300-8043!

Sources:

World Health – 1 in 3 Americans are Overweight or Obese (http://www.worldhealth.net/news/1_in_3_americans_are_overweight_or_obese/)

My Best Health Portal – Top 20 Reasons Why 95% of All Diets Fail (http://www.mybesthealthportal.net/features/featured-articles/top-20-reasons-why-95-of-all-diets-fail.html)

Empowered Parents – The Skinny on Raising Daughters to Become Healthy Eaters (http://www.empoweredparents.com/pages/Article14.htm)

Empowered Parents – Childhood Fears Take New Form: Body Image Concerns In Young Children (http://www.empoweredparents.com/1childhoodonset/childhood_01.htm)

Empowered Parents – Obesity, Overweight and their Connection to Eating Disorders (http://www.empoweredparents.com/pages/Article7.htm)

 

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2010, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2010, Dr J Renae Norton. http://edpro.wpengine.com’

Childhood Obesity

childhood obesity treatment cincinnait

  • 15% of children and adolescents 6-19 are overweight and another 15% are at risk
  • 10% of preschool children 2-5 are overweight
  • 1 in 5 children are currently obese
  • For those who are obese at 10-13 years of age, they are 70% more likely to be obese as adults
  • Self-esteem is negatively affected and may result in the development of personality disturbances that last a lifetime.

If you are looking for childhood obesity treatment in Cincinnati, there is help! Schedule a consultation with me at 513-300-8042.

Sources:

Empowered Parents – Obesity, Overweight and their Connection to Eating Disorders (http://www.empoweredparents.com/pages/Article7.htm)

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2010, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2010, Dr J Renae Norton. http://edpro.wpengine.com’

Bulimarexia: Why Are We Seeing More of It?

Bulimarexia Treatment Cincinnati

There is definitely an increase in the number of patients coming my way who are Bulimarexic, or suffering from symptoms of both Anorexia and Bulimia.  This is consistent with the information we have seen from our online survey. Please take the survey if you haven’t already done so!

Check out the chart for percentages of individuals reporting the type of Eating Disorder from which they are suffering.


The survey has been up for approximately two years.  The number of people reporting being Bulimarexic has tripled in that time. One year ago the percentage for Bulimarexia was only 24.9%, now it is nearly 48%!(Part of this is likely due to increased familiarity with the term.)

The question is why? According to our survey at the Norton Center of more than 200 individuals who report having been in treatment for an eating disorder, 16% of those suffering exclusively from Anorexia upon entering an inpatient program report being discharged with symptoms of Bulimia that they acquired during their inpatient stay. Likewise, 11% of those surveyed, report that they entered in-patient treatment suffering exclusively from symptoms of Bulimia and exited with symptoms of Anorexia as well.

Anyone treating this population knows that the most difficult group to treat by far is the group suffering from symptoms of both Anorexia and Bulimia, or Bulimarexia.  Likewise the risk of mortality is greater with this group than that of either group alone. If it isn’t apparent, the medical consequences of cycling between restricting sufficiently to be at an extremely low weight, followed by periods of bingeing and purging, are dramatic and often deadly. Thus, a treatment approach that may actually increase the likelihood of the development of Bulimarexia is a serious problem.

Obviously not all patients with Bulimarexia have developed the disorder while in an in-patient program. However, I am finding that an alarmingly high number of individuals “graduating” from inpatient treatment end up with Bulimarexia. Since I often see patients that other practitioners will not take into their practice because they are so sick, the number of Bulimarexic patients I see is probably higher than it would be in most practice settings.  None-the-less, this issue doesn’t appear to be on the radar of researchers and many practitioner groups which is a serious problem in my opinion.

To date, there is not even a diagnostic code specifically for Bulimarexia in the Diagnostic and Statistical Manual, Fourth Edition (DSM IV).

In the DSM-IV, the closest thing we have is a code for two types of Anorexia:

Restricting Type: During the current episode of Anorexia Nervosa, the person has not regularly engaged in binge-eating or purging behavior (self-induced vomiting or misuse of laxatives, diuretics, or enemas).
Binge Eating/Purging Type: During the current episode of Anorexia Nervosa, the person has regularly engaged in binge-eating or purging behavior.

These definitions do not capture the nature of Bulimarexia. For example, whether the individual started as Anorexic or Bulimic makes a difference in terms of their current symptoms.  The more Anorexic Type restricts most of the time and may or may not binge, but purges almost everything she does eat.  In other words, she is more likely to have “subjective” binges, i.e. a small amount of food seems like a binge to her so she is forced to purge it.

The more Bulimic Type of Bulimarexic can keep some food down, and/or has more flexibility in terms of what she allows herself to eat, i.e. she may eliminate fat altogether from her diet but allow foods with carbohydrates. She will have some criteria that she uses to establish a “good” day versus a “bad” day.  “Bad” days trigger the need to binge and purge whereas a “good” day allows her to skip this part of the cycle. These distinctions may not seem important, but they are critically important when it comes to treatment effectiveness.  The therapist that does not understand such subtleties is going to be much less effective treating these disorders and could end up doing more harm than good.

More attention needs to be paid to this problem, we need better in-patient alternatives and we need more research on outcomes in general, i.e. we need to look at the impact that both inpatient and outpatient therapy has on the incidence of Bulimarexia. Graduate students looking for research opportunities contact me at drnorton@eatingdisorderpro.com.

My experience treating this population has been that treatment effectiveness is driven by customizing strategies to the individual and not using a One Size Fits All © approach. In general, I believe that inpatient approaches have tended to lump all eating disorders together in terms of treatment. The upshot is often an increase in the type of symptoms during or following discharge, or crossover from one disorder to another.  This is a serious problem given the increased medical and psychological complications that result.

Excerpt from Dr. Norton’s upcoming book One Size Fits All Copyright Dr. J. Renae Norton 2010 All rights reserved.

Medical Advice Disclaimer: The information included on this site is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Reading the information on this website does not create a physician-patient relationship.

© 2010, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2010, Dr J Renae Norton. http://edpro.wpengine.com’