Eating Disorder Pro

Night Eating Syndrome and Sleep Related Eating Disorders; When “Midnight Snacks” Turn into Calorie Loaded Nightmares.

It is estimated that over 6 million Americans are affected by Night Eating Syndrome (NES) or Sleep Related Eating Disorders (SRED), yet most of us have never heard of either of these disorders.  Essentially they involve consumption of large quantities of high carb foods during the night. Because NES and SRED share  the characteristics of other eating, mood and sleep disorders they can easily be misdiagnosed and mistreated.  Those affected by NES or SRED often feel misunderstood, isolated and hopeless.  These feelings can exacerbate other eating disorders and perpetuate a cycle of disturbed eating patterns during the day as well as during the night.

How are NES and SRED different?

While they are similar in as which they involve uncontrolled night eating that interferes with sleep and daytime activities they are fundamentally different. Those with  NES have a difficult time falling asleep and wake frequently with an intense urge to eat, sleep is  prevented until the urge is satisfied.  This syndrome usually occurs when the individual is battling stress and depression. SRED is the act of preparing and eating food while sleep walking, these individuals will awake with no memory of eating the night before.  This disorder is very common in those who suffer from restrictive eating disorders.

Is Treatment Available for NES and SRED?

Yes, treatment is available.   NES and SRED are a combination of disorders so each disorder must be addressed.   The most effective treatment involves a combination of psychotherapy and behavior therapy, in some cases medication may also be necessary.  When seeking treatment it is advised that you find a health care provider that has experience with NES and SRED.

Filed under: Services on November 4th, 2009 | No Comments »

The Real Deal About Anorexia

Anorexia, a potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss, has seen a threefold increase over the past 40 years among women in their 20s and 30s. The percentage of teens afflicted has remained about the same with the exception of male teens. Whereas males used to represent only 5% of the ED population, they now represent closer to 10% and are over-represented among wrestlers, professional ice-skaters, jockey’s and the male homosexual population.

Anorexia is usually characterized by resistance to maintaining a body weight sufficient for normal functioning and/or for survival. In a small proportion of cases, the individual is not resisting weight gain, nor is she consciously trying to lose weight. Instead she is simply unable to eat enough to maintain a normal weight as a result of excessive anxiety. The eating disorder for this relatively small group develops partly as a result of a defense mechanism called Obsessive Compulsive Disorder (OCD) which drives her to restrict more and more in order to control the number of calories she is ingesting. Eating less and less becomes an obsession.  Unlike the majority of Anorexics, whose goal it is to loose weight, her goal is to control her calorie intake. Obviously, the outcome is the same, but it is important to understand the difference, otherwise she will be mislabeled and may end up being or feeling mistreated.

In most cases, the fear of weight gain or being “fat” is so intense that the individual consciously restricts to achieve a lower and lower weight.  For such individuals, the number is never low enough.  Suffers grossly distort the shape of her body, believing that she is “fat” in the face of deathly thinness. This condition is known as body dysmorphia and is a common symptom. In terms of personality, the anorexic tends to be a perfectionist, judging others and herself harshly.

Warning Signs of Anorexia

*Dramatic or persistent steady weight loss.

*Preoccupation with weight, food, calories, fat grams, and/or dieting.

*Refusal to eat certain foods, progressing to severe food restrictions.

*Frequent comments about feeling “fat” or overweight despite weight loss.

*Denial of hunger.

*Development of food rituals.

*Consistent excuses to avoid mealtimes or situations involving food.

*Excessive, rigid exercise regimen-despite weather, fatigue, illness, or injury.

*Withdrawal from friends and activities.

*Life revolves around weight loss, dieting, and control of food.

Filed under: Services on August 25th, 2009 | No Comments »

The health benefits of  incorporating low GL foods  into your daily diet include, a lower blood glucose level, decrease in cholesterol levels and a reduced risk of heart disease and type II diabetes.  But determining which foods have a low Glycemic load can be confusing.  You have probably noticed that many foods today have listed the glycemic index (GI), but if you are like most people you may not know what it is or why it is important. Specifically it is used in developing a scale that ranks carbohydrates by how much they raise blood glucose levels compared to a reference food.  The problem with using the GI alone is that it is based on a small quantity of food, 50 grams, which is typically less than a normal serving of food.

A more accurate or relevant measure is the glycemic load (GL) which reflects both the quality and quantity of dietary carbohydrates. This is important because, to put it very simply, blood glucose levels determine whether or not and how much fat your body stores.  Understanding GL allows us to maintain a healthy weight for our size. Because most foods with a low GL are whole foods (came out of the ground or had a face) instead of processed foods, this means that we will be eating more fruits and vegetables and healthier proteins.

To calculate the glycemic load of a food, divide the GI by 100 and multiply by the grams of carbohydrate in the serving size.  GL=GI/100 x # Carb grams per serving

Examples of How to Lower A Meal’s GL:

GI = 60    GL = 48                   GI = 42    GL = 31

A cereal with fiber plus a fruit, which also has fiber lowers the GL.

GI = 83    GL = 19                   GI = 14    GL = 1

Pretzels are made from bleached white flour, salt and a little sugar. Peanuts, even with the fat, are a much better snack because of the fiber.

So What is High, Medium and Low in Terms of the GL for a food

Low 0-10

Moderate 11-19

High 20+

What Should I Shoot for During the Course of a  Day?

Low: less than 80

Moderate: less than 100

High: greater than 100

How to Increase Consumption of Low GI Foods

*Eat high-fiber breakfast cereals, especially oats, bran and barley OR

*Add berries, nuts, flaxseed and cinnamon to high GI cereals

*Choose dense, whole grain and sourdough breads and crackers OR

*Add a heart healthy protein and/or condiment to high GI breads and crackers.

*Include 5-9 servings of fruits and vegetables every day

*Replace white potatoes with yams or sweet potatoes OR

*Eat smaller portions of high GI potatoes

*Eat less refined sugars and convenience foods OR

*Combine nuts, fruits, yogurt with commercial sweets – just watch portion sizes

It is important that one does not eat only low GL foods.  The result could be a calorically dense, high fat, low fiber, low carb diet (such as the Atkin’s Diet).  It is best to aim for a well balanced diet that includes low GL carbohydrates, such as fruits and vegetables and hi fiber grains and use the glycemic load as a guide for increasing these foods and for keeping blood sugar levels stable.

Filed under: Services on August 13th, 2009 | No Comments »

Binge eating is mostly associated with Bulimia but it is also a characteristic of other eating disorders such as Bulimarexia and Binge Eating Disorder.  There are two definable types of binge’s, objective and subjective.  Binge eating has often been associated with purging but not all binges are followed by a purge.  It should be noted that vomiting is not the only means of purging;  excessive exercising and the use of diet pills, diuretics, and laxatives are other methods of purging.  Some may just use one of these methods and others use a combination of these.

Objective and Subjective Binge Eating

An objective binge consists of  as much as 20,000 calories in one episode (which may last from minutes to  many hours) or huge amounts of low calorie foods, such as 6 heads of lettuce with no fat butter.  Binges generally have a function or serve a purpose such as procrastination, avoidance, or relieving anxiety and boredom.  The binge is usually thought out and requires a block of time and privacy.

A subjective binge is the intake of normal foods in normal amounts that the individual feels uncomfortable eating.  The person may feel uncomfortable because it contained a taboo such as fat, sugar or carbs.  Or it may have been “healthy” but they ate too much.  The most common reason for a purge is that the individual feels too full.  Research shows that Bulimic’s and Bulimarxics are unusually sensitive to the sense of fullness.

Situational Binge Triggers:

Meal Preparation, a person with an eating disorder can often be triggered into a binge by preparing a meal, as they are preparing the food they will begin to nibble on the ingredients used to prepare the meal.  The amount of food they consume during the preparation of the meal can be as much as the meal itself, the result is consuming twice as much food as intended.  This may lead to purging, depending on the type of eating disorder.

Dining out with a Group, this is usually very difficult for a person with an eating disorder.  The person with the eating disorder will usually consume an appropriate amount of  “healthy” food while those around them are eating “taboo” foods.  This often angers the person with the eating disorder and can lead the person to binge on those “taboo” foods when they get home in private.

DID YOU KNOW?

According to Dr. Norton’s online survey, in which over 130 people responded, over half of those that binge often find themselves fantasizing about foods to binge on while grocery shopping.

Occurrence by Eating Disorder

* Bulimarexia – 57.1%

* Bulimia – 53.3%

* Emotional Eaters – 53.3%

Filed under: Bulimarexia, Eating, Eating Disorder, Services, did you know on July 30th, 2009 | No Comments »

According to recent result’s of Dr. Norton’s online survey, in which more than 125 people have participated, Out-Patient Psychotherapy was found to be the most therapeutic of the following treatment options: Hospitalization for medical stability, Forced weight gain via feeding tube, In-Patient residential, In-Patient therapy group, Out-Patient psychotherapy, Out-Patient therapy group, Over Eaters Anonymous, Nutritional Counseling and Gastric Bypass Surgery.

Participants in Dr. Norton’s Survey rated their forms of treatment as follows:

Out-Patient Psychotherapy

*39.7% found Out-Patient Psychotherapy to be Very Therapeutic and

*36.2% found it to be Somewhat Therapeutic

*3.4% felt that this therapy did more harm than good

In-Patient Residential

*20.9% found In-Patient residential treatment to be Very Therapeutic and

*33.9% found it to be Somewhat Therapeutic

*18.3% felt that In-Patient Therapy did them more harm than good

Limitations of In-Patient Treatment

The learning taking place often does not  generalize to the home environment.  Patients are put on meal plans and are monitored 24/7 by staff such that they are not really learning to make new choices.  Also the daily stressors of family dynamics, school/work pressures and social demands are not present.  The patient has been removed from daily triggers that may have contributed to the eating-disorder in the first place.  Finally this treatment can also be very costly and often results in no insurance coverage as many HMO’s will not cover once the person has been in-patient.

Pro’s of Out-Patient Treatment.

Out-Patient Treatment, especially if it includes Family Treatment, allows the individual to deal with the eating disorder in their everyday setting and provides an atmosphere conducive for family involvement which can be key to recovery.  This method also involves persistent effort for the person with the eating-disorder to get better on their own.  Finally Out-Patient is more cost effective when compared to In-Patient treatment.

Our Strategy: We approach the problem by aligning with the patient rather than colluding against her, blaming her, or casting her in the role of someone who is incapacitated.  While those suffering from an eating disorder do have severe and/or debilitating distortions regarding food, weight and body image, they will ultimately have to choose for themselves whether or not to face their fears and change their relationship with food.  Taking away control only delays that decision and may have serious side effects.

Filed under: Services on June 26th, 2009 | No Comments »

3 Good Reasons to Assign Household Chores for Children:

1.  It can help create healthy habits. On average children age 8 – 18 spend 3 hours a day either watching t.v., playing video games or on the computer.  The responsibility of a household chore would get them away from the t.v. and up and moving.  Vacuuming, mopping, mowing the lawn and gardening are all good ways to increase your heart rate.  Children need at least 90 minutes of moderate to strenuous physical activity a day, chores are a great way to get your child moving.

2.  It can help reduce stress and family tension. A messy, cluttered house can cause a lot of tension and resentment within a family.  Often parents just complain or yell at their children for not helping.  This can create feelings of failure and anger for both the parent and the child.  A sedentary lifestyle combined with feelings of shame, failure and anger can lead into emotional eating habits.

3.  Allows parents more time to spend with their children. Why should parents spend their evenings and weekends doing all the housework?  When the kids pitch in the work could be done in half the time.  This time could be used to go for a family bike ride, walk or maybe even a game of chase or hide and seek.  Remember ” a family that plays together stays together”.

The prevelance of childhood obesity in the United States is increasing at an alarming rate.  According to the Center for Disease Control (CDC), the percentage of overweight children 2-5 years of age has doubled, with one in four pre-schooler’s being overweight or at risk for obesity.  Fifty percent of these children will become obese adults.  For more information about this study you can visit the CDC’s website at http://www.cdc.gov/HealthyYouth/obesity/#1

Filed under: ADHD, Eating, Eating Disorder, External Resources, Services on June 19th, 2009 | No Comments »

Grocery Shopping – Simple Task or Time Consuming Nightmare?

I don’t know of many people who actually enjoy the mundane task of going grocery shopping but for those who suffer from an eating disorder it can be an absolute nightmare. For them going to the grocery can be time consuming, mentally exhausting and costly.  Check the results we collected from Dr. Norton’s Online Survey concerning grocery shopping.

• 75.2%  debate whether or not to purchase each particular item
• 44.4% find themselves fantasizing about binging on certain foods while grocery shopping
• 30.1% spend more than they can afford on food

These statistics, which are from a sample of over 125 respondents, are good examples of why Dr. Norton provides the service of shopping coach.

Filed under: ADHD, Bulimarexia, Eating, Eating Disorder, Services on June 18th, 2009 | No Comments »

BULIMAREXIA – An eating disorder that has the characteristics of both Anorexia and Bulimia.  The person affected by this disorder will cycle between the restricting habits that are associated with Anorexia and the binging and purging characteristics of Bulimia.  This eating disorder is very dangerous and is physically and emotionally damaging.

After reviewing the data from Dr. Norton’s online survey we found that Bulimarexia had the largest population of those who took the survey.

*38% identified themselves as having Bulimarexia

*25% identified themselves as having Anorexia

*12.5% identified themselves as having Bulimia

*10.8% identified themselves as Emotional Eaters

*13.3% identified themselves as Obese

Why Bulimarexia Is So Dangerous

1.  The fact that it is not a recognized diagnosis yet so many people suffer from it causes a serious problem for the therapist/physician and creates a serious gap in treatment.

2.  The cycle of binging and restricting is very dangerous and can cause many serious health problems such as decreased bone density, loss of menses (difficulty conceiving), tooth decay and kidney damage just to name a few.

3.  Bulimarexia often goes undetected or thought of as “just a phase”.  For example a parent might notice their child’s decreased food intake and some weight loss but just as they start to take notice of  this the child cycle’s into the binging component of this disorder.  The parent is relieved to see their child eating again and their previous concerns are dismissed.

Filed under: Bulimarexia, Eating Disorder, did you know on June 16th, 2009 | No Comments »

➢ When the power of love is greater than the love for power;
The world shall know peace.
➢ Bring happiness to every encounter in life.
➢ Allow life and all its abundance to come to you.
➢ Take pleasure from what you possess without being attached
to these things.
➢ Extend your perspective beyond just your senses.
➢ Live in a conscious and continuous state of gratitude and bliss.
➢ Train your mind and body to live without suffering.
➢ Awaken to new possibilities and your Divine magnificence!
➢ Worries are interludes in happiness!!!
➢ The THOUGHTS the THINKER THINKS cause suffering.
➢ “True spirituality is a mental attitude you can practice at any time.” — Dalai Lama

Filed under: External Resources, Services on January 12th, 2009 | No Comments »

Currently in the United States we are experiencing an epidemic of obesity, especially among children. The fastest growing age group is from 2-5 years old.  Many of my patients started out as overweight children.

According to the Center for Disease Control (CDC), the percentage of overweight children 2-5 years of age has doubled, with one in four pre-schooler’s being overweight or at risk for obesity. Fifty percent of these children will become obese adults. Prevention requires reaching children before the age of 6.

Here are a few tips to help your child be more active. Organized sports are great, but not all children are comfortable with competitive activities or they just get burned out on them. That can turn them off to being physically active, sometimes for good.

There are lots of other activities your child may enjoy besides organized sports.  Your best bet is to lead by example and keep it simple. It doesn’t have to cost a lot of money to keep your child active but it may require some creativity and it does take time. For busy parents, that means making the most of every opportunity. For example, little children love to help with things like vacuuming or gardening.  It won’t be as efficient, but it teaches them good habits and gets them off the couch.

Probably the single most important thing that you can do is limit the amount of time your child spends in front of the TV, and/or with electronic devices such as Game Boys and computers. These devices keep your child absorbed for long periods of time during which there is no physical activity. There is a growing body of research suggesting that the over use of electronics compromises neurological development and can lead to sleep disturbances, excessive aggression and even wrist and back injury. And of course, we know that the lack of activity is a key factor in the increased incidence of obesity.

Here are some other activities that may interest your child:

•    Riding a bike – ride with them if you can.  The best thing you can do is set an example!
•    Climbing on a jungle gym – If you don’t have one, they are in almost every park today.
•    Jumping rope – this can even be done in-doors if you have a basement.
•    Playing hopscotch – can also be done indoors on a foam version of this old time favorite
•    Bouncing a ball, throwing a ball, hitting a ball…children love balls
•    Dancing – my grandsons (a 3 year old and a 14 month old) become hysterical when we dance together.   We can do it on and off for hours to the beat of pop music.  We even “seat dance” during long car rides.  You can teach a 2 year old to “raise the roof” which provides more exercise than you might think.
•    Shooting hoops – you can now get back-boards that are adjustable for younger children and simply grow with them.  If that isn’t in the budget, many parks have hoops, just bring your own basketball
•    A trampoline – either an in-door or an out-door version, is a great way for kids and their parents to get exercise in a confined space
•    Hiking is a great family activity – or barring a convenient place to hike, walk with your child to a nearby store instead of driving

In general, the more fun it is, the more likely they are to engage.  For example, little children love running through water sprinklers, even the ones who don’t enjoy swimming. They can get plenty of exercise at a water-playground, which more and more parks have instead of pools. Or you can purchase an attachment for your backyard hose that many children find delightful.

Maybe your child doesn’t like organized sports such as basketball, soccer, soft-ball or tennis. Let him or her kick the soccer ball around in the park, or hit a tennis ball against the garage or play a game of PIG with you at a local park. Parents tend to lose sight of why children need sports in their life. They need the exercise. Yes they need to learn self-discipline and sportsmanship and how to be a part of a team, but too often the pressure to be great at all of these things backfires and the child’s self-image is damaged.  Some children turn to food as a way of compensating for low self-esteem.  Others decide that they are inadequate when it comes to sports and refuse to engage in any physical activities as teenagers and young adults.

The idea, especially for little children, is for them to have fun using their bodies and being creative when it comes to entertaining themselves.  If you are a city dweller and your child does not have access to a soccer field, but you live on a street where there isn’t much traffic, help the neighborhood children organize a street ball or sand lot game. Children learn a lot about cooperation and teamwork when they are the ones responsible for organizing their free time.

This is all easier if you start them off on the right foot, i.e. when they are very small.  But don’t worry if you haven’t.  There is no time like the present. Start slow and keep trying. You couldn’t make a better investment in your child’s health and well-being!

Filed under: Services on October 22nd, 2008 | No Comments »