Eating Disorder Pro » Bulimarexia

Coconut Oil and Malnutrition

Dr. J Renae Norton — Mon, 10 Oct 2011 15:58:03 +0000

It’s a great honor to have Dr. Bruce Fife as a guest writer today. Dr. Fife was kind enough to write about some of the effects of coconut oil on malnutrition. Dr. Fife is an internationally recognized expert on the health and nutritional benefits of coconut oil and all coconut products. He operates the ‘Coconut Research Center’, a not-for-profit organization dedicated to educating the public and medical community about the many benefits of coconut and palm products. He has authored many books, including: ‘The Coconut Oil Miracle’, ‘The Palm Oil Miracle’, ‘Coconut Lover’s Cookbook’, ‘Eat Fat, Look Thin’ and most recently ‘Stop Alzheimer’s Now’. These books are highly recommended reads, and can be purchased at Amazon.com, and Piccadilly Books.

Coconut Oil Can Help Prevent Malnutrition

By: Dr. Bruce Fife

Coconut oil can be an excellent way to increase the nutritional content of foods and improve nutrient absorption. Coconut oil is different from other fats and oils because it is made primarily of a unique group of fats known as medium chain triglycerides (MCTs). Most all others fats in our diet are composed of long chain triglycerides (LCTs).

One of the advantages of MCTs over the more common LCTs is their speed and efficiency in digestion. MCTs digest very quickly, with minimal effort and stress placed on the body. LCTs require pancreatic digestive enzymes and bile in order to break down into individual fatty acids. MCTs, on the other hand, break down so quickly that they do not need pancreatic digestive enzymes or bile, thus reducing stress and conserving the body’s enzymes. The digestive systems of those people with malabsorption problems often have a difficult time digesting LCTs. Not so with MCTs. Consequently, MCTs provide a superior source of energy and nutrition than do LCTs.

The difference in the way MCTs are digested is of great interest in medicine because it provides a means by which a number of medical conditions can be successfully treated. Replacing a portion of the LCTs normally found in the diet with MCTs has allowed doctors to successfully treatment of a variety of malabsorption syndromes including defects in fat digestion and absorption, pancreatic insufficiency, liver and gallbladder disorders, defects in protein metabolism, cystic fibrosis, and celiac disease. MCTs can even, speed recovery after intestinal surgery.

Because of MCTs are digested more efficiently, they also improve the absorption of other nutrients. As far back as the 1930s researchers noticed that adding coconut oil to foods enhanced the food’s nutritional value. For example, researchers at Auburn University studied the effects of vitamin B-1 deficiency in animals given different types of fats. Vitamin B-1 deficiency leads to a fatal disease called beriberi. When rats were given a vitamin B deficient diet, coconut oil was effective in preventing the disease. Coconut oil doesn’t contain vitamin B-1. So how did coconut oil prevent a vitamin B-1 deficiency? Coconut oil made what little of the vitamin that was in the diet more biologically available, thus preventing the deficiency disease.

A number of studies have found similar effects. Coconut oil improves the absorption of not only the B vitamins but also vitamins A, D, E, K, beta-carotene, lycopene, CoQ10, and other fat soluble nutrients, minerals such as calcium, magnesium, and some amino acids—the building block for protein. Adding coconut oil to vegetables can increase the absorption of beta-carotene, lycopene, and other nutrients as much as 18 times!

What this means is that if you add coconut oil to a meal, you will get significantly more vitamins, minerals, and other nutrients out of the food than if you used soybean oil, canola oil, or another oil, or if you used no oil at all. Simply adding coconut oil to a meal greatly enhances the food’s nutritional value.

This fact has led researchers to investigate its use in the treatment of malnutrition. For example, coconut oil, mixed with a little corn oil, was compared with soybean oil for the treatment of malnourished preschool-aged children in the Philippines. The study involved 95 children aged 10-44 months who were 1st to 3rd degree malnourished. The children were from a slum area in Manila. The children were given one full midday meal and one afternoon snack daily except Sundays for 16 weeks. The food fed to the children was identical in every respect except for the oil. Approximately two-thirds of the oil in their diet came from either the coconut oil/corn oil mix or soybean oil. The children were allocated to one of the two diets at random: 47 children received the coconut oil diet and 48 children the soybean oil diet. The children were weighed every two weeks and examined by a pediatrician once a week. At the start of the study the ages, initial weight, and degree of malnutrition of the two groups as a whole were essentially identical.

After the 16 weeks, results showed that the coconut oil diet produced significantly faster weight gain and improvement in nutritional status compared to the soybean oil diet. A mean gain of 5.57 pounds after four months was recorded for the coconut oil group, almost twice as much as the weight gain of the soybean oil groups of 3.27 pounds.

Coconut oil or MCTs is included in all hospital infant formulas. Premature infants whose digestive systems are not fully matured have a difficult time digesting most fats. However, they can handle MCTs. When coconut oil is added to their formula they grow faster and have a higher survival rate. Adults also benefit with the addition of coconut oil. For this reason, coconut oil or MCTs are also included in the feeding formulas given to hospital patients of all ages. When MCTs are added to nutritional formulas, patients recovering from surgery or illness recover faster.

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.

What You Need to Know In Order to Help Your Obese or ED Patient

Dr. J Renae Norton — Tue, 27 Sep 2011 00:16:23 +0000

Research has clearly established a relationship between neurotoxins such as MSG, high fructose corn syrup (HFCS) and sweeteners Splenda and NutraSweet and the current epidemic of obesity. I believe that there is also a relationship between these neurotoxins and the proliferation of eating disorders in the US. For example, research has shown that patients suffering from Anorexia as well as those who are obese, suffer from a condition called leptin resistance.^¹^,² Further, this condition appears to be a function of the type and amount of neurotoxin ingested. In my practice, when I have helped those suffering from Anorexia, Bulimia, and Bulimarexia and obesity eliminate such neurotoxins from their re-feeding regimens, recovery time has shortened and the likelihood of relapse has decreased significantly. (I am in the process of publishing these anecdotal results and have also applied for several grants to research this relationship experimentally in greater depth.)

Treatment of obesity and eating disorders is negatively impacted for the uninformed treating professional i.e. re-feeding is a nightmare for those suffering from Anorexia, Bulimia, Bulimarexia, Binge Eating Disorder and Obesity when the role of these neurotoxins is not taken into consideration. Thus, to the degree that their impact on the eating habits of individuals suffering from ED’s and obesity is not understood, or worse, ignored, treatment is less likely to succeed, and in many cases, more likely to make the problem worse. For help on refeeding contact me directly. Also check out all of the blog articles on this site. ^³

For the past 40 years food additives, known to have neurotoxic effects, especially in children, have been added to the American food supply because they were profitable. These additives include MSG, sweeteners Aspartame and Aceulfame, (Splenda and NutraSweet) growth-enhancing hormones, and pesticides that are incorporated into the DNA of crops like soybeans. The amount of these neurotoxins added to our food has increased enormously since their introduction. For example, since 1948 the amount of MSG doubled every decade. By 1972 over 262,000 metric tons were being added. (Whetsell, 1993)[1] Today it is impossible to determine the actual amounts of the various neurotoxins that are added to the U.S. food supply, as the additives are effectively unregulated by the FDA or any other regulatory agency. As a result, they can be added in ways which make them difficult, if not impossible, to quantify.

Besides being difficult to quantify, the additives are very difficult for the average consumer to identify, as they can be called such innocuous names as “citric acid” “malted barley” and “natural flavoring”! Even for individuals who are well-informed, and therefore know what to look for, it is still a daunting task to try and avoid them. Presently, they are in 90 to 95% of all packaged, bottled, and/or processed foods, including organic and/or foods that are marketed as “healthier” choices.

Perhaps the most alarming issue is that food manufacturers target children’s foods for inclusion of these additives. In the U.S. to day, 1 in 3 children are obese. Many will remain that way for life. We are one of the only countries in the world to have children who suffer from Type II Diabetes, which heretofore has been a disorder of middle adulthood. The connection between childhood obesity and an eating disorder such as Anorexia, for example, is that a history of premorbid obesity increases the risk of the development and decreases the likelihood of recovery from the disorder.

1 J Lab Clin Med. 2002 Feb;139(2):72-9.Leptin in anorexia nervosa and bulimia nervosa: importance of assay technique and method of interpretation.

2 Metabolism: Clinical and Experimental [1997, 46(12):1384-9]Neuropeptide Y, galanin, and leptin release in obese women and in women with anorexia nervosa.

3 Other resources: http://dorway.com/ http://www.drkaslow.com/html/leptin_and_amylose.html www.msgtruth.org/obesity.htm

What Role Does the Family Play in An Eating Disorder?

webmaster — Fri, 30 Jul 2010 22:23:45 +0000

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.

Bulimarexia: Why Are We Seeing More of It?

Dr. J Renae Norton — Tue, 04 May 2010 22:38:37 +0000

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 by following the survey link at the bottom of this page.)

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.

Characteristics of Binge Eating

Dr. J Renae Norton — Thu, 30 Jul 2009 17:05:51 +0000

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%

Grocery Shopping – Simple Task or Time Consuming Nightmare?

Dr. J Renae Norton — Thu, 18 Jun 2009 18:25:05 +0000

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.

BULIMAREXIA, DID YOU KNOW?

Dr. J Renae Norton — Tue, 16 Jun 2009 20:07:19 +0000

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.