Archive for the ‘Eating Disorders and Obesity’ Category

What role has the American culture had in the development of eating disorders and obesity?

Sunday, May 29th, 2011

Right now, America has the distinction of being one of the top ten countries in the world for overweight adults.  60% of all American adults are classified as overweight, one out of four being morbidly obese. Also, obesity is increasing at such an alarming rate among U.S. children that they will be the first generation in decades that are projected to have a shorter lifespan than their parents! The question we must ask is why is this happening?  A common theory is that we are lazy slugs who eat too much and exert too little. Really?

First of all, let’s consider our lifestyle.  With the advancement of technology, most developed nations have experienced negative health consequences of more sedentary lifestyles.  However, when it comes to exercising and activity level, Americans are actually right in the middle of the pack. Yet still, we are at the top of the list for obesity and the attendant health problems! So much for our lack of physical fitness as the answer!

If it isn’t the exercise, it must be the way we eat.   Cross-cultural studies have demonstrated that “Westernized” societies are at greatest risk for obesity and weight related health problems. Of the top ten heaviest countries in the world, eight are located in the South Pacific. The only exceptions are the U.S. and Kuwait. Guess what the other eight have in common? If your thinking coconuts, think again. It’s us, the U.S. of A! For the past 50 years these eight countries have established significant economic ties with the U.S., which caused a surge in Western food imports and significant changes in their diet. Namely, they ate more processed and fast foods that originated in the U.S. Likewise, although China and Japan rank 148th and 163rd respectively for obese adults, compared to our ranking of 8th, both countries have shown marked increases in obesity the more “westernized” they have become.  Nothing like a Micky D’s to increase the average waist size of the populace!

These statistics demonstrate that the American diet has some major issues. But how is it that our food supply has become so fattening and why in the world have we allowed it? One of the issues is that we are dependent upon the convenience of packaged and/or fast foods. We like things now, because we don’t have time to wait. We are overworked to the point of having to rely upon the convenience of basic things like already prepared foods, because we simply don’t have the time to shop and cook.

It’s true, American workers play less and work more than the workers of any other developed nation in the world. In a report comparing international vacation and holiday laws, the researchers found that the United States is the only advanced economy that does not guarantee its workers any paid vacation or holidays. And vacation time is not the only problem. American workers are overworked day in and day out as well. Consider the following: At least 134 countries have laws setting the maximum length of the workweek; the U.S. does not. In the U.S. 85.8 percent of males and 66.5 percent of females work more than 40 hours per week, and according to the International Labor Organization, “Americans work 137 more hours per year than Japanese workers, 260 more hours per year than British workers, and 499 more hours per year than French workers.” The fact is that in our country, you’ve got to come in early, (before 7:00 a.m.) stay late, carry your cell and/or pager all weekend, and become a road-warrior, lest you fall behind in the never-ending work piled on top of you day in and day out! So we are not lazy, we are overworked!

Another part of the problem is that we have come to view cooking as an inconvenience.  It has become synonymous with being “old fashioned” or with traditionalism. As a result, we rely on packaged, processed, pre-cooked, pre-pared foods because it’s quick and easy. What’s wrong with that? Nothing except that these prepared foods are TOXIC.  The FDA looks the other way while food manufacturers pocket the profits from loading our food supply with additives that are addictive and cheap to manufacture.

Hard to believe?  Believe it. The research has been done. The data is good. The information is out there. The U.S. food industry has been polluting our food supply with addictives, poisonous additives called excitatory neurotoxins, like MSG, high fructose corn syrup, Splenda, and NutraSweet since the 1970’s.  These neurotoxins have been shown to cause all manner of neurological problems as well as obesity and it’s complications.  Guess when we started to become more obese? The 1980’s, shortly after we began to ingest sweeteners, and all manner of hydrolyzed proteins that literally excite the neurons in the centers of our brains that were designed to regulate appetite and fat storage!  At about the same time the rates of autism, ADD, Aspergers, Alzheimer’s, Parkinson’s and a number of different types of cancers, all of which appear to be driven by environmental toxins, began to climb, peaking recently. The sad thing is that these issues are not even on the radar of the vast majority of Americans, who blame themselves for their obesity, binge eating, bulimia, anorexia and all manner of disturbed eating patterns. Where does it end?

Sources:

Forbes Magazine (online version) – World’s Fattest Countries (http://www.forbes.com/2007/02/07/worlds-fattest-countries-forbeslife-cx_ls_0208worldfat.html)

New York Times (online version) – Americans’ International Lead in Hours Worked Grew in 90′s, Report Shows (http://www.nytimes.com/2001/09/01/us/americans-international-lead-in-hours-worked-grew-in-90-s-report-shows.html)

DORway (http://www.dorway.com)

Russell Blaylock, MD (http://www.russellblaylockmd.com/)

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.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://www.eatingdisorderpro.com’

Is There Really a Connection Between Full-Time Working Moms and Child Obesity?

Wednesday, May 25th, 2011

photo used under creative common license

Over the past 35 years, the percentage of U.S. mothers who hold down a job while raising kids have soared from less than 50% to more than 70%. During this same time frame, the childhood obesity rate-which is now close to 17%- has more than tripled. Many researchers are claiming that there’s a direct connection between these two figures. The journal of Childhood Development just published a study, which showed that the longer a mother is employed, the more likely her children are to be overweight or obese. The study demonstrated that for each additional five-month period that his or her mother is employed, a child of average height could be expected to gain 1 extra pound over and above normal growth. In addition, six graders with working mothers were found to be six times more likely than those with stay-at-home moms to be overweight.

Another study published in Business Week supports this same concept, finding that was a correlation between the number of hours a women works outside the home and the BMI of her children. This research found that for a third grader of average height, the increase in BMI was equivalent to an extra one and a half to two extra pounds over what that child would normally gain in a year.

With studies like these being done, the idea that American kids are getting fat because women work outside the home now, could seem convincing. But hold on. These are correlative studies, not experimental research. The problem with these conclusions is that there may be several other things occurring simultaneously “causing” or contributing to this dietary epidemic.

Obviously, if women are spending long hours at work, as many do, home cooked meals are less of an option. In our nation it has become far too common for the wife to pop something pre packaged into the oven at night or pick up a pizza on her way home in order to accommodate her family with a meal that is quick and tasty.

The issue is that convenience foods have become a way of life for Americans. The ability to buy ready-made food is so much the norm that cooking for yourself seems like overkill, like you’re trying to win the best mom ever trophy. When push comes to shove, and it often does, most moms say the heck with it! Bring on the pizza. But that’s when the real problem kicks in, as processed foods are loaded with MSG, HFCS, Aspartame and Acesulfame, all of which are neurotoxins and all of which contribute to weight gain or disturbed eating. It doesn’t matter if the wife had the WHOLE DAY to cook a meal anymore because she wouldn’t anyway. Not when she can just run down the street to KFC and have a bucket of chicken in less than 10 minutes.

Thus it is the additives in these convenience foods that are directly responsible for why our nation and our children have become so fat. The percentage of mothers working full time may have gone up over the past 35 years, but so has the amount of MSG and high fructose corn syrup being poured into the foods we buy. They are found in just about all prepackaged, frozen and fast foods. They keep our stomachs saying “yum!” and “more,” and our blood sugar levels on a constant rollercoaster.  Working mothers who have jobs don’t directly cause weight problems in their children. Reliance on and trust in processed foods containing dangerous addictive additives should be getting blamed. Unfortunately, most people don’t even know they’re there!

Sources:

Verropoulou G, Joshi H. Mothers’ Employment and Child Development. London, UK: Center for Longitudinal Development. 2006.

Business Week (online version) – WHAT! WORKING MOTHERS = FAT KIDS??? (http://www.businessweek.com/careers/workingparents/blog/archives/2007/05/who_knew_seems.html)

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.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://www.eatingdisorderpro.com’

Diet Foods and Artificial Sweeteners Cause Weight Gain

Tuesday, February 15th, 2011

So if sweeteners are so bad, why are so many people using them? Because they believe the alternative, weight gain, is worse. Think again: Research shows that people who use artificial sweeteners eat more than those that do not. We know that MSG, HFCS, and artificial sweeteners are all excitoxins, which means that they stimulate neurons to death. Excitoxins over-stimulate and damage the parts of the brain that regulate healthy eating behavior. In a study that included more than 18,000 people, researchers found that healthy adults who consumed at least one diet drink a day significantly increased their chances of gaining weight.

I find that my patients with the most intense food addictions consume diet soft drinks and diet gum in huge quantities. Many of them chew sugar free gum or drink diet soft drinks all day long. Some of them go through a pack of gum an hour while others have 5 to 10 cans of diet soft drinks a day and some do both. This is often a conscious decision to help them avoid eating. Of course, it doesn’t work. By evening, they are starving and usually end up overeating. For those with Bulimia, the intense hunger can trigger a binge/purge cycle. The research above would predict such an outcome. They are not experiencing normal hunger, they are voraciously hungry, psychologically and emotionally starving. This intense drive for food can take over their lives. They pass on social events, give up relationships and even put academic or career goals aside in the service of their nightly feeding ritual. At some point, they cannot wait until evening and that is when the addiction really becomes unmanageable.

“In a Purdue study, rats whose diets contained artificial sweeteners appeared to experience a physiological connection between sweet tastes and calories that drove them to overeat.”

The article goes on to say: “The information may come as a surprise to the 59 percent of Americans who consume diet soft drinks, making them the second-most-popular low-calorie, sugar-free products in the nation, according to a consumer survey from the Calorie Control Council, a nonprofit association that represents the low-calorie and reduced-fat food and beverage industry.”

(The Purdue’s researchers’ study, “A Pavlovian Approach to the Problem of Obesity,” appears in the July issue of International Journal of Obesity. Follow this link: http://news.uns.purdue.edu/html4ever/2004/040629.Swithers.research.html)

Most of these sweeteners also contain MSG, known for its propensity to destroy the body’s natural weight regulatory systems, as well as for its potential to increase the odds of heart attack and stroke. Is it worth it? Of course not! But this isn’t like smoking or drinking. You know when you light up or take that drink that you are putting a toxin into your body. And you know that it might be habit forming. But who would think that organic baby food, milk, or chicken broth would have a carcinogenic, neurotoxin in it? No one would knowingly eat toxic food additives while pregnant or feed them to their newborn baby, let alone have a steady diet of them for themselves and their families. But that is what’s happening. The result is that majority of us have unknowingly become addicted to these substances. For many, the problems are so severe, and the causes so obscure, that they suffer life-threatening medical and/or psychological consequences before seeking help. The saddest thing is that they blame themselves. Who else are they going to blame, none of the food producers take responsibility. There appears to be no accountability whatsoever. And where is the FDA? Isn’t its sole purpose to protect the consumer?

There is an epidemic of obesity in this and every other country that has become westernized and adopted our eating habits. A man in France went to jail for actively protesting against having a Micky D’s put up in his town. We have much to learn from the French! Other countries have not been so fortunate to have a brave man like this Frenchman. We are in the top ten fattest countries in the world. Of the other nine, eight are countries that import our food and have adopted our lifestyles. What more is there to say?

Want to help? We are presently putting together a list of grocery store chains as well as specific food brands that do not contain MSG or HFCS. Please help us. If you are an organization that produces food without these additives, please contact us at the address on my website. We will publish the information if it checks out. If you are a consumer and you find a brand or a specific food item, let us know! We can help each other.

Here is something else to try. Be an proactive consumer. I have been asking my local grocer every time I shop there for the past 5 years if they carry a particular item in an organic version. Whether it has anything to do with my efforts or not, the organic section at my Krogers is getting bigger all the time. In the past 6 months, I have started asking if they can help me find a box of cereal, or carton of milk, or a drink, for example, with no MSG and no HFCS. The saddest thing is that most of the time, they genuinely have no idea what to look for. They almost always tell me that all of their organic products are free of these substances! When I explain to them that this not so, and point out how many organic foods contain those substances, they find it hard to believe. I patiently explain how many different names the substances have, and whip out my list. I’m quite sure that they take me for a flake. But as often as not I end up leaving it behind at their request. I often see them looking at the list and shaking their heads. It’s overwhelming and a bit daunting to see how far we have to go, but it’s a start. Don’t be discouraged at the lack of information. Five years from now, most people will know much more about these things. Right now, my grocers run when they see me coming. One manager waves the list at me from across the store. I’m not sure if he is trying to look cooperative, or if he is trying to discourage me from approaching him again! I do anyway :)

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.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://www.eatingdisorderpro.com’

An Intro to MSG: The Nutritional Truth

Wednesday, January 5th, 2011

The article below is a summary of the video from Dr. Vincent Bellonzi which discusses the origins, facts and effects of MSG. Watch his video, “The Truth about MSG Monosodium Glutamate Clinical Nutrition” here: http://www.youtube.com/watch?v=g-pnzj0c06Q.

What if I were to tell you that there is a chemical being added to food that has been scientifically proven to effect how the body’s nervous system is formed so that as a person’s brain develops, they may have learning or emotional difficulties? Would it concern you to know that there is also credible evidence that this chemical could permanently damage a critical part of the brain that controls hormones, which could consequently cause a person to experience endocrine problems? To continue, I could tell you that this chemical has been identified to hasten brain tumors, and furthermore, that this chemical has been demonstrated to aggravate and even generate several epidemic neurodegenerative brain diseases such as Parkinson’s disease, Huntington’s disease, ALS, ADD, ADHD, and Alzheimer’s disease.

The chemical that I am describing, known as MSG or Monosodium Glutamate was introduced to the food industry a long time ago because it was found to enhance the taste of food. At first, it was only added to babies’ food because it made babies who would not eat, become more excited about eating; but today it is being added in significant amounts to almost all processed foods, fast food items, and even sit down restaurant foods items. The food industry knows that they can make anything taste good by adding MSG. To be honest, they can even make dirt taste good if they add MSG to it! This is because the glutamate that’s in MSG excites the body’s reward system as it’s being consumed. So, it sends an excitatory message to the brain and as a result, a person thinks whatever they’re eating tastes a lot better than it actually does.

The problem with MSG and the food industry is this: the food industry is constantly competing for consumers. To make their food taste better than competitors they add more MSG to it. As a result, the amount of MSG that is being added to our food today has become far too concentrated for our nerves to handle properly. Thus, our nerves overexcite when we consume the chemical and by frequently overexciting our nerve impulses we are severely damaging our neurons. Damaging neurons as so, causes a person to lose control of their emotions and their ability to think. This is a really terrible combination that can create or worsen a number of behavioral health related conditions. For example, for children suffering from autism it makes a bad situation worse. There have been countless cases of autistic children whom could not even speak, completely recover by entirely eliminating MSG from their diets. Same story holds true for people who have suffered from obesity, depression, bulimia, ADD, ADHD, and other disorders.

Statistics also show that with the increase in MSG consumption there has been a correlating increase in several neurodegenerative brain diseases, behavioral disorders, and brain tumors. For example, Alzheimer’s disease was not even an identifiable healthcare cost before MSG, but since the food industry began adding this chemical to their food the number of people who suffer from this disease has sky rocketed. It now ranks third, after cancer and heart disease, among the most costly health problems in America.

The science behind what the chemical is doing to our body is clear. Countless amounts of evidence justify it, and the statistics prove it. MSG is extremely harmful. So why on earth is the FDA doing nothing to regulate our consumption of MSG? In fact, the FDA has classified MSG as “generally regarded as safe,” (GRAS). Therefore, sets no limit as to how much MSG gets poured into the food we consume and today Americans are consuming over 300 million pounds of it! When will this stop?

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.

© 2011, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2011, Dr J Renae Norton. http://www.eatingdisorderpro.com’

What Role Does the Family Play in An Eating Disorder?

Friday, July 30th, 2010

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://www.eatingdisorderpro.com’

Incidence and Risk Factors of Eating Disorders

Thursday, July 1st, 2010

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://www.eatingdisorderpro.com’

Relationship Between Obesity and Eating Disorders?

Thursday, July 1st, 2010

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.

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://www.eatingdisorderpro.com’

Childhood Obesity

Thursday, July 1st, 2010


  • 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.

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://www.eatingdisorderpro.com’

Bulimarexia: Why Are We Seeing More of It?

Tuesday, May 4th, 2010

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.

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://www.eatingdisorderpro.com’

Night Eating Syndrome & Sleep Related Eating Disorders

Wednesday, November 4th, 2009

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.


Sources:

Allison K, Stunkard A, Thier S. Overcoming Night Eating Syndrome. Oakland, CA: New Harbinger Publications; 2004.

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