Eating Disorder Pro » Anorexia

News You Can Use – January 15 – 22

Dr. J Renae Norton — Mon, 23 Jan 2012 21:22:35 +0000

There is so much information in the news about our health these days, that it can become quite overwhelming. In hopes of relieving some of the stress this can inflict on both my patients and my readers, I’ve highlighted some of the weekly health news that was of particular interest to me. Here is your news update for the week of Jan 15-22 2012!

Obama says NO to WhiteHouse.gov petition to legalize raw milk at federal level
Popular orange juices flavored with secret “flavor packs” not listed on the label
New scientific study links bee deaths to pesticides
Kids may have higher obesity risk if dad is overweight, study says
Consumers’ thirst for organic milk exceeds supply
Effort gets underway to require GMO food labeling
The Truth About Natural Foods
3 Surprising Reasons to Give Up Soda
Watching ‘The Biggest Loser’ may increase anti-fat attitudes
A randomized controlled trial of adjunctive family therapy and treatment as usual following inpatient treatment for anorexia nervosa adolescents
Children Diet To Keep Off Pounds And Ward Off Bullying, Survey Says
Good Intentions Ease Pain, Add to Pleasure
Mindful Eating Restaurant Study

Were there any news articles that you saw this week that really grabbed your attention? Leave a comment with a link. If the article helped you, it will likely help some of my other readers!

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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.

iTherapy – Integrating the iPhone into Therapy

Dr. J Renae Norton — Wed, 18 Jan 2012 18:37:04 +0000

I recently read an article by Dr. Weissman of the Chicago Institute of Psychoanalysis that introduced the concept of using an iPhone in the treatment of anorexia and body dysmorphic disorder.

Times are changing faster than ever. Technological advances, such as the introduction of the iPhone, have drastically changed the way we communicate and perform everyday activities. We can easily observe our everyday lives via the video and photo component of the iPhone. Weissman believes that this component of iPhone technology could be an effective tool in the treatment of the body dysmorphia that often accompanies anorexia.

Many of my patients that are in treatment for anorexia also experience some level of body dysmorphia; they see an obese person looking back at them in the mirror even though they are drastically underweight. Today, body dysmorphia is typically treated through psychotherapy, nutritional support and medication. For some patients, these approaches have limited success rates.

When a patient talks to me about the “obese person” that they see in the mirror, I often introduce a body image exercise involving “photo-therapy”. I ask the patient to take a photograph of themselves and bring it to their next treatment session. Oftentimes, when the patient returns and we talk about the photograph, the same body that was once described as being “fat” and “obese” is now described as being “underweight” and “malnourished”.

Weissman explains that when an anorexic patient looks in the mirror, their self perception is instantly fused with a distorted body image. The brain is so overwhelmed by this distortion, that it cannot process the image of the “real” body. The brain becomes trapped in this optical illusion, this distorted view. In contrast, when an anorexic patient sees his or her self in a photograph, the brain first acknowledges that there is a person in the photograph, it then focuses on the physicality of the photographed person. The brain then sends the message to the patient that they are the person in the photograph.

Integrating iPhone Therapy into the treatment of anorexia could definitely be a powerful tool in overcoming the body dysmorphia associated with anorexia. Based upon psychotherapy techniques developed by Frieda Fromm-Reichmann in Principles of Intensive Psychotherapy I, the steps below are Weissman’s suggested approach to integrating the iPhone into treatment:

Patient and therapist look at patient in the mirror. Patient describes what they see.
Therapist takes a photograph of the patient with iPhone. Patient describes what s/he sees.
Therapist and patient discuss the differences between the description of the patient in the mirror and the patient in the photograph.
A photograph of the patient standing beside the therapist is taken. Patient describes the image of the therapist. If the patient see distortion in the therapists image, the therapist and patient develop a jointly shared description of the therapist.
Patient describes image of self. If patient sees distortion, the therapist and patient develop a jointly shared description of the patient.

Weissman points out the importance of the therapist not correcting the distorted view of the patient. If the patient does experience distortion in the photograph, the therapist should remind the patient that they both agreed on the description of the image of the therapist in the same photograph. It is necessary that the therapist and patient try to come to an agreement on the description of the patient.

Weissman predicts that utilizing this iPhone exercise will lead to an eventual reduction in the amount of distortion that the patient experiences when looking in the mirror. A combination of iPhone Therapy, Cognitive Behavioral Therapy (CBT) and nutritional counseling may lead to the patient gaining the important ability to maintain a healthy weight with little outside assistance. If the therapist successfully teaches the patient to be able to independently perform this exercise on a regular basis, there could be a drastic drop in relapse rates.

Sources: “Photo-Therapy: A Promising Intervention in Anorexia Nervosa?” http://www.psychiatrictimes.com/eating-disorders/content/article/10168/2016956

News You Can Use – Jan 9 – 16 2012

Dr. J Renae Norton — Tue, 17 Jan 2012 02:31:17 +0000

Does Internet Addiction Disorder change teens’ brains?

Are ’50s moms to blame for today’s obesity rates?

Aspirin guidelines need overhaul, researchers say

Receptor for Tasting Fat Identified in Humans

Magnesium-rich diet tied to lower stroke risk

Exercise Hormone May Fight Obesity and Diabetes

Trans-Fats STILL Lurking In Grocery Store Foods

Will Ding Dongs, Wonder Bread, and Twinkies disappear? Hostess Brands to file Chapter 11 bankruptcy, again

New Approach To Diagnosing Anorexia Nervosa By Stages Of Severity

High-Fructose Corn Syrup is Harmful, New Research Concludes

Were there any news articles that you saw this week that really grabbed your attention? Leave a comment with a link. If the article helped you, it will likely help some of my other readers!

Appetite Hormones 101: Peptide YY

Dr. J Renae Norton — Thu, 05 Jan 2012 16:45:11 +0000

In this third and final installment of the series, “Appetite Hormones 101”, we will discuss Peptide YY (PYY). The purpose of this series is to explain the role of hormones on both appetite and body weight goals, as it relates to both weight loss and weight restoration. If you’re a new reader, be sure to check out “Appetite Hormones 101: Leptin” and “Appetite Hormones 101: Ghrelin“.

Peptide YY (PYY)

PYY is a hormone that suppresses appetite. It was discovered to play a role in digestion in 1985. PYY regulates food intake, and is believed to improve leptin sensitivity. The amount of PYY released by our bodies is influenced by the number of calories we ingest; the more calories we ingest, the more PYY is released. The diagram below shows how our PYY levels, ghrelin and leptin levels typically fluctuate before and after meals:

PYY levels are highest in individuals battling anorexia, followed by those individuals that are lean,which explains why both groups have less hunger and also may have more difficulty eating. PYY levels are lowest among obese and morbidly obese individuals. Individuals with bulimia also experience low levels of PYY, which helps to explain why all three groups feel more hunger. Research shows that the obese individual can decrease their PYY levels by 30% by reducing their body weight by 5.4%. PYY levels are not believed to be effected by weight restoration during recovery from anorexia. It is also important to note that high levels of PYY in anorexic individuals is associated with decreased bone mineral density (BMD).

Our mood also effects our PYY levels. Recent studies show that PYY levels are higher in those suffering from major depression. This explains why many people with major depression have a decreased appetite and experience weight loss.

PYY levels can be regulated through both diet and exercise. Diets high in quality protein tend to raise PYY levels highest, followed by diets high in healthy fats. High carbohydrate diets tend to raise PYY levels the least. Aerobic exercise has also been proven to raise PYY levels, whereas strength-training has no effect on PYY levels (although strength-training does lower ghrelin levels).

In conclusion, PYY regulates our appetite. The higher our PYY levels are, the more satiated we will feel. You can ensure your PYY levels are highest by eating a high protein diet and including aerobic exercise in our workout routine.

© 2012, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.
Please credit ‘© 2012, Dr J Renae Norton. http://www.eatingdisorderpro.com)’.

Sources
J Clin Endocrinal Metab. 2009 Nov; 94(11): 4463-71 Epub 2009 Oct 9

http://news.sciencemag.org/sciencenow/2006/09/06-02.html

http://jcem.endojournals.org/content/91/3/1027

http://www2.massgeneral.org/harriscenter/about_bn.asp

http://www.eatingdisordersreview.com/nl/nl_edr_18_1_5.html

http://www.thebonejournal.com/article/S8756-3282(08)00162-2/abstract

http://ajpregu.physiology.org/content/296/1/R29.full

J Endocrinal Invest. 2011 Dec 15 [Epub ahead of print]

News You Can Use – Dec 26 – Jan 1

Dr. J Renae Norton — Tue, 03 Jan 2012 16:34:24 +0000

Your weekly health news update!

Coconut Oil Protects Our Brain from the Effects of MSG

Five new government restrictions on food, medicine, and health freedom that are set to take effect on January 1, 2012

Global food giants are moving away from BPA in packaging

Add some vitality to your hot chocolate this winter

Trap of addiction invisible to users

Protecting babies from neurotoxins

Gluten-free diet linked to increased depression and eating disorders

Diet ‘can stop brain shrinking’

Obesity Linked to Changes In The Brain

The Most Delicious Appetite Suppressant on Earth

How Much of Your Food Labeled as Organic Is Actually Organic?
Fighting Anorexia – Eating IS medicine

Self-imposed standards are central to perfectionism in eating disorders
10 Things You Shouldn’t Say To An Eating Disorder Sufferer

Were there any news articles that you saw this week that really grabbed your attention? Leave a comment with a link. If the article helped you, it will likely help some of my other readers!

The Holiday Season – Tips to Reduce Stress

Dr. J Renae Norton — Wed, 21 Dec 2011 13:37:46 +0000

The holiday season is a particularly stressful time for many of my patients. Holiday gatherings are typically highly food-centered, which results in a lot of anxiety for those recovering from an eating disorder. I’ve created a list of useful tips on reducing holiday stress. I know this will help a lot of my patients!

Eat regularly throughout the day. Don’t skip meals in anticipation of a large dinner.

Be prepared. Try to find out what is being served ahead of time and work some of the foods you feel comfortable with into the meal. Bring one of your favorite dishes to share with the dinner guests, that way you will know you will have something you feel good about eating.

Discuss any specific concerns with your treatment specialist. Try to role play situations that you suspect may arise (such as comments about your weight, about your food choices etc). Be as prepared as you can be to avoid counter-productive coping behaviors.

Have an “emergency plan” in case you find yourself in a stressful situation. Get some fresh air, go to another room and practice some relaxation or deep breathing exercises, arrange for a close friend to be “on-call” in case you need someone to talk to.

Is someone going to be at the dinner that you feel makes healthy choices? Pay attention to what they are eating, their portion sizes. Use them as your reality check.

Set realistic goals. Don’t set yourself up for a stressful holiday season by over-scheduling yourself. You need to be your own #1. Make sure you leave some time to focus on yourself, allow yourself to get an adequate amount of sleep, engage in activities that make you feel good (exercise, relax or meditate).

Don’t isolate! Spend time with family and friends. If it isn’t possible to physically be with your loved ones, have a phone conversation or use Skype! Isolating yourself won’t make you feel better, in many situations it may even make you feel worse.

Be in the moment! Enjoy the time with your loved ones, have great conversations, laugh, make memories!

Sources:

http://ed-bites.blogspot.com/2010/11/tip-day-surviving-thanksgiving-without.html

http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/Holiday.pdf

Your Health in the News – Dec 12 – 19

Dr. J Renae Norton — Wed, 21 Dec 2011 04:49:52 +0000

Your weekly health news update!

Four Ways Monsanto Threatens the Environment and Public Health

Toxic Flame Retardant Detected in Popular Soda

The Best Place to Find Local Food this Winter

Why Eating Junk Food Just Twice a Week is Risky

Why Sugar Makes Us Sleepy & Protein Wakes Us Up

Obesity Rate Falls for New York School Children

UCSF Study Challenges Thinking on Anorexia

Enforcement Hammer Falls on Giant Arizona Organic Factory Farm Dairy

Were there any news articles that you saw this week that really grabbed your attention? Leave a comment with a link. If the article helped you, it will likely help some of my other readers!

Your Health In The News – Nov 27 – Dec 4

Dr. J Renae Norton — Tue, 06 Dec 2011 01:38:24 +0000

Your weekly health news update!

Do chemical flavors turn us into food addicts?

Yoga may ease insomnia, menopause problems

The Increasingly Absurd Fight Over High Fructose Corn Syrup’s Name

Many Anorexics Struggle with ‘Authentic’ Self

Your Ideal Weight Could Be Making You Fat

Fast food nutrition facts – mystery ingredients are industrial chemicals

How Exercise Benefits the Brain

Were there any news articles that you saw this week that really grabbed your attention? Leave a comment with a link. If the article helped you, it will likely help some of my other readers!

Appetite Hormones 101: Ghrelin

Dr. J Renae Norton — Thu, 10 Nov 2011 17:11:40 +0000

This is the second part of the series, ”Appetite Hormones 101″. This series is designed to explain the role of hormones on both appetite and body weight goals, whether it’s weight loss or weight restoration. “Appetite Hormones 101” will be made up of three articles that describe the major appetite hormones: leptin, ghrelin, and peptide YY.

Ghrelin

Ghrelin, discovered in1999 by scientists, is known as “the hunger hormone”. Produced in the stomach and pancreas, Ghrelin stimulates the appetite with the purpose of increasing the intake of food and promoting the storage of fat. So when Ghrelin levels are high, we feel hungry. After we eat, Ghrelin levels fall and we feel satisfied.

Leptin and Ghrelin have a “teeter-totter” relationship. When leptin levels rise, ghrelin levels fall. Likewise, when ghrelin levels rise, leptin levels fall.

Ghrelin levels are highest right before eating meals and lowest right after eating meals.

Leptin, acts on regulatory centres in the brain to inhibit food intake and increase energy expenditure, acting as a long-term regulator of body weight. Whereas Ghrelin is a fast-acting hormone that operates as a meal-initiation signal for short-term regulation of energy balance.

There are distinct abnormalities in the production of Ghrelin among obese and eating disordered individuals. Those with anorexia tend to have high levels of ghrelin which often normalize with weight restoration. Among those with bulimia, Ghrelin does not respond as strongly when food is eaten, which could contribute to binge eating as the individual suffering from Bulimia does not “get full” even if they have overeaten. Obese individuals tend to have low levels of Ghrelin, probably because they are Leptin Resistant, since Leptin and Ghrelin are inversely related. Research also shows that Ghrelin levels are higher after an individual loses weight, which may make it more difficult to maintain weight loss.

There are several easy things we can do to help manage ghrelin levels:

Eat a diet high in good quality protein (organic, grass-fed, free range etc. when possible)
Get an adequate amount of sleep
Practice meditation and relaxation techniques to reduce everyday stress
Drink plenty of water, since ghrelin levels are affected by thirst
Avoid processed fructose (especially high fructose corn syrup)

Although these things can make irregular ghrelin levels tolerable, the best way to normalize ghrelin levels is to address the root cause head on. In most cases, irregular ghrelin levels can be corrected by committing to living a healthier lifestyle through exercise, healthy dietary choices, weight restoration (for the anorexic individual), or weight loss (for the obese individual).

Sources:

Medscape News – Sibling hormone to appetite-boosting ghrelin has opposite effects, raising hopes for a new obesity treatment – http://www.medscape.com/viewarticle/538867

WiseGEEK – What Is Ghrelin? – http://www.wisegeek.com/what-is-ghrelin.htm

Journal of Pediatrics – Ghrelin levels in obesity and anorexia nervosa: effect of weight reduction or recuperation – http://www.jpeds.com/article/S0022-3476(03)00737-6/abstract

Appetite Hormones 101: Leptin

Dr. J Renae Norton — Thu, 27 Oct 2011 16:04:14 +0000

This series is designed to explain the role of hormones on both appetite and body weight goals, whether it’s weight loss or weight restoration. “Appetite Hormones 101” will be made up of three articles that describe the major appetite hormones: leptin, ghrelin, and peptide YY.

Leptin

Leptin, discovered by scientists in 1994, is also known as the “starvation hormone”. According to leptin expert, Dr Robert Lustig, leptin sends a signal to our brains that fat cells have enough stored energy to engage in normal metabolic processes. Every individual has an optimal level of leptin, which is thought to be determined genetically. When leptin levels are below optimal levels, the brain receives a message to conserve energy because the body is in a state of deprivation. When this occurs, the brain sends a message to the body that it is hungry (in an attempt to get the individual to eat) so that leptin levels can be restored to an optimal level.

Leptin levels are typically high in both obese and severely underweight/malnourished individuals. When leptin levels are too high, the individual experiences leptin resistance.

When an individual becomes leptin resistant, the body prevents leptin from passing through the blood brain barrier, which also prevents the brain from receiving the signal that leptin levels are at an optimal level. Instead, the brain senses that the body is in a state of starvation, and the individual becomes hungry. Leptin levels go up as a result.

High triglyceride levels also contribute to the prevention of leptin passing through the blood brain barrier. Triglyceride levels are often high in obese individuals as a result of poor dietary choices. In the individual with anorexia, triglyceride levels are often high because of liver damage and anorexia-induced hormone disruption.

If you think that you may be suffering from Leptin Resistance, there are several things that you can do.

Get plenty of sleep. Lack of sleep disrupts many hormonal processes, including leptin levels.
Avoid non-fruit sources of fructose. Studies show that fructose raises triglyceride levels, blocking leptin from crossing the blood brain barrier. To read more on these studies read “Fructose, Leptin and The Rapid Weight Gain They Can Bring”
Avoid lectins, (carbohydrate-binding proteins that are found in most plants, particularly seeds and tubers such as cereal crops, potatoes, and beans) especially those from cereal grains (rice, wheat, barley, corn and oats) as they tend to bind to leptin receptors, preventing leptin binding. This intensifies the affect of leptin resistance. For an easy cereal replacement, read my article on amaranth!
Cook and supplement with healthy fats, like coconut oil. Coconut oil lowers triglyceride levels, increases metabolism, and promotes healing in the gut (and liver for those recovering from anorexia).
Eat a high protein, low carb diet and stay active! Diet and exercise have the greatest effect on overcoming leptin resistance.

Sources:

BMC Endocrine Disorders – “Agrarian diet and diseases of affluence – Do evolutionary novel dietary lectins cause leptin resistance?” (http://www.biomedcentral.com/1472-6823/5/10)

Mark’s Daily Apple – “A Primal Primer: Leptin” (http://www.marksdailyapple.com/LEPTIN/)

The Fat Resistance Diet – “Leptin Resistance” (http://fatresistancediet.com/leptin-weight-loss/66-leptin-resistance)

Low Carb Age – “Leptin Resistance” (http://lowcarbage.com/blog/2011/04/07/leptin-resistance/)

Live Strong – “High Cholesterol Levels in Anorexia” (http://www.livestrong.com/article/86767-high-cholesterol-levels-anorexia/)

Science 2.0 – “Fructose, Leptin and The Rapid Weight Gain They Can Bring” (http://www.science20.com/news_releases/fructose_leptin_and_the_rapid_weight_gain_they_can_bring)