Tag Archives: Binging Anorexia

The Norton Center Video – Eating Disorder Therapy in Cincinnati

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

Eating Disorder Research

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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

 

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://edpro.wpengine.com’

The Connection Between Leptin Levels and Eating Disorders

Leptin

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Recently the Division of Endocrinology at the University of Kentucky College of Medicine performed a study on the connection between Leptin levels and eating disorders. Leptin is a peptide hormone neurotransmitter produced by fat cells and involved in the regulation of appetite. It signals your brain when you’ve eaten enough and stimulates you to burn more calories. In order to span a full range of human body weights for their investigation, the analysts, examined serum leptin levels in anorexic, bulimic, obese, and control individuals.

Compared to the analysis generated from non-anorexic patients, patients with anorexia nervosa were found to have much higher serum leptin levels values. In effect, having leptin levels so high is contributory to a blunted physiologic response to being underweight and consequently builds resistance to dietary treatment. Simply put, they have too many of these leptin hormones being sent to the brain that are saying, “You are full.” Therefore, anorexic patients repel the need to consume enough of the nutrients their body realistically needs to function properly.

On the other hand, what this study found in bulimic patients when compared to non-bulimic patients is the opposite effect. Bulimic patients were found to have much lower leptin levels. This deficiency of leptin hormones is usually caused by a form of Leptin resistance and this contributes to the patients food-craving behavior. The Leptin resistance found in most bulimic patients comes from a chemical surge located in the pleasure center of our brain. This chemical surge overrules leptin’s messages that are trying to tell the bulimic patient “your tank is full.” So in other words, there is a chemical battle going on inside a bulimic patients brain. The leptin hormones are trying to tell the defense to kick in and protect them against overeating but at the same time, in a much louder voice, the pleasure center of the brain is saying, “No! Pass those cookies this-a-way.”

When examining leptin levels in most obese people, it was found that they actually have high leptin levels. However, their bodies usually cannot respond to these leptin hormones because they have another form of leptin resistance. Instead of leptin messages being rejected and overruled by the pleasure center of the brain (like the type of resistance indicated in most bulimic patients), obese patients cells’ have completely stopped accepting leptin messages all together. Therefore, they do not receive any message from their leptin hormones that would be telling them to stop eating.

Essentially, regulating your leptin levels and defeating leptin resistance plays a large role in overcoming an eating disorder. Foods that are high in sugar or additives such as high fructose corn syrup and MSG should be avoided because these ingredients excited the pleasure center of your brain making it much more difficult to respond to your leptin hormones. So basically, the more foods you consume with these ingredients, the louder the voice saying, “Pass those cookies this-a-way,” will become and the softer the voice saying, “You are full!” will become. Also, your cells become more sensitive and responsive to leptin when you exercise and build muscle!

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://edpro.wpengine.com’

Sources:

The National Center for Biotechnology Information – Leptin in anorexia nervosa and bulimia nervosa: importance of assay technique and method of interpretation (http://www.ncbi.nlm.nih.gov/pubmed/11919545)

 

Bulimarexia: Why Are We Seeing More of It?

Bulimarexia Treatment Cincinnati

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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