Tag Archives: refeeding

Why Rapid Weight Gain Decreases Treatment Success Rates

At many inpatient eating disorder treatment centers patients with anorexia nervosa are required to restore their weight quickly; I’ve had patients that were forced to gain 20 pounds in 21 days! Not coincidentally, 21 days was the amount of time that managed care would cover.  There are numerous reasons as to why gaining weight this quickly actually sets the patient up for relapse. Let’s look at what gaining weight at a rapid rate does to leptin levels.

In the malnourished, underweight anorexic, leptin levels are typically very low, due to low fat reserves. Usually, leptin levels reach normal levels during weight restoration. However, when weight is gained too quickly, leptin levels rise too quickly and may exceed the normal range. Of course this has the opposite effect needed for refeeding and individuals experience suppressed appetite and suppressed energy expenditure. As a result, it becomes increasingly difficult for the patient to eat, often interfering with the refeeding process.  Many of the patients who have had this experience, were told, in effect, that they were at fault, or “not trying”. The reason that this happens is that not enough practitioners know about Leptin and the role that it plays in re-feeding. For someone who already has control issues, this is an extremely painful and often damaging experience.

At the Norton Center, our anorexic patients are helped to restore their weight slowly, but steadily. This, along with other important nutritional factors, plays a major role in our high success. It is important to note that many treatment programs use weight gain at the conclusion of treatment as the measure of success.  This is a distortion in as much as the 20 pound weight gain is often gone in a matter or months, and sometimes in a matter of weeks. We measure success as weight gain that is maintained for a at least one year post treatment.  Currently, our success rates  for those patients that remain in treatment is about 90%; in comparison, many inpatient treatment centers experience a much lower success rate, or about 30 to 40%.

How Low Leptin Effects the Physical Complications and Behaviors Typical of Anorexia Nervosa

Low leptin plays a significant role in many of the physical complications and behaviors that are typically associated with anorexia nervosa; amenorrhea, hypothyroidism, hypercortisolism, osteopenia, immune changes, and increased physical activity.

Leptin levels of less than 1.85 µg suggests amenorrhea and subnormal luteinizing hormone (a hormone that stimulates ovulation) in women with anorexia nervosa. As leptin levels normalize through weight restoration, the hypothalamic-pituitary-gonadal axis may be activated. Not all patients with anorexia nervosa resume menses upon weight restoration.

The majority of women with anorexia nervosa exhibit osteopenia. Low leptin levels are also associated with a reduction in bone formation rate. Although there are other endocrine changes that contribute to osteopenia, low leptin levels appear to play a significant role.

Individuals with anorexia nervosa, often experience a compromised immune system. This could also be due, in part to low leptin levels although most of the compromised immunity is due to increased cortisol levels.  Cortisol is the hormone that we associate with stress.  Patients who are gaining weight too rapidly, are under considerably more stress, and may also be experiencing increased cortisol levels

Finally, up to 80% of patients with Anorexia Nervosa tend to engage in excessive physical activity. It is believed that there is an inverse correlation between food intake and physical activity during the weight loss phase. In other words, the lower the leptin levels, the more drive there is to exercise excessively, which causes more weight loss or less weight gain. One study demonstrated that patients reported a decreased feeling of restlessness or hyperactivity (need to exercise) as leptin increased during the refeeding/weight restoration phase of treatment.

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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.

© 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://edpro.wpengine.com’

Sources: Monteleone P. Di Lieto A. Castaldo E, et al. Leptin functioning in eating disorders. CNS Spectrums. 2004;9:523–529. [PubMed]

News You Can Use – Feb 5 – 12 2012

News You Can Use

“As an Eating Disorder Professional, I know that many of my clients that are in treatment for Anorexia, Bulimia, Bulimarexia, Binge Eating Disorder or Obesity are overwhelmed by all the information in the news about our health. In hopes of relieving some of the stress this can inflict on both my patients and readers, I’ve highlighted some of the weekly health news that was of particular interest to all of us at The Norton Center for Eating Disorders and Obesity. From my eating disorder treatment center in Cincinnati, here is your news update for the week of February 5-12 2012!”

8 Creepy Mystery Ingredients in Fast Food

More American Using Mobile Devices at Grocery Stores

Trans fat levels drop in US Adults

Is Adding Fiber to Food Really Good for Your Health?

Research Team Delves Into the Roots of Hunger and Eating

Mindful Eating as a Way to Fight Bingeing

HFCS Explained: Here’s Why It’s Far More Dangerous to Your Health than Table Sugar

Walnuts Help Protect Against Prostate Cancer, Osteoperosis and CHD

Neotame the next Aspartame? FDA doesn’t require labeling of the latest sweetener from Monsanto.

New Lavender Oil Clinically Proven to Relieve Occasional Anxiety

‘Hunger Hormone’ Could Help Chemo Patient
for more info on this Hunger Hormone, check out this article

With no firm science, sleep standards are slipping

How Healthy is Coconut Water?

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!

Let’s Connect!

Take my new Eating Disorder survey!

Like me on Facebook

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Contact Dr Norton by phone 513-205-6543 or by form

Inquire about booking Dr Norton for a speaking engagement

Read About Dr Norton

View video about Dr Norton

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.

© 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://edpro.wpengine.com’

Coconut Oil and Malnutrition

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.

HOW CHORES HELP CREATE HEALTHY HAPPY FAMILIES

benefits of household chores

3 Good Reasons to Assign Household Chores for Children:

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

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

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

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

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.

© 2009, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2009, Dr J Renae Norton. http://edpro.wpengine.com’

Grocery Shopping – Simple Task or Time Consuming Nightmare?

grocery shopping eating disorder anxiety

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.

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.

© 2009, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2009, Dr J Renae Norton. http://edpro.wpengine.com’