Yearly Archives: 2008

Prevention: Getting Your Child Off the Couch

childhood obesity treatment cincinnati

Currently in the United States we are experiencing an epidemic of obesity, especially among children. The fastest growing age group is from 2-5 years old.  Many of my patients started out as overweight children.

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. Prevention requires reaching children before the age of 6.

Here are a few tips to help your child be more active. Organized sports are great, but not all children are comfortable with competitive activities or they just get burned out on them. That can turn them off to being physically active, sometimes for good.

There are lots of other activities your child may enjoy besides organized sports.  Your best bet is to lead by example and keep it simple. It doesn’t have to cost a lot of money to keep your child active but it may require some creativity and it does take time. For busy parents, that means making the most of every opportunity. For example, little children love to help with things like vacuuming or gardening.  It won’t be as efficient, but it teaches them good habits and gets them off the couch.

Probably the single most important thing that you can do is limit the amount of time your child spends in front of the TV, and/or with electronic devices such as Game Boys and computers. These devices keep your child absorbed for long periods of time during which there is no physical activity. There is a growing body of research suggesting that the over use of electronics compromises neurological development and can lead to sleep disturbances, excessive aggression and even wrist and back injury. And of course, we know that the lack of activity is a key factor in the increased incidence of obesity.

Here are some other activities that may interest your child:

•    Riding a bike – ride with them if you can.  The best thing you can do is set an example!
•    Climbing on a jungle gym – If you don’t have one, they are in almost every park today.
•    Jumping rope – this can even be done in-doors if you have a basement.
•    Playing hopscotch – can also be done indoors on a foam version of this old time favorite
•    Bouncing a ball, throwing a ball, hitting a ball…children love balls
•    Dancing – my grandsons (a 3 year old and a 14 month old) become hysterical when we dance together.   We can do it on and off for hours to the beat of pop music.  We even “seat dance” during long car rides.  You can teach a 2 year old to “raise the roof” which provides more exercise than you might think.
•    Shooting hoops – you can now get back-boards that are adjustable for younger children and simply grow with them.  If that isn’t in the budget, many parks have hoops, just bring your own basketball
•    A trampoline – either an in-door or an out-door version, is a great way for kids and their parents to get exercise in a confined space
•    Hiking is a great family activity – or barring a convenient place to hike, walk with your child to a nearby store instead of driving

In general, the more fun it is, the more likely they are to engage.  For example, little children love running through water sprinklers, even the ones who don’t enjoy swimming. They can get plenty of exercise at a water-playground, which more and more parks have instead of pools. Or you can purchase an attachment for your backyard hose that many children find delightful.

Maybe your child doesn’t like organized sports such as basketball, soccer, soft-ball or tennis. Let him or her kick the soccer ball around in the park, or hit a tennis ball against the garage or play a game of PIG with you at a local park. Parents tend to lose sight of why children need sports in their life. They need the exercise. Yes they need to learn self-discipline and sportsmanship and how to be a part of a team, but too often the pressure to be great at all of these things backfires and the child’s self-image is damaged.  Some children turn to food as a way of compensating for low self-esteem.  Others decide that they are inadequate when it comes to sports and refuse to engage in any physical activities as teenagers and young adults.

The idea, especially for little children, is for them to have fun using their bodies and being creative when it comes to entertaining themselves.  If you are a city dweller and your child does not have access to a soccer field, but you live on a street where there isn’t much traffic, help the neighborhood children organize a street ball or sand lot game. Children learn a lot about cooperation and teamwork when they are the ones responsible for organizing their free time.

This is all easier if you start them off on the right foot, i.e. when they are very small.  But don’t worry if you haven’t.  There is no time like the present. Start slow and keep trying. You couldn’t make a better investment in your child’s health and well-being!


Centers for Disease Control and Prevention – Childhood Obesity Facts (

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.

© 2008, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2008, Dr J Renae Norton.’

You are what you eat!

eating disorder treament quotes

“Food is medicine. It’s powerful,We eat every single day, several times a day, so we have the opportunity to take medicine that’s good for us or medicine that’s not so good for us. I can only provide the information; people themselves are in charge of creating the right mindset to want to do this.” – Bauer


Bauer J, Svec C. Food Cures: Treat Common Health Concerns, Look Younger & Live Longer. Emmaus, PA: Rodale Books; 2007.

New Service: Metabolic Testing

What Is It?

HabiTrack is an effective, accurate metabolic monitoring and nutritional analysis system. It provides you with the information you need to manage your weight, whether you are re-feeding, losing or maintaining. It is customized specifically for you and it works!

Accurate, individualized, and continuous feedback are the key success factors in any behavioral change program! That is what we have created, a feedback loop that will allow you to re-establish or perhaps establish for the first time, a healthy relationship with food.

How Does It Work?

HabiTrack gives you a comprehensive analysis of your resting metabolism and 5 days worth of your typical food intake.

For those whose metabolism is unusually slow or fast, the goal will be to bring it into the normal range by making changes in food intake, exercise and supplementation. The system will allow us to accurately track the progress that you are making in doing this and make adjustments where necessary.

For those whose metabolism falls within the normal range, the system will take the guess work out of eating healthy, as you will know exactly how many calories/day you can eat to gain, maintain or lose weight. Research shows that most people needing to lose weight guesstimate too low, which results in YoYo’ing and increases the likelihood that they will fail and regain the unhealthy weight.

I believe that this is a program that many of you have been waiting for and I can’t wait to share it with you!

Who needs it?

Anyone trying to manage an eating disorder and everyone wanting a more healthy lifestyle!
If you are re-feeding as a result of being Anorexic, Bulimic or Bulimarexic your biggest fear is gaining weight in an uncontrolled way. Knowing your resting metabolism and the foods that you can eat without fear of rapid weight gain, allows you to begin the process of re-feeding with significantly less anxiety.

If you are overweight or suffering from Obesity, the research is clear that you probably cut your calories too much by dieting, which inevitably leads to failure and additional weight gain. Knowing the exact number of calories you burn while at rest usually allows you to eat much more than you think you should. This prevents you from slowing your metabolism down and insures your long term success.
The Process

Diagnostic Session:
In the initial session your RMR (resting metabolic rate) is taken, which will establish a base-line for your metabolism. You will be asked to provide us with a five-day food record, which we will analyze using a state of the art food analysis program. We will combine the results of the RMR and nutritional analysis in preparation for your consult with Dr. Norton.

Consulting Sessions:

During this session with Dr. Norton, you will be given feedback that accurately describes your metabolic status along with recommendations for eating and exercise strategies as well as supplements that have been shown to positively impact metabolism. The information has been customized to meet your unique nutritional, psychological and physiological needs.

Armed with this information, you can take charge of your recovery and/or your weight management. For individuals who are recovering from Anorexia or Bulimarexia, the information will greatly reduce the stress of re-feeding. For individuals suffering from obesity, or for those who are overweight, it will eliminate the need to diet, WHICH DOESN’T WORK!

Follow-up RMR Sessions:

We recommend that you repeat the RMR assessment monthly until you have met your metabolic goal. If you are engaged in activities to increase or decrease your metabolism, this will allow us to monitor the relative effectiveness of the changes that you are making and to make suggested changes when necessary.

Follow-up Food Analysis:

You can submit another food record for analysis at this time, or any time you wish, to Lesley or Elisa. Simply fill out the form below, cut and paste it into an email and send it to us at Your results will be emailed to you. If you are already a client, they’ll be in your chart at your next visit. We can even generate recipes and grocery lists that have been analyzed especially for you. Just let us know what you need!

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.

© 2008, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2008, Dr J Renae Norton.’

Eating Disorder as Addiction

Refeeding, A Step at a Time

Refeeding, A Step at a Time

Re-feeding: What is Normal? 

The central and most difficult issue to be dealt with in the treatment of serious eating disorders is the issue of re-feeding and/or the establishment of a healthy relationship with food. The degree to which the patient can do this determines her success in conquering her disorder. The problem is that “normal” eating is a very complicated phenomenon, let alone the intricacies of re-feeding. This is one of the reasons that the “cure” rate for eating disorders is so low.

In some ways, it is more difficult to treat a severe eating disorder than it is to treat alcoholism or drug addiction. There is no such thing as cold turkey when it comes to eating. We have to eat every day, preferably 5 or 6 times a day. Likewise we cannot avoid the situations that trigger maladaptive eating behavior like the alcoholic or drug addict can do in an attempting to recover from their addictions. We eat for many reasons, under many different circumstances. We eat when we are hungry, not hungry, starving or full. We eat to socialize, to celebrate and to mourn. We eat to reward, nurture or punish ourselves. We eat when we are procrastinating, trying to relax or as part of a “working” breakfast/lunch/or dinner. We eat when we are happy, sad, mad, or for some of us, whenever we feel emotional.

Dieting Doesn’t Work

An equally important part of eating is the whole “not eating” thing, also known as “dieting”.  Ninety-five % of US women believe that they are overweight and 65% of the general population diets. The dieting mind-set is so well ingrained in our society that some 5 and 6 year olds are worrying about how many calories and how much fat is in their Lunchables. Indeed, so many people in the US are dieting that it is a 93 billion dollar a year industry. There are hundreds of “diets”, diet workshops and diet programs, the vast majority of which fail. In fact, without exercise, 95% of all diets fail.

So why do so many people do it?  We try to lose weight out of fear, vanity, pride or guilt or we may diet to feel stronger, more disciplined, superior and/or healthier, or we may just diet because everyone else seems to be doing it. The combination of being bombarded with advertisements  to eat along side strong media pressure to be thin is constant in our culture.

Eating Disorders

All of the above behavior comes under the heading of “normal” eating. For those whose eating problems have risen to the level of a disorder, eating triggers feelings such as euphoria, guilt, shame and intense anxiety. Those suffering from Bulimia or Bulimarexia (restricting, binging and purging or just restricting and purging) engage in mindless eating or bingeing to numb or distract themselves from stressful situations or unhappy thoughts and memories.

Purging by vomiting or abuse of laxatives can last hours, keeping the individual up late into the night or causing her to miss work or school when she cannot resist the impulse to binge and purge during the day. One patient recently described a nightmarish scene in which she could not purge into her toilet because it was broken and so took a chance on using the tub drain as she showered. Unfortunately, the food would not go down that drain either. In horror she continued to vomit into the tub until she was standing in a foot of water thick with vomit.  It took her and her mother hours to scoop the vomitous water out with buckets, which they then had to carry to another bathroom and flush down another toilet.  The unbelievable part?  Though repulsed by the mess, she was astonished and secretly impressed by the amount of vomit that she was able to produce!

Once she has binged (or simply eaten something she is uncomfortable eating) the need to purge is often so compelling that it goes beyond all reason, as in the case above.  However this is a temporary “fix”.  The purging gives the individual a temporary “high” followed by feelings of guilt and anxiety and a determination not to repeat the experience. Unfortunately this leads to restricting, which eventually leads to bingeing and the cycle begins again.

Sounds like drug and alcohol addiction, doesn’t it? Eating disorders are very much like other addictions, i.e. they are part of a classic addictive cycle. This includes an increase in tension, which the addict believes can only be relieved by the “fix”. In most addictions, relief from the fix is of shorter and shorter duration before the cycle begins again. This is what is known as a very vicious cycle.

Though not as obvious, the individual suffering from Anorexia is also an addict of sorts, i.e. she restricts to overcome feelings of inferiority, helplessness and hopelessness and to make herself feel in control. Often, she can only be proud of herself when she is pushing starvation to the extreme. This is her “fix”. Many of my patients describe the feeling of being able to function or stay alive on as few calories as possible as a “high”. Indeed there is scientific evidence that fasting does cause the release of endorphin’s, which do make us feel good. Not coincidentally, they report to the same part of the brain that drugs and alcohol do.

To summarize, even “normal” eating behavior can be stressful. Disordered eating takes over the individual’s life, much like alcoholism and drug addiction take over the addict’s life, robbing her of her relationships, her independence, her health and in far too many cases, her life. The mortality rate for eating disorders is higher than that of any other psychological disturbance.

Unfortunately, eating disorders are less likely to be understood as addictions, and more likely to elicit a judging stance from the general public, families and even a surprisingly high proportion of treating professionals. It seems as though the more serious the disorder, the more likely it is to be viewed as an attempt at getting attention or being manipulative.

Take, for example, the Cincinnati physician that said to one of our very attractive patients suffering from Bulimarexia, “You’re beautiful and you’re rich. You have it all. You should be counting your blessings. Why would you want to do something as stupid as refusing to eat?”

But the topper might be the psychiatrist that had another very attractive patient stand up at her first appointment so that he could “assess” her physique and make the following brilliant observation “Yup, you have breasts, hips and thighs. In other words you have curves, what’s the problem?” Individuals such as this often view Anorexia and Bulimia or Bulimarexia as vanity issues.

What Causes An Eating Disorder?

The causes are complicated and for most of the people suffering from an eating disorder, not the result of one factor, but many. The well-known causes are societal pressures to be thin, peer pressure, a major set-back at a critical point in the individual’s life, such as a loss or a traumatic event, childhood disturbances and/or dysfunctional family relationships, etc. However, there are also bio-physiological issues that play a significant role, although they tend to be poorly understood.

Many eating disorders are driven by cravings that are part of a classic addictive cycle, which may actually be perpetuated by food industry profits. In the early 70’s, the food industry discovered that high fructose corn syrup (HFCS) was much less expensive than sucrose. This was primarily because it was much sweeter. So, in it went into our foods, everything from baby food to hot dog buns and cigarettes! They ultimately took it out of most of the baby food, but it is still in the cigarettes, just in case cigarettes aren’t addictive enough without the sugar!

In Cincinnati, there are many fast food establishments still using HFCS’s in their buns, including; Arby’s, Blimpie, Burger King, Chick-fil-A, Dairy Queen, Jack in the Box, KFC, McDonald’s, Subway, and Taco Bell. You’re not safe at the Cincinnati Kroger’s either, or any of the major grocery chains for that matter, since it is actually harder to find foods at the supermarket without HFCS’s, than it is to find foods with it. For example, there are no less than 10 teaspoons of HFCS’s in a single 12 once can of soda. Likewise they are found in almost all snacks, dairy products, condiments, canned goods, cereals, bread, even supplements and vitamins. In total, the average American eats 83 pounds of corn syrup a year plus 66 pounds of sucrose, for a total of 149 pounds of refined sugars.

What does that mean in terms of unnecessary weight gain? Well let’s do the math: We have 159,360 calories from the corn syrup, and 102,168 from the sucrose totaling 261,528 calories per year from sugar. If it takes 3500 calories more than you use in a given period of time to gain 1 pound, that means that unless you work it off, you could gain 75 lbs/year from ingesting sugar you don’t need and probably don’t realize you are eating. To avoid gaining weight from the HFCS’s added to processed foods, the average person would have to run a total of 438 hours per year or 8 hours per week. The net/net of all of the above is to avoid processed foods, i.e. if it didn’t have a face (meat, poultry, fish, fowl) or come out of the ground (fruits, vegetables, nuts, legumes), think twice about eating it. (The exception would be dairy products, such as yogurt, soft European cheeses, and milk. The lower fat varieties of these foods are very good for you, especially when they are lactose free.)

Sugar and Eating Disorders

Sugar Cubes

photo used under creative commons license

What does HFCS have to do with eating disorders? For starters, sugar has recently been shown to be the main culprit in insulin resistance, which is the precursor to obesity. In this country, obesity has become the nation’s most critical health problem. Ultimately it leads to such chronic diseases as Type II diabetes, high blood pressure and heart disease. These diseases are threatening to dismantle our entire health care system because of their increased incidence and skyrocketing cost of treatment.

Binge eating, bulimia, and bulimarexia are basically sugar addictions, as most individuals suffering from these disorders binge on simple carb’ s (highly refined foods that are often loaded with HFCS’s). Simple carbohydrates convert to sugar in the blood stream. Research has shown that sugar is as addictive as alcohol and/or cocaine.

Recovery from a food addiction (eating disorder) requires a basic understanding of the addictive nature of food and a commitment to replace the offending food(s) with something equally satisfying but less addictive. Otherwise you find yourself in a perpetual and very vicious cycle of restricting or deprivation (dieting) followed by the onset of withdrawal symptoms (food cravings, obsessive thoughts) a build up of anxiety and behaviors designed to quiet the beast, (bingeing, cutting, compulsive spending, binge drinking) and possibly efforts to compensate (purging with vomiting, excessive exercising, abuse of laxatives and/or diet pills). This leads to guilt and a profound sense of failure, which is followed by renewed determination to stop the cycle by not “eating so much” which is a euphemism for restricting or dieting, at which point the cycle begins again.

Unfortunately, many in an effort to avoid the offending food(s) restrict too much and end up avoiding the foods that could break the cycle, proteins or complex carbohydrates i.e. low fat meats, cheeses and fish or fresh fruits and vegetables. Instead they eat foods that actually contribute to the food addiction and cause the cycle to begin again. For example, so many of my patients avoid all protein because of their fear of fat and eat simple carbs, like pretzels or diet soft drinks when they are in restricting, dieting or “being good”. Or worse, they eat candy that has no fat, like jellybeans, thinking that this is a safer snack than a piece of chocolate or a handful of nuts. The chocolate, especially if it’s dark chocolate, does have some fat, but it has fewer sugars than a bag of jellybeans and, because it is dark chocolate, it has antioxidants. And the nuts have a good deal of fiber, which means that they usually have a glycemic load of 0. (This means that they do not enter the blood stream as a sugar and therefore do not contribute to a sugar addiction, which is the primary culprit in the weight gain that leads to obesity).

The jelly beans, on the other hand, and even the diet drink, make the problem much worse because they enter the blood stream almost immediately as glucose, adding to the sugar addiction, which in turn drives more binging behavior. They also have dyes and additives and no nutritional value. The real kicker however, is the long term negative impact that carb loading followed by purging or restricting has on ones’ metabolism, i.e. it slows it down to such a degree that it is almost impossible for the individual suffering from bulimia to eat normally without gaining weight. Until she understands which foods and supplements will stimulate her metabolism instead of suppressing it, she is stuck in this terrible self-perpetuating vicious cycle.

Once she understands how delicious real food can be and how much more of it she can eat without fear of gaining weight if she is exercising and supplementing, she has begun the journey toward a healthy relationship with food and the end of her eating disorder. But this requires courage, patience and lot’s of support from family, friends and allied professionals.

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.

© 2008, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2008, Dr J Renae Norton.’

ADHD and Incidence of Eating Disorders

ADHD and eating disorders

Eating Disorders Common In ADHD Girls: Compulsive Behavior Tied To Body Image Problems

Girls with attention deficit hyperactivity disorder are more likely to have an eating disorder, a new study said. “Adolescent girls with ADHD frequently develop body-image dissatisfaction and may go through repeating cycles of binge eating and purging behaviors that are common in bulimia nervosa,” said University of Virginia psychologist Amori Yee Mikami.

ADHD is thought to be three times more common in boys than girls, so researchers are still learning its long-term effects on girls. But eating disorders are 10 times more common in girls. “Our finding suggests that girls may develop a broader range of problems in adolescence than their male counterparts,” Mikami said. She said girls often go undiagnosed and untreated for ADHD, which could increase the risk of eating disorders. “As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the binging and purging symptoms,” she said.

The results are based on a study of 228 girls in the San Francisco Bay area; 140 had ADHD. “An additional concern is that stimulant medications used to treat ADHD have a side effect of appetite suppression, creating a risk that overweight girls could abuse these medicines to encourage weight loss, though we have not yet investigated that possibility,” Mikami said. The findings appeared in the Journal of Abnormal Psychology. Note: if you treat both eating disorders and ADHD, then consider joining our sister organization at


UVA Today – Adolescent Girls with ADHD Are at Increased Risk for Eating Disorders

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.

© 2008, Dr J Renae Norton. This information is intellectual property of Dr J Renae Norton. Reproduction and distribution for educational purposes is permissible.

Please credit ‘© 2008, Dr J Renae Norton.

Quinoa Pancakes

Quinoa Pancakes

Photo courtesy of


1 cup cooked quinoa
3/4 cup Jovial Foods Einkorn Flour
2 tsp baking powder
1/2 tsp kosher salt
1 large egg, plus 1 large egg white (organic, pastured)
1 tbsp unsalted grassfed butter, melted
1/4 cup Snowville or Traders Point whole milk
2 tbsp coconut nectar or maple syrup

In a medium bowl, whisk together quinoa, flour, baking powder and salt.
In another bowl, whisk together egg, egg white, butter, milk, syrup until smooth.
Add egg mixture to quinoa mixture, whisking til combined.

In a non-stick skillet, melt a little coconut oil over medium to medium-high heat.
Drop batter by heaping tablespoonful into the skillet.
Cook until bubbles appear on top, approximately 2 minutes.
Flip cakes and cook until golden brown on underside, 1-2 minutes.

Serve with maple syrup, fresh fruit or preserves.

Makes 12 pancakes.

Can be made ahead of time. Freeze cooked pancakes between sheets of waxed paper in zip-top bags, up to 1 month. Reheat in toaster.

Nutrition Info (per pancake)
73 Calories
2 g Fat
2.5 g Protein
12 g Carbs
0.5 g Fiber

Scrambled Eggs with Onions + Peppers

eating disorder recovery recipes

This recipe serves: 4
Preparation time: 5 minutes
Cooking time: 5 minutes

1 teaspoon coconut oil
1/2 cup diced organic red bell pepper
4 tablespoons diced organic Vidalia onion
4 large organic, pastured, eggs
salt to taste
freshly ground black pepper
2 tablespoons chopped parsley


1. Heat the oil in an 8″ non-stick frying pan over medium-high heat.
2. Add the peppers and onions to the pan and cook for about 2 minutes. Remove the vegetables and set aside. Wipe the pan clean so that it can be reused for the eggs.
3. Whisk the eggs with the salt and pepper until well blended.
4. Pour the eggs and vegetables into the frying pan and stir constantly over low heat with a rubber spatula. When the eggs begin to get firm, add the parsley and continue stirring.
5. When the eggs have reached the desired degree of doneness, put them on warm plates and serve immediately.

NUTRITION INFO (per serving)
Calories 84
Total Fat 5 g
Saturated Fat 1 g
Protein 7 g
Total Carbohydrate 3 g
Dietary Fiber 1 g
Sodium 113 mg

Percent Calories from Fat 54%
Percent Calories from Protein 33%
Percent Calories from Carbohydrate 14%