Tuesday, June 12, 2012
Eating disorders can have fatal results
"Tragically, there is a 15-21 percent mortality rate among anorexics. It's very common for someone to die of starvation or a complication from it."
Those words illustrate the seriousness of anorexia nervosa. They were spoken by Batesville psychiatrist William H. Goodin Jr., who classified the conditions of anorexia nervosa and bulimia as psychiatric disorders with physical manifestations.
A parent, friend or spouse who suspects a loved one might be suffering from one of the disorders should, Goodin said, "confront them. . .honestly and directly. . .and not accuse them or label them."
complete physical is a must, he said. "It's important not only for the individual to talk to the physician, but for the parent to as well."
He said the person to treat anorexia nervosa should be a medical doctor specializing in psychiatry who has the expertise for treating anorexia nervosa. Goodin said results of treatment generally are much quicker in someone suffering from bulimia. "Treatment for someone with anorexia nervosa is often long-term and requires frequent hospitalization."
Studies indicate that the incidence of bulimia is highest among college-age students, all though in the general population, it is very common from early adolescence through age 30, Goodin said.
Engaging in bulimic behavior may begin as a fad for college-aged girls, but those with some predisposed fears about getting overweight and who are overly concerned with their physical apearance do get into a pattern of bulimia. The pattern may shift from periodically inducing vomiting to recurrent episodes of eating until stuffed. "At that point," Goodin said, "it becomes an emotional
problem. And soon, it becomes a physical problem." Not only does the bulimic begin to consume large amounts of food, but she (or he) consumes it privately, often very rapidly and compulsively. The pattern includes stuffing within a two-hour period. After binging, the person may become very sleepy and withdrawn, and many immediately make themselves vomit.
Goodin said two giveways of bulimia a physician may discover during a physical exam are an abrasion on the hand from inducing vomiting and erosion of tooth enamel froni stomach acid.
Bulimia is more common in families that tend to be overweight. "The young woman (or man) is generally making strong attempts to lose weight," Goodin said. "She generally is not overweight but becomes obsessed with fear of being overweight.''
Her regimen may include highly restrictive diets, self-induced vomiting, use of diurectics (fluid pills) and laxatives. Her weight can fluctuate as much as 10 pounds from day to day.
"The bulimic is generally very aware that her eating pattern is abnormal, and she is not denying it to herself, as is the anorexic," he continued. "She has a fear that once she starts eating normally, she might not be able to stop.''
Depression is common to bulimics, especially after gorging. Related physical problems include fatigue, chemical imbalance, including dangerously lowering the body's potassium level, and arrhythmia of the heart.
Dr. Arnold E. Andersen, assistant professor of psychiatry and behaviorial sciences at the Johns Hopkins University and author of "Practical Comprehensive Treatment of Anorexia Nervosa and Bulimia," described anorexia nervosa as: " ... a serious, life-threatening disorder which occurs primarily in females who are typically 12-25 years of age at the onset of the condition.''
He said the syndrome is more common among patients from middle and upper-middle-class backgrounds, and the pre-illness personality is characterized by perfectionism, perseverance, model behavior as children and limited emotional insight.
With the progressive loss of weight, Andersen said, "the patient ironically perceives herself as still being overweight, even when severely emaciated. Food becomes a major obsession. Physical activity usually increases as a means of further weight loss.''
As weight is lost, mere is an increased interest in food preparation, and the anorexic becomes an expert in the caloric and fat contents of foods. "A person with anorexia nervosa has an intense fear of being fat," Goodin said. "That fear does not dissipate with weight loss. The person still feels fat. There is no way to talk her out of it." Although Goodin might suspect a patient of being anorexic, he said he assumes a physical problem might exist "until I've found otherwise."
The National Association of Anorexia Nervosa and Associated Disorders (ANAD) says families, not just the victim, needs therapy. "The real solution lies in getting the patient to talk out her feelings and begin to accept herself," ANAD says in its literature. "Once a patient becomes aware of why she has an eating disorder, she has a chance of beginning the slow, painful journey back toward self-control and self-confidence. The best help the victim's family can offer is not shaking a scolding finger or trying to force the loved one to eat, out a listening ear and an understanding heart."
Saturday, June 9, 2012
Teen-ager Can't Stop Dieting
I'm 16 years old, and have always been on the chubby side. The kids in school used to tease me about my weight so I decided to lose a few pounds. Now, a year later, I have lost 20 pounds. Everyone tells me I look too thin and my parents are always nagging me to eat. We fight all the time over this. I just can't stop dieting.
Do you think I should find help for this?
Answer:
Your feeling of not being able to stop dieting may be a symptom of an eating disorder called anorexia nervosa. Anorexics have a fear of being fat and of not being able to control their eating. Some anorexics deny their hunger and refuse to eat while others binge and induce vomiting. Either behavior can cause abnormal weight loss and lead to many serious consequences such as absence of menstruation, weakness, fainting and malnutrition.
Very often, as in your case, the symptoms first appear after the individual decides to lose some excess weight. This, of course, does not happen to everyone. In fact, there is little agreement on why it happens. Most doctors do agree, however, that there is an emotional basis for the symptoms and that anorexia nervosa can become most disabling, contributing to problems in the family such as those you are experiencing with your parents. Yes, I think you should seek professional help either alone or if possible with your parents. You may want to show them this column and share your concerns with them. Fortunately, there is treatment available for anorexia nervosa. In recent years, perhaps because of the rise in the number of cases, professionals have become very attentive to the problems of the anorexic. There are many area therapists both in private practice and in outpatient facilities who specialize in the treatment of anorexia through the use of individual, family or group counseling.
Friday, June 8, 2012
Board rejects anorexia study request
Dr. Pierre Leichner, of the university's medicine faculty, had requested students in the division to complete the survey.Trustee and Curriculum Committee chairman Mildred Murray said the, survey's questions were of a personal nature and she was wary of how the children would react. Students from grades seven through to 12 were being asked to participate.
"We were concerned of the possible affects the questions would have on the students," she said. "It wasn't really a factual survey. Rather it asked for an emotional response from the children."
Dr. Leichner expressed disappointment but would not look to appeal the board's final decision. He agreed that the survey's questions were of an emotional nature but
defended them by pointing out that causes for anorexia nervosa and bulimia may stem from a child's emotional background.
Basically, anorexia nervosa and bulimia are eating disorders. A victim is so overcome with the notion of losing weight that he literally starves himself. It usually affects teenagers.
"There have been studies done on it in industrial European cities," Dr. Leichner said. "But there doesn't seem to be any data available here.
"It only makes sense the survey contain questions relating to one's emotional background since that is the problem's source," he said.
Anorexia nervosa may also be attributed to the low carbohydrate diets currently out on the market. "My feelings are that a great number of susceptible young people get hooked on these things and find it difficult to turn back," Dr. Leichner said.
The doctor will continue his research and try to find enough of a cross section of students interested in taking the survey.
Drastic diet dangers
It's no secret that ballet dancers are diet conscious. For physical and esthetic reasons, they must be thin but strong, must have grace and stamina. But dieting, or sticking to a maintenance diet can be difficult. And in a few cases, dieting can become an obsession and may lead to anorexia nervosa or anorexic symptoms.
Anorexia nervosa is a syndrome characterized by a morbid fear of gaining weight, even when the person is already thin. Anorexia affects a person's physical well-being; among other things, loss of sleep, constipation and loss of menstrual periods can result. As well, the sufferer becomes preoccupied with food and loses concentration.
David Garner, a psychologist at Toronto's Clarke Institute of Psychiatry and the University of Toronto who has studied anorexia nervosa in the general population for seven years, was in Winnipeg and spoke to students in the Royal Winnipeg Ballet's professional program about the results of a study he did on dancers and eating habits.
His study, done over the last few years, involved 183 dance students and professionals from three dance schools in Canada, including the Royal Winnipeg Ballet.
His article in Dance in Canada reveals that 44 per cent of the dancers surveyed scored high enough on an Eating Attitudes Test questionnaire to "indicate a significant degree of anorexic-like symptoms."
"Twelve definite cases of anorexia nervosa were identified, 6.5 per cent of the total dance sample. All but one of these cases had developed while the individual was studying dance."
These results were "at least six to 10 times higher than the highest prevalence rates reported in medical literature."
While the majority of dancers have no anorexic symptoms. Garner said, "it may be that for the kind of disciplined, striving individual in search of perfection who would ordinarily be prone to anorexia, dancing could accentuate this vulnerability."
Too much emphasis
Pressure to be thin is rampant in society and ballet is only an extension of that, he said. "There's too much concern in our society with weight and shape."
The higher incidence of anorexia among dancers Is due to a number of factors, Garner said, including pressures to he thin and high performance expectations and, as an "alternate hypothesis, that these types of people are attracted to ballet.
"Anorexic people tend to come from higher socio-economic groups, tend to be females and it occurs iri families where there are high-performance expectations. This seems to be the same social class distribution. The upper social class is over-represented in ballet."
When he began talking to dancers, Garner indeed found "that the ballet world is an obsessionally weight-conscious subculture."
Jackie Weber, vice-principal of the RWB's professional program, said in more than 10 years the school has encountered only two cases of anorexia which forced the dancer to be sent home.
However, she said, "there are some people here who have the tendency for anorexia. If we see someone who has the symptoms we talk to them, ask them how they're eating, sleeping and we'll approach the parents if they're nearby." Those suspected of having such a tendency are usually sent to a doctor or dietitian, she said, "who makes them out an individualized diet."
The RWB,' like any company and school, must set standards for its dancers' weights. If a girl is five feet, three inches, she should weigh no more than 100 pounds, Weber said. At the same time, the directors are concerned about possible anorexic tendencies.
"It's a well-known fact that you have to be thin to get into the program. But some people get in, gain weight and then have to be told. Some of them go too far and some can't lose the weight either. We're concerned about good health in all the students."
Being thin is important because the female dancers must be lifted by a man, sometimes several times in a dance, Weber "said. There are also esthetic reasons because lighting and costumes can make a dancer look a bit heavier. However, dancers, because of their superb muscle tone and strength, "shouldn't look emaciated," she said.
Monitor teen-agers
"Some people have a tendency toward anorexia from the beginning, before they walk into ballet. We find young teen-agers are trying to emulate the older ones. They want to be thin and they can be vulnerable to becoming obsessed with it. We haven't found it a problem but we do watch it carefully. 1 feel very lucky that way."
The most important thing a dancer can do is learn how to maintain her weight and stay healthy once she has lost what was required, Weber said.
Anorexia nervosa is a syndrome characterized by a morbid fear of gaining weight, even when the person is already thin. Anorexia affects a person's physical well-being; among other things, loss of sleep, constipation and loss of menstrual periods can result. As well, the sufferer becomes preoccupied with food and loses concentration.
David Garner, a psychologist at Toronto's Clarke Institute of Psychiatry and the University of Toronto who has studied anorexia nervosa in the general population for seven years, was in Winnipeg and spoke to students in the Royal Winnipeg Ballet's professional program about the results of a study he did on dancers and eating habits.
His study, done over the last few years, involved 183 dance students and professionals from three dance schools in Canada, including the Royal Winnipeg Ballet.
His article in Dance in Canada reveals that 44 per cent of the dancers surveyed scored high enough on an Eating Attitudes Test questionnaire to "indicate a significant degree of anorexic-like symptoms."
"Twelve definite cases of anorexia nervosa were identified, 6.5 per cent of the total dance sample. All but one of these cases had developed while the individual was studying dance."
These results were "at least six to 10 times higher than the highest prevalence rates reported in medical literature."
While the majority of dancers have no anorexic symptoms. Garner said, "it may be that for the kind of disciplined, striving individual in search of perfection who would ordinarily be prone to anorexia, dancing could accentuate this vulnerability."
Too much emphasis
Pressure to be thin is rampant in society and ballet is only an extension of that, he said. "There's too much concern in our society with weight and shape."
The higher incidence of anorexia among dancers Is due to a number of factors, Garner said, including pressures to he thin and high performance expectations and, as an "alternate hypothesis, that these types of people are attracted to ballet.
"Anorexic people tend to come from higher socio-economic groups, tend to be females and it occurs iri families where there are high-performance expectations. This seems to be the same social class distribution. The upper social class is over-represented in ballet."
When he began talking to dancers, Garner indeed found "that the ballet world is an obsessionally weight-conscious subculture."
Jackie Weber, vice-principal of the RWB's professional program, said in more than 10 years the school has encountered only two cases of anorexia which forced the dancer to be sent home.
However, she said, "there are some people here who have the tendency for anorexia. If we see someone who has the symptoms we talk to them, ask them how they're eating, sleeping and we'll approach the parents if they're nearby." Those suspected of having such a tendency are usually sent to a doctor or dietitian, she said, "who makes them out an individualized diet."
The RWB,' like any company and school, must set standards for its dancers' weights. If a girl is five feet, three inches, she should weigh no more than 100 pounds, Weber said. At the same time, the directors are concerned about possible anorexic tendencies.
"It's a well-known fact that you have to be thin to get into the program. But some people get in, gain weight and then have to be told. Some of them go too far and some can't lose the weight either. We're concerned about good health in all the students."
Being thin is important because the female dancers must be lifted by a man, sometimes several times in a dance, Weber "said. There are also esthetic reasons because lighting and costumes can make a dancer look a bit heavier. However, dancers, because of their superb muscle tone and strength, "shouldn't look emaciated," she said.
Monitor teen-agers
"Some people have a tendency toward anorexia from the beginning, before they walk into ballet. We find young teen-agers are trying to emulate the older ones. They want to be thin and they can be vulnerable to becoming obsessed with it. We haven't found it a problem but we do watch it carefully. 1 feel very lucky that way."
The most important thing a dancer can do is learn how to maintain her weight and stay healthy once she has lost what was required, Weber said.
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