Family Forum / By Judy Konitzer: Have you ever thought to yourself “Why is that person so skinny or why is he/she such a picky eater?”
We are inundated by super-thin models who display the clothes we would love to wear, but might not look the same on us. We think, “They must starve themselves to look like that. Or maybe they are anorexic!”
I personally hurt for someone I love who is trying to deal with anorexia, but hopefully it was discovered early enough to benefit from current treatment. I shared her symptoms and on-going treatment with a good friend who was extremely grateful as he said, “You may have saved our daughter’s life as the symptoms are the same and we had no idea what we were dealing with!”
So my purpose for this article is to bring awareness to a disorder, which if discovered and acknowledged early on, can prove to be a lifesaver for some.
Old Not New
It may seem like a modern disorder, but many historians believe that many of the “fasting saints” of the Middle Ages did indeed have anorexia. In 1689, Richard Morton, a London physician described it as a “Nervous Consumption caused by sadness and anxious cares.”
It wasn’t until 1983 and the death of the singer Karen Carpenter that the disorder became a household word. She died from heart failure due to anorexia nervosa with the spectacle of a healthy attractive young girl’s determination to starve herself. Up to one in five people with chronic anorexia may die as a result of their illness, either due to the direct effects of starvation and malnutrition or due to suicide, making it the deadliest of all psychiatric disorders.
Scientists have made tremendous progress in decoding the underlying biology of eating disorders and in finding ways to intervene in cases of teenage anorexia before the disorder becomes chronic. But effective treatments for adults are somewhat trickier, although possible. Eating disorders typically begin in adolescence and although the exact circumstances that trigger the onset of anorexia aren’t clear, nearly all cases begin when a person fails to meet their energy needs, placing them in a state of what researchers call negative energy balance. In other words, they burn more calories than they eat.
For some, a weight loss diet precipitates the eating disorder; for others, it’s increased sports training, a growth spurt, an illness, decreased appetite from stress, or even new braces. Personality traits like perfectionism, inflexibility, having to follow the rules, excessive doubt and caution, and a drive for order and symmetry also increase the risk of developing the disorder. Those with a predisposition for anorexia have a completely different experience when it comes to food. Starvation makes them feel better.
Dr. Walter Kaye, director of the Eating Disorder Treatment and Research Program at the University of California, San Diego, in working with women who have recovered from anorexia nervosa, found unusually high levels of the neurotransmitter serotonin in the cerebrospinal fluid that bathes the brain, most likely there before the onset of anorexia. While low levels of serotonin aren’t necessarily better, because they are linked to depression, higher levels create a state of chronic anxiety and irritability. He found that almost three-quarters of those studied had an anxiety disorder before their eating disorder began, most commonly social anxiety and OCD (Obsessive Compulsive Disorder). It was this anxiety that Kaye believes makes some people much more vulnerable to anorexia. We get the amino acid tryptophan in our diet and this is how the body synthesizes serotonin. The theory is eating less food, gives you less tryptophan and therefore less serotonin. If you are predisposed to anorexia, starvation reduces the anxiety and irritability normally associated with high serotonin levels.
It follows then that all you have to do to stop this cycle is to eat less. However, the brain has different ideas and it fights back, increasing the sensitivity, and causing someone to cut back even more on what they are eating. Each time a person tries to return to a normal eating pattern, the brain is flooded with a surge of serotonin which creates panic, rage, and emotional instability.
Another reason for people with anorexia to be able to starve themselves is that when they get hungry, the parts of their brain that should be driving reward and motivation just aren’t getting activated. They truly have a biologically based brain disorder.
Some of the newer treatment options for anorexics involve using positive as well as negative traits used to succeed at their eating disorder to succeed in their recovery, and to educate family members and enlist their support too. Unfortunately many short term treatments at residential or outpatient facilities funded by insurance companies fail to create lasting behavioral changes. The wellness habits needed to make lifelong recovery possible take time and lots of practice of eating enough to replace the ingrained habitual behavior of restriction.
For more detailed information, go to National Eating Disorder Association at www.nationaleatingdisorders.org; and lastly, if you know or suspect anyone having this disorder, don’t wait to get help. Their life could depend on you!!!