Links for Keyword: Anorexia & Bulimia

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By Matt Richtel For decades, eating disorders were thought to afflict mostly, if not exclusively, women and girls. In fact, until 2013, the loss of menstruation had long been considered an official symptom of anorexia nervosa. Over the last decade, however, health experts have increasingly recognized that boys and men also suffer from eating disorders, and they have gained a better understanding of how differently the illness presents in that group. A small but growing body of scientists and physicians have dedicated themselves to identifying the problem, assessing its scope and developing treatments. Recently, two of these experts spoke to The New York Times about how the disease is affecting adolescent boys, what symptoms and behaviors parents should look for, and which treatments to consider. Dr. Jason Nagata is a pediatrician at the University of California, San Francisco, who specializes in eating disorders; he is senior editor of the Journal of Eating Disorders and editor of the book “Eating Disorders in Boys and Men.” Dr. Sarah Smith is a child and adolescent psychiatrist at the University of Toronto who specializes in eating disorders; she was the lead author on a study published in JAMA Open Network in December that showed sharp increases in the rates of hospitalizations for boys with eating disorders. The medical and scientific understanding of eating disorders is changing and expanding. What happened? Dr. Smith: Historically, eating disorders have been conceptualized mostly as anorexia, which has been portrayed as an illness of adolescent females who want to lose weight for aesthetic reasons. Dr. Nagata: There’s increasing recognition, particularly in the last decade or so, that some people with body image dissatisfaction are not trying to lose weight at all. Some men and boys are trying to become large and muscular. In fact, one-third of teenage boys across the United States report that they’re trying to bulk up and get more muscular. And a subset of those may develop eating disorders or muscle dysmorphia that can lead to significant psychological distress and physical health complications. © 2024 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 12: Sex: Evolutionary, Hormonal, and Neural Bases
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 8: Hormones and Sex
Link ID: 29140 - Posted: 02.08.2024

By Harriet Brown The minute I saw the headline — “Should Patients Be Allowed to Die From Anorexia?” — in The New York Times Magazine last month, my heart sank. Over the last two years, more and more psychiatrists have floated the idea that it’s OK to stop trying to cure some people with anorexia nervosa. People with anorexia develop a deep fear of food and eating, often losing so much weight that they die of starvation or complications. About 20 percent die by suicide. Anorexia is a terrible disease, one that inflicts maximum pain on the person diagnosed and their families and friends. The suffering is continuous and intense, and it gets even worse during recovery. Our family experienced this for eight years. Having to watch my daughter suffer made me realize that anorexia is not a choice or a question of vanity but a tsunami of fear and anxiety that makes one of the most basic human acts, the act of eating, as terrifying as jumping out of a plane without a parachute. It usually takes years of steady, consistent, calorie-dense eating to fully heal the body and brain of a person with anorexia. Without the right kind of support and treatment, it’s nearly impossible. So when psychiatrists suggest that maybe some people can’t recover and should be allowed to stop trying, they’re sidestepping their own responsibility. What they should be saying instead is that current views on and treatments of anorexia are abysmal, and medicine needs to do better. If you’ve never experienced anorexia firsthand, consider yourself blessed. Anorexia has one of the highest mortality rates of any psychiatric illness. People with anorexia are 18 times as likely to die from suicide as their peers. Fewer than half of those with anorexia make a full recovery.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 29139 - Posted: 02.08.2024

April Smith Did you know that anorexia is the most lethal mental health condition? One person dies from an eating disorder every hour in the U.S. Many of these deaths are not from health consequences related to starvation, but from suicide. Up to 1 in 5 women and 1 in 7 men in the U.S. will develop an eating disorder by age 40, and 1 in 2 people with an eating disorder will think about ending their life. About 1 in 4 people with anorexia nervosa or bulimia nervosa will attempt to kill themselves, and those with anorexia have a risk of death by suicide 31 times higher than peers without the disorder. In fact, nonsuicidal self-injury, suicidal ideation, suicide attempts and suicide deaths are all more prevalent among those with any type of eating disorder compared to those without an eating disorder. Why might that be? I am a clinical psychologist who studies eating disorders and self-harm, and I have spent the past 15 years researching this question. We still don’t have the answer. But new work on perception of the internal state of the body points to some promising possibilities for treatment. And what we’re learning could help anyone improve their relationship with their body. To understand why people with eating disorders are at risk of dying by suicide, I first want to ask you to do a little thought exercise. I’d like you to really think about your body: Think about your hair, face, arms, stomach, chest and legs. What words and feelings come to mind? Are there any things you wish you could change? Feel free to close your eyes and try this out. © 2010–2024, The Conversation US, Inc.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 29127 - Posted: 02.03.2024

By Katie Engelhart The doctors told Naomi that she could not leave the hospital. She was lying in a narrow bed at Denver Health Medical Center. Someone said something about a judge and a court order. Someone used the phrase “gravely disabled.” Naomi did not think she was gravely disabled. Still, she decided not to fight it. She could deny that she was mentally incompetent — but this would probably just be taken as proof of her mental incompetence. Of her lack of insight. She would, instead, “succumb to it.” It was early 2018. She had come to the hospital voluntarily, because she was getting so thin. In the days before, she had felt her electrolyte levels dip toward the danger zone — and she had decided that, even after everything, she did not want to be dead. By then, Naomi was 37 and had been starving herself for 26 years, and she was exquisitely attuned to her body’s corrupted chemistry. At the hospital, she was admitted to the ACUTE Center for Eating Disorders & Severe Malnutrition for medical stabilization. There, doctors began what was once called refeeding but is now more commonly called nutritional rehabilitation, using an intravenous line that fed into her neck. Reintroducing food to an emaciated body can be dangerous and even lethal if done too quickly. Physicians identified this phenomenon in the aftermath of World War II, when they observed skeletal concentration-camp survivors and longtime prisoners of war eat high-caloric foods and then drop dead of cardiac failure. “Well, here I am,” Naomi said in a video message that she recorded for her parents. “I am alive, but am I happy? I don’t know. … It’s pretty pathetic. I don’t know how I feel about the fact that I would have died had I not come.” In the video, she was wearing a hot pink tank top, even though it was cool in the hospital room, because she wanted to shiver, because shivering burned calories. A few days later, when she was not imminently dying anymore, Naomi announced that she was going home — and the hospital responded by placing her on a 72-hour mental-health hold. Clinicians then obtained what Colorado calls a short-term certification, which required, by judicial order, that Naomi be detained and treated, in her case until she reached what physicians determined to be 80 percent of her “ideal body weight.” In Colorado, as in most states, a patient can be treated against her will if she is mentally ill and found incapable of making informed decisions. That day, Naomi was transferred to a residential program at Denver’s Eating Recovery Center (E.R.C.) © 2024 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 29075 - Posted: 01.03.2024

By Frieda Klotz Tess Olmsted stopped eating sugar when she was just 12 years old. She had previously been treated for obsessive compulsive disorder, or OCD, and soon found herself following rituals around eating. “For me it was never, ‘Oh I need to get skinnier,’” she recalls. Once she started to diet, she simply couldn’t stop. Two years later, on a summer day in 2019, her father saw her on the family’s patio wearing a loose-fitting swimsuit. He soon noticed how little Tess was eating and insisted she see the pediatrician. During a subsequent appointment with a specialist, he recalls, the family learned that Tess’s blood pressure and heart rate were dangerously low. She was admitted to a hospital in life-threatening condition. Across the United States, up to 2 million adults have had anorexia, a mental health condition in which a person severely restricts their food intake, often due to an intense fear of gaining weight. Almost 1 percent of all U.S. women will experience anorexia at some point in their lives. Patients are developing the condition increasingly early in life — sometimes as young as 8 years old — and new figures suggest that symptoms in children worsened during the Covid-19 pandemic, leading to increased numbers of hospitalizations. At one treatment center in Michigan, the admission rate of young people aged 10 to 23 more than doubled during the pandemic’s first year. These sobering developments are due, in part, to the fact that there are no drugs or devices approved by the U.S. Food and Drug Administration to treat the condition. For adults, there are three first-line treatments: an adapted form of cognitive behavioral therapy, known as CBT-E; a structured psychotherapy designed with patient input; and an approach that combines psychotherapy with nutritional support. Studies have shown that these approaches can help more than 50 percent of patients. But experts acknowledge that the studies are not high quality. Patients with anorexia are hard to engage in treatment, and as a result, studies are small and drop-out rates are high.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 29002 - Posted: 11.13.2023

By Kelsey Herbers The comments started the day I became engaged in December 2018: “You’re going to be such a beautiful bride.” “I can’t wait to see you in your dress.” “Everything is going to be perfect.” Before my fiancé and I even booked our wedding date, originally April 25, 2020, or saved a color scheme on Pinterest, I felt an intensifying pressure to live up to the high expectations that I thought my friends and family already had for my wedding day. I was determined to meet those expectations. But the innocent, wedding-driven diet that commenced shortly after my engagement ultimately spiraled into a full-fledged eating disorder. I was shocked by how quickly I fell ill and how deep that illness was. There was nothing about my journey, however, that surprised Robyn L. Goldberg, a registered dietitian and author of “The Eating Disorder Trap.” “The research shows one out of three people who diet develop an eating disorder — it’s very, very common,” said Ms. Goldberg, who has worked in private practice for the last 25 years with clients who have eating disorders, including many future brides. Some have ended up in residential treatment, she said. “You get so consumed that to pull yourself out of that dark hole seems impossible.” In the early days of wedding planning, my lifestyle changes were subtle. I bought an elliptical machine, took note of my calorie intake and found healthier meal options. But when the pandemic hit and kept me at home with my gym equipment, measuring cups and extra time on my hands, the opportunities to try new weight loss methods and obsess over my progress grew. It also forced us to postpone our wedding date. In just a few months, I was severely limiting my calorie intake, weighing myself several times a day and adhering to strict, self-proclaimed exercise rules. This included 45 minutes of running on a treadmill and 120 minutes of walking (180 minutes on weekends) daily. Before my engagement, I had never heard of intermittent fasting, but it didn’t take long for me to master it. These behavioral changes happened so gradually that I didn’t even recognize something was wrong until nearly two years later. By then I had lost 50 pounds, though initially I had wanted to shed only 25. © 2023 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 28650 - Posted: 02.01.2023

By Gina Kolata What if an uncontrollable urge to rapidly eat large amounts of food is rooted in an impaired brain circuit? If that were the case, people who live with binge eating disorder — a psychiatric diagnosis — might be no more at fault for overeating than a patient with Parkinson’s disease is for their tremors. That question led doctors to try a new treatment different from anything ever attempted to help people with this common but underreported eating disorder. At least 3 percent of the population has it, said Dr. Casey Halpern, a neurosurgeon at the University of Pennsylvania. He and his colleagues decided to try deep brain stimulation, a method routinely used to quell tremors in patients with Parkinson’s. It involves placing electrodes in the brain to regulate aberrant signals. The wires, connected to the electrodes, are placed under the scalp, where they are invisible and unobtrusive. For the binge eating treatment, the device only stimulates neurons when the device detects a signal to start a binge. The pilot study, funded by the National Institutes of Health and published earlier this year in the journal Nature Medicine, involves two women and will be expanded in a few months to include four more people living with binge eating disorder who regained the weight they lost after bariatric surgery. Before the treatment can be approved by the Food and Drug Administration, researchers will need to rigorously test the method in at least 100 people in multiple medical centers. Such a study would take several years to complete. The two women whose devices were implanted a year ago will be followed for up to three years. They had the option to have their devices removed after 12 months, but both wanted to keep them because they no longer felt irresistible urges to binge. One of them, Robyn Baldwin, 58, of Citrus Heights, Calif., described herself as a “chunko child” who had “always been big.” She tried a wide range of diets. Once, she consumed only protein shakes for a month. In 2003 she had bariatric surgery, which usually involves altering the digestive system so that the stomach is smaller and food is more difficult to digest. It has enabled many people to lose weight when other methods failed. But for Ms. Baldwin, the weight she lost came back. © 2022 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 28545 - Posted: 11.09.2022

Kate Siber Sharon Maxwell spent much of her life trying to make herself small. Her family put her on her first diet when she was 10. Early on Saturday mornings, she and her mother would drive through the empty suburban streets of Hammond, Ind., to attend Weight Watchers meetings. Maxwell did her best at that age to track her meals and log her points, but the scale wasn’t going down fast enough. So she decided to barely eat anything on Fridays and take laxatives that she found in the medicine cabinet. Food had long been a fraught subject in the Maxwell household. Her parents were also bigger-bodied and dieted frequently. They belonged to a fundamentalist Baptist megachurch where gluttony was seen as a sin. To eat at home was to navigate a labyrinth of rules and restrictions. Maxwell watched one time as her mother lost 74 pounds in six months by consuming little more than carrot juice (her skin temporarily turned orange). Sometimes her father, seized with a new diet idea, abruptly ransacked shelves in the kitchen, sweeping newly forbidden foods into the trash. Maxwell was constantly worried about eating too much. She started to eat alone and in secret. She took to chewing morsels and spitting them out. She hid food behind books, in her pockets, under mattresses and between clothes folded neatly in drawers. Through Maxwell’s teenage years and early 20s, eating became even more stressful. Her thoughts constantly orbited around food: what she was eating or not eating, the calories she was burning or not burning, the size of her body and, especially, what people thought of it. Her appearance was often a topic of public interest. When she went grocery shopping for her family, other customers commented on the items in her cart. “Honey, are you sure you want to eat that?” one person said. Other shoppers offered unsolicited advice about diets. Strangers congratulated her when her cart was filled with vegetables. As she grew older, people at the gym clapped and cheered for her while she worked out. “People would say: ‘Go! You can lose the weight!’” she says. While eating in public, other diners offered feedback — and still do to this day — on her choices, a few even asking if she wanted to join their gym. Some would call her names: Pig, Fatty. Sometimes people told her she was brave for wearing shorts, while others said she should cover up. She was always aware, whether she wanted to be or not, of how others viewed her body. © 2022 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 28519 - Posted: 10.19.2022

By Matt Richtel During the pandemic, emergency rooms across the country reported an increase in visits from teenage girls dealing with eating and other disorders, including anxiety, depression and stress, according to new data from the Centers for Disease Control and Prevention. The report provides new detail about the kinds of mental health issues affecting a generation of adolescents. Mental health experts hypothesize that the pandemic prompted some youth to feel isolated, lonely and out-of-control. Some coped by seeking to have control over their own behavior, said Emily Pluhar, a pediatric psychologist at Boston Children’s Hospital and instructor at Harvard Medical School. “You take a very vulnerable group and put on a global pandemic,” she said. “The eating disorders are out of control.” In the C.D.C. study, the agency said that the proportion of eating disorder visits doubled among teenage girls, set off by pandemic-related risk factors, like the “lack of structure in daily routine, emotional distress and changes in food availability.” The agency said that the increase in tic disorders was “atypical,” as these disorders often present earlier, and are more common in boys. But the C.D.C., reinforcing speculation from other clinicians and researchers, said that some teenage girls may be developing tics after seeing the phenomenon spread widely on social media, notably on TikTok. “Stress of the pandemic or exposure to severe tics, highlighted on social media platforms, might be associated with increases in visits with tics and tic-like behavior among adolescent females,” the C.D.C. wrote. In a related report, the C.D.C. also said on Friday that the increase in visits for mental health issues occurred as emergency rooms reported sharp declines overall in visits during the pandemic. As compared with 2019, overall visits fell by 51 percent in 2020 and by 22 percent in 2021, declines that the agency attributed in part to families delaying care, and a drop in physical injuries from activities like swimming and running. © 2022 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 11: Emotions, Aggression, and Stress
Link ID: 28213 - Posted: 02.19.2022

Julia F. Taylor Eating disorders began to spike among young people shortly after the onset of the COVID-19 pandemic. Experts believe the increase occurred due to disruptions in daily living, emotional distress and more time spent on social media – which research has shown can lead to lower self-esteem and negative body image. One peer-reviewed study indicates that eating disorder diagnoses increased 15% in 2020 among people under 30 compared to previous years. Other studies have suggested that patients who already had an eating disorder diagnosis got worse during the pandemic. The researchers reported an increase in eating disorder symptoms along with anxiety and depression. Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding and eating disorders such as atypical anorexia. The peak age of onset is 15-25 years old, but individuals can develop eating disorders at any age. Don’t let yourself be misled. Understand issues with help from experts We are a physician and a psychotherapist who specialize in treating eating disorders in teens and young adults. We’ve seen the increased demand for eating disorder services in our own clinic. While eating disorders have historically been underdiagnosed in certain groups – specifically males, racial/ethnic minorities, and people who are higher-weight, LGBTQ or from poorer backgrounds – the recent COVID-related increase in patients presenting for care has reinforced that no group is immune from them. Here are three groups of young people who are often overlooked when it comes to eating disorders. 1. Adolescent boys and young men Historical research on diagnosing eating disorders has focused on females. This has made it harder for doctors, families and patients to recognize eating disorders in males. For example, adolescent boys may be more prone to focus on muscle strength and steroid use – indicators that are not captured in traditional, female-focused screening tools and diagnostic criteria. H © 2010–2021, The Conversation US, Inc.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 28059 - Posted: 11.03.2021

By Kate Conger, Kellen Browning and Erin Woo A 27-year-old YouTube star, prodded by her millions of followers with concerns about her health. A 19-year-old TikTok creator who features posts about being skinny. Teen communities throughout the internet, cleverly naming and culling their discussions to avoid detection. They present a nearly intractable problem for social media companies under pressure to do something about material on their services that many people believe is causing harm, particularly to teenagers. Those concerns came into sharp focus in recent weeks in a pair of Senate subcommittee hearings: the first featuring a Facebook executive defending her company, and the second featuring a former Facebook employee turned whistle-blower who bluntly argued that her former employer’s products drove some young people toward eating disorders. The hearings were prompted in part by a Wall Street Journal article that detailed how internal Facebook research showed Instagram, which is owned by Facebook, can make body image issues worse for some young people. On Tuesday, executives from YouTube, TikTok and Snapchat are scheduled to testify before a Senate subcommittee about the effects of their products on children. They are expected to face questions about how they moderate content that might encourage disordered eating, and how their algorithms might promote such content. “Big Tech’s exploiting these powerful algorithms and design features is reckless and heedless, and needs to change,” Senator Richard Blumenthal, a Democrat of Connecticut and the chair of the subcommittee, said in a statement. “They seize on the insecurities of children, including eating disorders, simply to make more money.” But what exactly can be done about that content — and why people create it in the first place — may defy easy answers. If creators say they don’t intend to glamorize eating disorders, should their claims be taken at face value? Or should the companies listen to users complaining about them? © 2021 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 14: Attention and Higher Cognition
Link ID: 28049 - Posted: 10.23.2021

Kayla Hounsell · CBC News · Sarah White has always been a 'picky eater' but says the pandemic exacerbated her difficult relationship with food. It ultimately led to a diagnosis of avoidant restrictive food intake disorder. (Eric Woolliscroft/CBC) Sarah White sets a timer to remind herself to eat. She sets it six times a day so that she eats three meals and three snacks. White says she's always been a "picky eater." But when she started working from home, her routine was interrupted and her already difficult relationship with food became dangerous. It ultimately led to an eating disorder diagnosis during the pandemic. "I had all of the time in the world to eat, but I was finding I wasn't eating nearly as much as I should have been," White, 33, said during a physically distanced interview at her Halifax apartment. "It started to feel a lot more serious than it had in the past." There's been an alarming spike in the number of people seeking help for eating disorders. The National Eating Disorder Information Centre says the volume of inquiries to its help line and online chat service has been up 100 per cent during the pandemic. "There's been literature coming out across the world really suggesting that the numbers are skyrocketing and we're trying to understand why that is," said Dr. Jennifer Couturier, principal investigator for the Canadian Consensus Panel for In May, the panel, which consists of clinicians, policymakers, parents and youth, received a $50,000 federal grant to determine how best to treat eating disorders during a pandemic, particularly in children and young adults under 25. Couturier says she feels this age group hasn't received a lot of attention when it comes to research generally. ©2021 CBC/Radio-Canada.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27729 - Posted: 03.13.2021

Sophie Balisky, 26, says she struggled with anorexia and bulimia through most of her teens but got help three years ago and was doing great — until COVID hit and she lost her job as a flight attendant. She found herself reverting to old coping patterns in dealing with stressful and uncertain situations. "I was actually quite shocked, I was a bit taken aback, because I consider myself to be quite strong in my coping against my eating tendencies," said Balisky. Advocates for those who struggle with eating disorders say the pandemic is exacerbating the problem — prompting a greater need for community supports. Experts believe the problem is related to the stress, uncertainty and isolation that stems from the pandemic and related-restrictions and say it's not only a problem in the province but around the world. Some eating disorder support groups in Alberta who connect with people of all ages say they have seen a steady rise in demand since the pandemic hit. The Eating Disorder Support Network of Alberta is reporting a 5½ times increase in participants year-over-year between the period from March to the end of August. "So a huge surge through this," said Lauren Berlinguette, executive director of the support network. Another community-based agency that offers support to those who are struggling as well as their families, the Calgary Silver Linings Foundation, says it's experiencing a substantial increase in demand, too. The number of participants in all of its adult programs went from 37 to 64 participants, year-over-year. ©2020 CBC/Radio-Canada.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27627 - Posted: 12.15.2020

By Michelle Konstantinovsky Rosey has lived with bulimia for more than a decade. The 31-year-old resident of Melbourne, Australia, started therapy for her eating disorder six years ago. Although she says she had never considered herself “cured,” she had reached a point in her recovery that felt hopeful and manageable. Then along came the novel coronavirus. When mandatory COVID-19 lockdowns began in Australia in March, Rosey’s anxiety went into overdrive. “I’m single, I live alone, my family lives in another state, and I’m not able to see friends,” she says, adding that her need for control—something she has now lost in almost every area of her life—has played a major role in the resurgence of symptoms: “To have everything I knew and had control over, including how I managed my illness, ripped away has been one of the hardest things.” Rosey is living an experience that may be familiar to anyone dealing with an eating disorder while weathering the unexpected storms of 2020. Recent research indicates that pandemic-related stay-at-home orders have ramped up anorexia, bulimia and binge-eating disorder symptoms. A study published last month in the International Journal of Eating Disorders revealed that during the first few months of the pandemic, many individuals with anorexia reported restricting their eating more. Meanwhile others with bulimia and binge-eating disorder reported more bingeing urges and episodes. Respondents also noted increased anxiety and concern about COVID-19’s impact on their mental health. More than one third of the 1,021 participants (511 in the U.S. and 510 in the Netherlands) said their eating disorder had worsened—and they attributed this change to issues such as a lack of structure, a triggering environment, the absence of social support and an inability to obtain foods that fit their meal plans. © 2020 Scientific American,

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27439 - Posted: 08.29.2020

By Jane E. Brody Appearances, as I’m sure you know, can be deceiving. In one all-too-common example, adolescents and young adults with disordered eating habits or outright eating disorders often go unrecognized by both parents and physicians because their appearance defies common beliefs: they don’t look like they have an eating problem. One such belief is that people with anorexia always look scrawny and malnourished when in fact they may be of normal weight or even overweight, according to recent research at the University of California, San Francisco. The researchers, led by Dr. Jason M. Nagata, a specialist in adolescent medicine at the university’s Benioff Children’s Hospital, found in a national survey that distorted eating behaviors occur in young people irrespective of their weight, gender, race, ethnicity or sexual orientation. And it’s not just about losing weight. The survey revealed that among young adults aged 18 to 24, 22 percent of males and 5 percent of females were striving to gain weight or build muscle by relying on eating habits that may appear to be healthy but that the researchers categorized as risky. These practices include overconsuming protein and avoiding fats and carbohydrates. The use of poorly tested dietary supplements and anabolic steroids was also common among those surveyed. The Covid-19 pandemic has likely exacerbated the problem for many teenagers whose daily routines have been disrupted and who now find themselves at home all day with lots of food being hoarded in kitchens and pantries, Dr. Nagata said in an interview. “We’re seeing more patients and referrals for eating disorders and their complications,” he said. © 2020 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27389 - Posted: 07.29.2020

By Susan Burton “Diet” is a strange word, used to describe both a deviation from the norm and the norm itself: the foods that make up a day, a week, a lifetime. From the beginning, my diet was a big part of my story, even the one that others told about me. “All babies like rice cereal,” my mother will say. “But you didn’t.” In the high chair, I would tighten my lips and turn away. When I was two, at the first preschool parent-teacher conference, they told my mother, “Susan never eats snack.” Recalling encounters with foods I disliked as a small child raises an old alarm in me. A sip of a soda at the zoo one afternoon, the prickling shock of the bubbles. It would be more than a decade before I would try something fizzy again. Melba toast at a white-tablecloth restaurant in Chicago. The next day, I vomited. The bright yellow worm of mustard on a hot dog at a public beach. The jagged chopped nuts on a hot-fudge sundae, even though I’d asked for it plain. In any choice related to food, I always preferred plain. I went through primary school never eating a salad or a single bite of fruit. The term “picky eater” didn’t apply to me. Picky eaters had to be reminded to pay attention to their plates. But I never forgot about food, in the way you never forget about anything you fear. I was scared of feeling sick. I was scared of not liking tastes. I was scared of something getting in me that I could never get out. I was scared of something happening to my body that would make me not me. In many ways, my adolescence was stereotypical. I was an awkward middle-schooler who transformed herself with the help of Seventeen magazine. I stood in bleachers at Friday-night football games. I read Sylvia Plath and wrote furiously in my journal. I learned to smoke cigarettes on a weekday afternoon in a wood-panelled car. I signed the notes I passed in class “Love, Susan.” I tried to be the perfect teen-age girl. But I was also a troubled one, and the dark part of my adolescence became its heart. © 2020 Condé Nast.

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27306 - Posted: 06.17.2020

By Susan Burton I ordered heritage flour from Minnesota and made a loaf of bread with a crackling crust. Those are facts. But what is the tone of that sentence? Am I bragging about my baking prowess, my ingredient sourcing, and the privilege that allows me to spend the pandemic in the kitchen? Or is the sentence a setup to a tear-down of entitlement? Or the beginning of an essay about an activity that brings many, including me, comfort amid uncertainty? All of these; none of them. Really I am writing that sentence the way I have always written any sentence about food: As someone with an eating disorder, someone who is working toward recovery but is not yet recovered. Stay-at-home orders present special challenges for people with eating disorders. The kitchen is always there: You can’t get away from it. You can’t get away from food online, either, where it’s more present than ever: Sourdough starters and bean shortages and the ease with which people with healthier, typical relationships with food joke about these things, or fill their Instagrams with photos of family meals. I don’t begrudge others that ease; I long for it. Eating disorders are isolating. They are often misunderstood, perceived as the kind of thing you could get over if you just got a grip. Right now, many in our country are suffering profoundly, facing death and loss of livelihoods. Being able to afford food is a marker of privilege. Shouldn’t our primary relationship with food be one of gratitude for it? It’s not that simple for people with eating disorders. For someone with an active eating disorder, food can be an agent of destruction. For someone in recovery, isolation can prompt a shift to old coping mechanisms. Eating disorder outreach has risen online: On Instagram, @covid19eatingsupport provides “meal support” — somebody to eat with. The National Eating Disorders Association offers video sessions that explore subjects such as family dynamics during quarantine and eating disorders during midlife. © 2020 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27246 - Posted: 05.14.2020

By Jennifer Couzin-Frankel In college in the 1990s, Alix Timko wondered why she and her friends didn’t have eating disorders. “We were all in our late teens, early 20s, all vaguely dissatisfied with how we looked,” says Timko, now a psychologist at Children’s Hospital of Philadelphia. Her crowd of friends matched the profile she had seen in TV dramas—overachievers who exercised regularly and whose eating was erratic, hours of fasting followed by “a huge pizza.” “My friends and I should have had eating disorders,” she says. “And we didn’t.” It was an early clue that her understanding of eating disorders was off the mark, especially for the direst diagnosis of all: anorexia nervosa. Anorexia is estimated to affect just under 1% of the U.S. population, with many more who may go undiagnosed. The illness manifests as self-starvation and weight loss so extreme that it can send the body into a state resembling hibernation. Although the disorder also affects boys and men, those who have it are most often female, and about 10% of those affected die. That’s the highest mortality rate of any psychiatric condition after substance abuse, on par with that of childhood leukemia. With current treatments, about half of adolescents recover, and another 20% to 30% are helped. As a young adult, Timko shared the prevailing view of the disease: that it develops when girls, motivated by a culture that worships thinness, exert extreme willpower to stop themselves from eating. Often, the idea went, the behavior arises in reaction to parents who are unloving, controlling, or worse. But when Timko began to treat teens with anorexia and their families, that narrative crumbled—and so did her certainties about who is at risk. Many of those young people “don’t have body dissatisfaction, they weren’t on a diet, it’s not about control,” she found. “Their mom and dad are fabulous and would move heaven and Earth to get them better.” © 2020 American Association for the Advancement of Science

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 27181 - Posted: 04.10.2020

By Abby Sher The rules were simple. Whenever Madonna sang, we strutted our stuff up and down the matted blue carpet. If the music stopped, we struck a pose in front of the full-length mirror. “Your face is crooked!” my friend Diana shrieked. “Your legs are 10 feet long!” I yelled back. It wasn’t an insult; it was true. The mirror in my bedroom was old and warped, like in a fun house. We spent hours in front of it, jutting out our hips and crossing our eyes; laughing at how ugly we looked. How round and pointy, long and short we could be, all at the same time. I don’t know exactly when it became painful for me to look at my reflection. Maybe when I was told to cover the mirrors in our house for my father’s funeral (a Jewish tradition). I was 11 at the time and couldn’t understand how these pale lips and string bean legs of mine were here, while my dad was forever gone. So I kept staring at my body in that glass, feeling a new kind of grief and confusion rip through me. A few weeks later, I started junior high, where looks were everything. I used a mirror so I could run turquoise eyeliner across my lids or zero in on a blooming pimple. But I got more and more frustrated by what I saw. My splotchy skin and bushy eyebrows felt untamable; my arms too long. By high school, I grew out my frizzy bangs to hide my face and wore baggy overalls with a tiny cowbell around my neck, as if I were lost in the fields and needed to find my way home. It wasn’t until after college that I dove headlong into an eating disorder. There was no definitive moment where I said, I’m going to try starving myself today. Instead it was a gradual whittling away at my body. I became obsessed with shrinking myself down to a size 0; spending hours at the gym until I was dizzy and frantic, fueling myself on coffee and sugarless gum. © 2020 The New York Times Company

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment; Chapter 18: Attention and Higher Cognition
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 14: Attention and Higher Cognition
Link ID: 27068 - Posted: 02.25.2020

Jules Montague In a dark, nondescript room tucked away in the depths of a London research centre, Lucy Gallop is demonstrating how we might treat eating disorders in future. Improbably, she presses on a pedal under a desk, like a driver pulling away in first gear. Magnetic pulses pass through an electromagnetic coil which is held to a patient’s head. Clicking sounds fill the room and the patient’s neural activity is temporarily altered over the course of a few minutes. A brain scan is visible to her right, the target area already visualised. “The neuronavigation tells you whether or not you’re at the right place,” Gallop says of the process, known as repetitive transcranial magnetic stimulation (rTMS). “It’s replicable so you know when the participants come in the next time, you’re stimulating the same area.” Gallop’s work carries deep personal significance: “My sister had anorexia so I was exposed to family therapy from a young age. And truthfully, it really exposed me to how treatment is very difficult – making a full recovery from anorexia is very difficult.” New treatment innovations are urgently needed for eating disorders, which affect an estimated 1.25 million people in the UK. Hospital admissions have almost doubled in the last six years and patients are sent hundreds of miles away from home for treatment. Earlier this month, new figures showed that one in six consultant posts in eating disorder services are vacant. Patients with eating disorders are twice as likely to die prematurely than the general population. © 2019 Guardian News & Media Limited

Related chapters from BN: Chapter 13: Homeostasis: Active Regulation of the Internal Environment
Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment
Link ID: 26719 - Posted: 10.18.2019