In a recent study published in PLoS One, a number of autoimmune diseases were found to be linked to eating disorders. The study researchers suggested that the autoimmune diseases may have played a role in the development of eating disorders.
The study comprised a large sample of more than 2,000 Finnish people with eating disorders. Of these 2,000 people, a higher proportion that would otherwise be expected of a healthy sample, reported coexisting autoimmune diseases.
Autoimmune diseases, such as diabetes type 1, coeliac disease and IBS occur when the immune system incorrectly attacks and destroys healthy cells in your body.
The researchers said of their findings “The immune system appears to contribute to the start and continued problems of eating disorders, at least in this group of patients”.
Over the course of about 16 years, the researchers examined 2,342 people currently in treatment for bulimia nervosa, anorexia nervosa and binge-eating disorder.
Each patient was then compared with four age- and sex-matched healthy people. Also, data on 30 autoimmune diseases from a hospital discharge register from 1969 to 2010 were analyzed.
Results showed that 8.9% of the people with eating disorders and 5.4% of healthy people had been diagnosed with at least one autoimmune disease by the end of follow-up.
The immune system has previously been recognized as playing a role in disorders including autism spectrum disorders, ADHD, obsessive-compulsive disorder, and post-traumatic stress disorder. Additionally, previous research has reported autoimmune diseases and severe infections to be significant risk factors for mood disorders and schizophrenia.
Eating disorders are known to have a very strong psychological component, but this study provides evidence for their also being a possible biological component to eating disorders.
Orthorexia nervosa has gained increasing attention in the press in recent years, but what is it? Sometimes described as orthorexia nervosa, it describes those who may be seen as having “unhealthy obsessions” with otherwise healthy eating. Orthorexia usually starts out as a harmless attempt to follow certain healthy eating rules. However, in some cases, these rules start to become all consuming obsessions. At this point, a person may be referred to as having orthorexia. ‘Healthy’ dietary rules will be followed to an extreme, and the person will become fixated on food quality and purity. Deviations or ‘slip ups’ from these rigid food rules become highly distressing, and are often taken as evidence that the person is a failure, or has no will power. ‘Punishment’ is often used following any deviation from these very rigid rules, and may include fasting, increased dietary restriction or strict exercise. Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Is Orthorexia An Eating Disorder?
Orthorexia is a term coined by Steven Bratman, MD to describe his own experience with food and eating. It is not an officially recognized disorder in the DSM-V, but is similar to other eating disorders – those with anorexia nervosa or bulimia nervosa obsess about calories and weight while orthorexics obsess about healthy eating (not about being “thin” and losing weight).
Why Does Someone Get Orthorexia?
Orthorexia appears to be motivated by health, but there are often additional underlying motivations, which can include safety from poor health, compulsion for complete control, escape from fears, wanting to be thin, improving self-esteem, searching for spirituality through food, and using food to create an identity.
Do I Have Orthorexia?
Consider the following questions. The more questions you respond “yes” to, the more likely it is that you may be suffering from orthorexia:
Why is orthorexia unhealthy?
When food choices become so restrictive, in both variety and calories, health suffers. The diet of orthorexics can actually be unhealthy, with nutritional deficits specific to the diet they have imposed upon themselves. These nutritional issues may not always be apparent as a person may continue to ‘feel’ healthy.
Social problems are often more apparent. A person with orthorexia can easily become socially isolated, often because they plan their life around food. They may have little room in life for anything other than thinking about and planning food intake. Orthorexics lose the ability to eat intuitively – to know when they are hungry, how much they need, and when they are full. Instead of eating naturally they are destined to keep “falling off the wagon,” resulting in a feeling of failure familiar to followers of any diet.
In the long term, obsessions with healthy eating will start to crowd out other activities and interests, impair relationships, and become physically dangerous.
What does Recovery from orthorexia look like?
Recovered orthorexics will still eat healthily, but they will achieve a different understanding of what healthy eating is. They will realize that food will not make them a better person and that basing their self-esteem on the quality of their diet is irrational. Their identity will shift from “the person who eats health food” to a broader definition of who they are – a person who loves, who works, who is fun. They will find that while food is important, it is one small aspect of life, and that often other things are more important!
Orthorexia, being a relatively newly recognised condition, will rarely be diagnosed by a GP however, professional help is usually required. Psychologists at The London Centre are skilled in helping people overcome the limitations of orthorexia and CAN help you.
Binge eating disorder, or BED, is a serious condition characterized by uncontrollable eating, usually with resulting weight gain. It is estimated that 3.5% of women, @% of men and 30 – 40% of people seeking weight loss treatments can be diagnosed as having binge eating disorder. People with binge eating disorder frequently eat large amounts of food (beyond the point of feeling full) while feeling a loss of control over their eating. Often, these habits develop as a way of coping with depression, stress or anxiety. Although the bingeing behavior is similar to what occurs in bulimia nervosa, people with binge eating disorder do not engage in compensatory behaviours such as vomiting or exercise in order to get rid of the calories consumed during a binge.
Many people who have binge eating disorder use food as a way to cope with uncomfortable feelings and emotions. These are people who may have never learned how to deal effectively with stress, and find it comforting and soothing to eat food. Unfortunately, they often end up feeling sad and guilty about not being able to control their eating, which increases the stress and fuels the cycle.
Most people overeat from time to time, and many people say they frequently eat more than they should. Eating large amounts of food, however, does not mean that a person has binge eating disorder. People with binge eating disorder have several of the following symptoms weekly for at least 3 months:
People who have binge eating disorder also tend to have:
Over 60% of women in the UK have dysfunctional eating habits. These are almost always fuelled by a poor or negative body image. Poor body image may not have the alarming medical consequences of severe eating disorders, but the social, emotional and psychological impact of living with a poor body image may be just as worrying. Ninety-six percent of all women will not have or be able to have the ideal body type portrayed by todays media.
Men and women both experience pressure to achieve an unrealistic physical ideal. Meanwhile the diet industry profits billions from our national preoccupation with size. Achieving a healthier body image is possible however. Below are some suggestions for developing a healthier relationship with your body:
Ninety-five percent of diets do not work, with weight regain, often to a higher point that you were at before, being a common consequence of dieting. Instead of dieting, start eating normally. Normal eating involves eating when you’re hungry, listening to your body and stopping when you feel full. Try to include all foods you enjoy in your diet in moderation. This will reduce cravings for those foods. A healthy eating structure will include eating three regular meals at roughly the same time each day and snacking once or twice if you’re hungry.
Focus on the total person
You are more than individual body parts. Instead of focusing on particular physical features (generally the ones you don’t like), try and look at yourself as a whole, spending as much time focussing on the areas that you do like. Think also about the qualities, other than appearance, that make you who you are.
Enjoy your body
The most helpful lifestyle improvement is for sedentary people to become active. This doesn’t have to mean hours of exercise in the gym. Treat your body well. Instead of exercising to reach a target weight, try to engage in activities you enjoy – going for a walk, gardening, walking round the shops. A good idea is to spend a few minutes walking with a friend each day or look for small opportunities to become more active: Take the stairs instead of the lift or deliberately park as far as possible from the entrance to a store. Enjoy being active without worrying about weight.
Practice positive thinking
Positive thinking is an essential part of healthy living, directly affecting our physical and mental well being. Try to give yourself a compliment each day, or notice and acknowledge your achievements, however small they may be.
Try to think about other positively, regardless of their size. Accept your friend, colleagues or family members at any size. Compliment behavior, ideas and character instead of appearance and develop more self-acceptance, self-appreciation and self-respect.
Be aware of the impact of emotions
Often people start to feel bad about their bodies because they are struggling with some other emotion, often totally unrelated to their appearance. Stress at work, problems in relationships, tiredness, an argument with a friend etc.. may all trigger body dissatisfaction. Try to be aware of your emotions and recognise when you may be feeling worse about your body because of an emotional trigger. Think about what you need to do to change or cope with the original emotion, rather than focussing solely on your feelings about you body.
Recognise when you need support
Some people will find it extremely difficult to change their own body image without help or support from others. If you find yourself disagreeing or struggling with the ideas above, consider seeking help from a professional who will help you to achieve a healthier relationship with your body.
Parents and teachers are being urged to be mindful of their eating habits and comments they make about body image in front of their children after a government report found body dissatisfaction in children as young as eight.
At least two in five children aged 8-11 desired a thinner than average body size, the study of more than 4,000 children by the Australian Institute of Family Studies found.
Children were surveyed about their attitudes towards their body and their desired body size at age 8-9, and again at 10-11. Their mothers also answered questions about their child’s eating habits.
By age 10-11, most children reported trying to control their weight. Among underweight children, 16% of girls and 11% of boys wanted to be even thinner than they were, and half wanted to stay underweight.
Of the boys and girls who were dissatisfied with their body, the proportion of mothers who were concerned about their child eating too much or unhealthy food was greater among boys than girls, at 55% and 49% respectively.
The largest eating disorders charity in Australia, the Butterfly Foundation, said the findings highlighted the importance of parents in promoting self-esteem.
“We would encourage all parents to develop positive body image and a healthy relationship with food and exercise in order to be positive role models for their children and their teenagers,” foundation chief executive Christine Morgan said.
In addition, anti obesity campaigns being rolled out in schools may also be of concern.
“The impact of health campaign messaging about child obesity, and the messages they receive from multiple sources every day about ideal body shape and size, is clearly producing an unintended consequence.”
This has long been a concern for eating disorder specialists who have expressed concern over the ‘norm’ of dieting and weight concern. Dr. Bryony Bamford of The London Centre for Eating Disorders and Body Image states ‘The governments campaigns to tackle obesity in school age children could be considered a risk to those who may be susceptible to developing eating disorders.
Teenagers do not need to be dangerously underweight to be practicing the dangerous eating behaviors associated with anorexia.
A recent Australian study noted that a drastic drop in weight carries the same risk for life-threatening medical problems even if the patient is a normal weight.
Anorexia nervosa is a mental illness characterized by excessive weight loss and psychological symptoms that include a distorted self-image and fear of weight gain. In some patients, this can also include depression and anxiety. Using current diagnostic guidelines (set to change in 2015), those who have these symptoms but are not underweight enough to qualify for the definition of anorexia fall under a different diagnosis, known as Eating Disorder Not Otherwise Specified (EDNOS).
“Emaciated bodies are the typical image portrayed in the media of patients with restricting eating disorders such as anorexia nervosa,” said lead researcher Melissa Whitelaw, a clinical specialist dietitian at The Royal Children’s Hospital in Melbourne, Australia. “This paper highlights that it is not so much about the weight but the weight loss that can lead to a serious eating disorder. The complications of malnutrition can occur at any weight.”
In her study, which included 99 teens aged 12 to 19, Whitelaw found only 8 percent of the patients had EDNOS-Wt in 2005, but more than 47 percent of the patients had it in 2009.
“I was surprised to see how much it increased,” Whitelaw said. “I was also surprised at how similar they were not only physically but also psychologically. Everything about them was anorexia except that they don’t look really skinny.” Both groups had even lost a similar amount of weight: a median 28 pounds for those with anorexia and 29 pounds for those with EDNOS-Wt.
Other experts noted that it can be difficult to spot this less obvious eating disorder.
“We are conditioned to think that the key feature of anorexia nervosa is low body mass index [BMI],” said Cynthia Bulik, director of the Center of Excellence for Eating Disorders at the University of North Carolina at Chapel Hill. BMI measures whether a person is a healthy weight for their height.
“In fact, we miss a lot of eating disorders when focusing primarily on weight,” Bulik added.
Leslie Sim, an assistant professor of psychology at Mayo Clinic Children’s Center in Rochester, Minn., said, “People are calling it atypical anorexia, but we see it every day. We see people who have all the psychological, behavioral, cognitive and physical symptoms of anorexia nervosa, but the only difference is their weight.”
In this study, the side effects of having an eating disorder were also very similar. Dangerously low phosphate levels occurred in 41 percent of anorexia patients and 39 percent of EDNOS-Wt patients. The lowest pulse for the teens was 45 beats per minute (bpm) for those with anorexia and 47 bpm for the other group. Meanwhile, 38 percent of the EDNOS-Wt patients and 30 percent of the anorexia patients required tube feeding.
“[Normal-weight patients with anorexia symptoms] were becoming medically unstable, despite the fact that they had what you would call a normal body weight,” Whitelaw said.
The reasons for the apparent increase in these patients is less clear, but both Sim and Whitelaw said it is likely a combination of increased awareness of the problem and an increased focus on obesity. One tricky aspect of identifying these patients, Sim said, is that the weight loss appears at first to be a positive development.
“These patients just fly under the radar and when they’re in that earlier stage, it’s harder for people to see it,” Sim said. “Parents say to me every day, ‘I thought my daughter was doing something good and making healthy choices until it got out of control. We didn’t know it was a problem until she couldn’t eat the cake at her birthday party.’ “
The experts emphasized that eating disorders are not parents’ fault. Instead, parents can play an important role in identifying the symptoms of an eating disorder, especially in its early stages, said Jessica Feldman, a licensed social worker and site director of The Renfrew Center in Radnor, Pa. Symptoms include significant changes in eating patterns, excessive exercising, a teen’s negative statements about their body image, an increase in depression or anxiety, and a loss of interest in previously enjoyable activities.
“No one chooses to have an illness. We would never tell someone with allergies to ‘just stop sneezing,'” Bulik said. “Although dieting might be a first step, the illness takes over and develops a life of its own — sufferers often cannot eat, even if they want to.” (Source: WebMD; posted by: Dr Bryony Bamford)
The exact cause of binge eating disorder is still unknown, but researchers are beginning to understand factors that lead to its development. Like other eating disorders, binge eating disorder seems to result from a combination of psychological, biological, and environmental factors.
Binge eating disorder has been linked to other mental health disorders. Nearly half of all people with binge eating disorder have a history of depression, although the exact nature of the link is unclear. Many people report that anger, sadness, boredom, anxiety, or other negative emotions can trigger an episode of binge eating. Impulsive behavior and other psychological problems also seem to be more common in people with binge eating disorder.
Eating disorders, including binge eating disorder, can sometimes run in families, suggesting that a susceptibility to eating disorders might be inherited. Researchers also are looking into possible abnormal functioning of chemical messages to the brain involving hormones that regulate appetite (such as leptin and ghrelin) and proteins that regulate blood sugar and body metabolism (such as adiponectin).
People with binge eating disorder often come from families that overeat or put an unnatural emphasis on food; for example, they may use food as a reward or as a way to soothe or comfort, leading to binge eating as a learned behavioral response to stress.
Binge eating also sometimes can be an undesirable side effect of certain psychiatric or other medications that stimulate appetite and may interfere with people being able to sense when they are full after eating a meal.
Can Binge Eating Disorder Be Prevented?
Although it might not be possible to prevent all cases of binge eating disorder, it is helpful to begin treatment in people as soon as they begin to have symptoms. In addition, teaching and encouraging healthy eating habits and realistic attitudes about food and body image also might be helpful in preventing the development or worsening of eating disorders.
In what would be a landmark move, Italian officials are proposing that owners and publishers of pro-anorexia or pro-bulimia websites be subject to jail time or fines. The legislation would work by adding a clause to an existing law that makes it illegal to assist or instigate suicide, reports Yahoo Health. The Italian government is worried that the rise of pro-ana types of websites is promoting eating disorders as positive lifestyle choices and that they pose a public health threat. Yet critics of the bill say that targeting website owners would mean targeting many young people who are suffering from eating disorders – and who may already be in a vulnerable state. “People who create and consume this content are not villains; they are struggling, and sometimes they are very sick,” said Claire Mysko, teen outreach coordinator for the National Eating Disorders Association. “That’s why we believe so strongly in providing a positive alternative.” If the bill is approved, offenders could face up to two years in jail or fines of $10,000 to $100,000 euros. The fines would double if the website in question was found to have influenced the behavior of a person 14 years old or younger. Critics are calling the move ultra-conservative, stating that the law would only punish those that truly need help. The law has yet to be voted on, but both houses of parliament must approve the legislation in order for it to pass. Source: yahoo health
One of the most common contributors to low mood or mood shifts is negative thinking. The 10 questions below are designed to help you explore the thoughts you are having either about yourself or about a situation that you are in. In particular, they will help you to assess whether your thinking is overly negative or critical. One way to help people to improve their mood is to help them develop a compassionate voice. Start to think about the role that your thinking has in shaping your mood, and whether you are able to show any more kindness or compassion towards yourself.
1. Do I think like this ALL the time? If not why am I thinking like this now?
2. If my best friend / daughter thought like this what would I tell them?
3. If my best friend knew I was thinking like this what would they say to me?
4. If I told someone I was thinking like this would they say I was being fair or that I was being harsh on myself
5. Would I speak to someone else like I am speaking to myself? If not what would I say to them
6. If I was being kinder to myself what might I say?
7. Are there any positives that I am discounting? What positives about myself or my life can I remind myself of?
8. Is there any advantage to speaking to myself as I am? What other language could I use?
9. 5 years from now how will I look back on this situation, how important will it be to me then?
10. Am I blaming myself for something over which I have little control? Are there any other influences over this situation that I might be discounting?
We praise the recognition among schools that encouraging pupils to strive for perfection in all areas can increase the risk of mental health conditions including depression and eating disorders.
Unrelenting standards and a core sense of failure or not being good enough are common difficulties among people who present to us for treatment. Targeting these issues at a younger age and encouraging people to resist the urge to need to be perfect at all times is crucial to good mental health. We hope to see more schools following this example.