by D. Blake Woodside, M.D. Psychiatric Times The occurrence of eating disorders in men remains relatively rare but consistent. This is true despite recent research suggesting that male cases are far more numerous than had been previously thought. This brief article will comment on recent research findings in this area and describe their relevance to assessment and treatment. Two studies support the notion that eating disorders are more common than had previously been thought (Health Canada, 2003; Woodside et al., 2001). Woodside et al. (2001) reported on the results of a 10,000-person community epidemiologic study. Combining full- and partial-syndrome eating disorder cases for both men and women, the investigators showed an overall rate of three female cases for every one male case-a far cry from the typical 10:1 or 20:1 ratio found in most treatment settings. However, this study assessed only limited Axis II parameters and, as DSM-III-R diagnoses were generated from the data, the prevalence of binge-eating disorder could not be assessed. More recently, Health Canada (2003) released preliminary results from a national, face-to-face mental health survey of over 30,000 people performed in 2001 and 2002. This survey assessed for full-syndrome eating disorders and reported a ratio of male to female cases of approximately 1:5. This was somewhat higher than the findings from Woodside et al. (2001) but showed many more cases than might otherwise have been thought. The somewhat higher ratio in the Health Canada survey is almost certainly related to only full-syndrome cases that the Woodside et al. survey was too small to allow for. © 2004 Psychiatric Times. All rights reserved.

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Link ID: 5207 - Posted: 06.24.2010

Blame biology, not parenting, new theory suggests By Ellen Ruppel Shell, Globe Correspondent, Anorexia, she contends, is not primarily a psychological condition brought on by a troubled childhood -- as is often thought -- but a disorder based in biology, specifically in the appetite regulation mechanism in the brain. Her theory postulates that anorexics have a biological adaptation to weight loss that causes their bodies to shut off hunger signals, and to ratchet up physical activity, even as their flesh melts away. "Anorexics are often told to stop dieting, to listen to their body and to give it what it wants," Guisinger said. "But the reality is that they are listening to their bodies, and their bodies are telling them not to eat. The truth is, they have to stop listening." Guisinger, who has treated eating disorders in private practice in Missoula, Mont., for nearly two decades, trained in evolutionary biology in the late 1970's before getting a doctorate in clinical psychology at the University of California at Berkeley. This background, coupled with her upbringing on a farm in Washington state, convinced her that Freudian and other purely psychological explanations for anorexia were inadequate. © Copyright 2003 Globe Newspaper Company.

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Link ID: 4762 - Posted: 06.24.2010

Although thought of as a psychological problem, the eating disorder anorexia nervosa often runs in families, suggesting that it has a genetic component. Now researchers have found two genes that help determine the risk of acquiring the disease. The results suggest that variations in genes involved in mood and appetite can put women at risk for anorexia. People with anorexia, usually women, have a distorted body image, starve themselves, and tend to be perfectionists. Studies over the last decade have suggested that genes play a role. The risk of becoming anorexic is about half a percent in the general population, but in 2000, researchers found that the risk jumped 11-fold in people with anorexic family members. Family dynamics don't appear to explain the link: Psychiatrist Walter Kaye at the University of Pittsburgh and colleagues found a variation of a region on chromosome 1 that was common in people with the disease. Copyright © 2003 by the American Association for the Advancement of Science.

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Link ID: 3811 - Posted: 06.24.2010

NewScientist.com news service Anorexic women have much higher levels of a mysterious molecule suspected to affect appetite, researchers have shown for the first time. The peptide, called CART, could be a candidate for new appetite-altering drugs, they say. Levels of CART were 50 per cent higher in blood samples from anorexic women, compared with women without the eating disorder, says Sarah Stanley, an endocrinologist at Imperial College London. CART levels were also found to rise as the women's weight fell. However, the function of CART in humans is not known. "And because we know so little, it is difficult to know if CART is the cause of the weight loss or the result," Stanley told New Scientist. © Copyright Reed Business Information Ltd.

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Link ID: 3624 - Posted: 06.24.2010

Victims Learn Dangerous Behavior SAN DIEGO -- Anorexia Nervosa is considered one of the deadliest mental illnesses around. But instead of helping victims learn to overcome the eating disorder, dozens of Web sites actually promote, teach and support the disease. "There's a camaraderie there that people are seeking, in a very sad and tragic way," Dr. Trish Stanley said. Neely Weir started suffering from the disease in 8th grade. Now recovered, Weir helps other teens and finds pro-anorexia sites disturbing. © 2002, Internet Broadcasting Systems, Inc. and The McGraw-Hill Companies.

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Link ID: 1525 - Posted: 06.24.2010

By DANA WALTERS In high school, I was a skeleton of who I am now. With pangs of hunger and a jutting rib cage, I was waiting for confidence and determination to flesh me out, fill me and protect me. The story of eating disorders, of young girls starving themselves for the sake of perfection, is a common one, written on the bathroom walls amid the graffiti of rumors and insults. Despite its ubiquity in high school, I believed my hunger was mine alone. Only later did I discover just how truly commonplace my story was. My eating disorder did not make me special. Only curing myself would. I grew up in Swarthmore, Pa., a town not unlike Middlebury, Vt., where I now attend school, but I still thought the substitution of the Green Mountains for the Philadelphia skyline would be just enough to drastically shift my unbalanced psyche. But the deeply instilled sense of overwork and suicidal efficiency still flourished. In Swarthmore, it dotted the driveways of professors, lawyers and doctors, gave nourishment to the soil along the streets named after the most competitive universities in the nation, and resonated in the enthusiasm with which parents flipped through the college announcement edition of the town paper. My new environment, it turned out, was much the same. When I arrived at Middlebury, the beautiful New England buildings screamed of the same hunger for achievement. The competition for perfection was not over. Students glowed with the masochism that drove us to fast ourselves into oblivion. Copyright 2009 The New York Times Company

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Link ID: 13102 - Posted: 07.27.2009

More people with eating disorders could benefit from "talking therapies" which aim to release them from obsessive feelings, say UK researchers. They said a specially-created form of cognitive behavioural therapy might work in four out of five cases. A 154-person American Journal of Psychiatry study, by the University of Oxford, found most achieved "complete and lasting" improvement. At present, the treatment is officially recommended only for bulimia patients. Some statistics suggest that more than a million people in the UK are affected by some kind of eating disorder, the best known types being anorexia nervosa and bulimia. Approximately 40% of those with eating disorders have bulimia, 20% have anorexia, and the remainder have "atypical disorders", which can combine both bulimic and anorexic-type symptoms. The National Institute of Clinical Excellence has backed cognitive behavioural therapy for bulimia, but Professor Christopher Fairburn, the Wellcome Trust funded researcher who led the project, believes his version could help many more people. His study focused on bulimia and "atypical" patients, but excluded those with anorexia. The technique works using a series of counselling sessions which help the person involved to realise the links between their emotions and behaviour, and work out ways to change what they are doing. Professor Fairburn developed two versions specifically for people with eating disorders, one which focused completely on the eating problems, and another, which took a wider view of not only the eating disorder, but also problems with self-esteem which might be contributing to it. Both treatments involved 50-minute outpatient sessions repeated once a week for 20 weeks. (C)BBC

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Link ID: 12341 - Posted: 12.15.2008

The French National Assembly has passed a groundbreaking bill which seeks to criminalise the promotion in the media of extreme thinness. The bill targets pro-anorexia websites and publications that encourage girls and young women to starve themselves. It will affect websites, fashion houses, magazines and advertisers. If approved by France's upper house, those found to have encouraged severe weight loss could be fined up to 45,000 euros and face three years in prison. French Health Minister Roselyne Bachelot said the proposed law would help stop advice on how to become ultra-thin being spread through pro-anorexia sites on the internet. "Encouraging young girls to lie to their doctors, advising them on foods that are easier to regurgitate and inciting them to beat themselves up each time they eat is not freedom of expression," Ms Bachelot told the assembly. "These messages are death messages. Our country must be able to prosecute those who are hiding behind these websites," she said. Jacques Domergue, a lawmaker supporting the bill, said that the intention was to send a strong message to society. (C)BBC

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Link ID: 11531 - Posted: 04.16.2008

Campaigners are calling for social networking websites, such as Facebook and MySpace, to clamp down on pro-anorexia sites. Doctors at one of the country's largest eating disorders treatment centres said they needed to act more responsibly. The eating disorders charity, B-eat, said little progress had been made on combating "pro-ana" sites. The networking sites said it was hard to distinguish between support groups and "pro-anorexia" groups. But a spokesperson for MySpace said they were working with organisations such as B-eat. Over 1.1 million Britons are known to suffer from an eating disorder. The vast majority are women, although experts believe the numbers could actually be much higher as many cases go undiagnosed. Specialists and charities say the rise of the internet and new media has played a significant part in providing easier access to information on how to get thin. Research has shown that young women exposed to pro-ana websites felt more negative, had lower self-esteem, perceived themselves as heavier and were more likely to compare their bodies with other women. Dr Ty Glover, consultant psychiatrist on the Eating Disorders Unit at Cheadle Royal Hospital, said it had proven difficult to shut down pro-ana websites, but the situation was slightly different for sites such as Facebook. "Social networking sites can censor their material and we expect them to act responsibly," he said. Rather than censor these groups, we are working to create partnership (C)BBC

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Link ID: 11331 - Posted: 02.25.2008

Babies who go on to develop anorexia may be programmed in the womb by their mother's hormones, evidence suggests. Women are usually much more likely than men to have the eating disorder, but a University of Sussex study found men with a female twin were more at risk. This suggests the hormones released to aid female development may be key. Commenting on the Archives of General Psychiatry study, a UK expert said other factors in childhood and adolescence remained important. It is estimated that up to 90,000 people will be receiving treatment for eating disorders in the UK at any one time, with many other cases going undiagnosed. No-one is sure why women are more prone than men. Some experts suggest that the pressures of modern society are partly to blame while others look at brain changes much earlier in life. Research into twins is a way to examine the factors involved, as the single most important period for brain development is during the months of pregnancy. Dr Marco Procopio, from the University of Sussex, worked with Dr Paul Marriott from the University of Waterloo in Canada to look at information drawn from thousands of Swedish twins born between 1935 and 1958. Overall, as expected, female twins were more likely to develop anorexia than male twins. The only exception was among mixed-sex twins, where the male was as likely to develop anorexia as the female. The researchers wrote that the most likely reason was because of sex steroid hormones released into the womb during pregnancy. (C)BBC

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Link ID: 11038 - Posted: 12.04.2007

Sophisticated scans have revealed the eating disorder anorexia is linked to specific patterns of brain activity. Even young women recovering from anorexia who have maintained a healthy weight for over a year had vastly different brain activity patterns. The findings in the American Journal of Psychiatry point to a brain region linked to anxiety and perfectionism. The University of Pittsburgh authors said the understanding might help with the development of new treatments. The work could also explain why people with anorexia nervosa are able to deny themselves food. It is estimated that one in 100 women between the ages of 15 and 30 has anorexia. The main symptom is the relentless pursuit of thinness through self-starvation. This may become so extreme that it is life-threatening. Dr Walter Kaye and his team studied 13 women who were recovering from anorexia and 13 healthy women. The women were asked to play a computer quiz where correct guesses were rewarded financially. At the same time, the researchers observed what was going on inside the mind using a type of brain scan called functional magnetic resonance imaging. During the game, brain regions lit up in different ways for the two groups of women. While the brain region for emotional responses - the anterior ventral striatum - showed strong differences for winning and losing the game in the healthy women, women with a past history of anorexia showed little difference between winning and losing. Dr Kaye said that, in anorexia, this might impact on food enjoyment.

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Link ID: 11032 - Posted: 12.03.2007

By Robin Hilmantel, USA TODAY Whenever Leslie Lipton was handed a menu, she'd freeze. She suddenly would feel that all eyes were upon her, noticing and judging her eating habits. This was something she couldn't quite swallow when she was a teenager. "I'd sit there, and I'd wait, and I'd see what everyone else was ordering before I ordered," says Lipton, now 21 and a student at Barnard College in New York City. Lunch in the high school cafeteria felt like a competition. "Everyone would be looking at everyone else's tray to see what everyone else was eating," says Lipton. "If you eat less, at least the comparisons are good." Lipton says this reluctance to eat in public was the prologue to her anorexia, the starvation eating disorder from which she has since recovered. But, she says, many girls across the country avoid food in public even if they eat normally at home. This self-conscious group is convinced that without the classical symptoms of an eating disorder, such as extreme weight loss, there's no problem. But parents and friends are often left wondering at what point such behavior indicates that an eating disorder is brewing. Lipton, who now speaks to girls across the country about eating disorders and her recovery, says the phenomenon is "rampant." The author of Unwell: A Novel, which was published last year, Lipton blames society's emphasis on thinness. "People don't seem to look at girls as needing food," she says. Copyright 2007 USA TODAY,

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Link ID: 10763 - Posted: 09.21.2007

AUDIO VISUAL LINK As London fashion week begins there is concern about the effect 'thinspirational' websites have on anorexic people.

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Link ID: 9962 - Posted: 02.13.2007

By Sarah Waldron As the government attacks "fashion and the tyranny of thinness" for undermining the confidence of girls, experts are seeing younger and younger children with eating disorders. But blaming stick-thin models might be too simplistic. Rhodes Farm is a clinic dealing with children suffering from anorexia nervosa. Opened 16 years ago, it has seen the average age of clients drop and children as young as eight are now being treated. Culture Secretary Tessa Jowell has pledged to tackle "the cult of size zero" by establishing a task force with fashion leaders, but for many girls at the clinic the issue is more about control. Twelve-year-old Natasha was admitted to Rhodes Farm after her weight fell to less than four-and-a-half stone. She says the furore over "size zero" models and celebrities has nothing to do with why she stopped eating. "[The media's] story is people get anorexia because they want to be thin and they see other people in magazines and on the catwalk and they think 'I want to be like that'," she says. "That's a really good story and why would they change it - it's a perfect story. But it's not the truth. Maybe for some people it is, but I know that for me it's not. I haven't got anorexia because I've been inspired to look like other people. It's the image in my head. There's no one that's my idol. (C)BBC

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Link ID: 9905 - Posted: 01.31.2007

PITTSBURGH, -- Misstatements and ignorance claiming that families "cause" eating disorders is like blaming parents for diabetes or asthma or cancer says an international group of eating disorders researchers. Recent damaging statements by fashion model Gisele Bundchen stating that unsupportive families cause anorexia nervosa only perpetuate misconceptions and further stigmatize eating disorders. Contrary to her claim, there is no scientific evidence that families cause anorexia nervosa. In fact, the researchers are finding that anorexia nervosa is far more complex than simply wanting to be slim to achieve some fashionable slender ideal. The data show that anorexia nervosa has a strong genetic component that may be the root cause of this illness. "An uninformed opinion such as Bundchen's causes harm on a number of levels. By contributing to the stigma, it drives sufferers underground and creates obstacles to seeking help. It damages attempts at advocacy and hurts parents who are desperately fighting for their child's recovery," said Allan S. Kaplan, M.D., Loretta Anne Rogers Chair in Eating Disorders at the University of Toronto. "Such thinking also misinforms third party payors who may not want to pay for the treatment of these biologically-based illnesses if they think its primary cause is family dysfunction." Dr. Kaplan is a member of the international group of researchers attempting to find which genes contribute to anorexia nervosa through a National Institute of Mental Health-funded study of families with a history of anorexia nervosa. The current study, which is being conducted at 10 sites across the world, hopes to further clarify which genes play a role in anorexia nervosa. The study builds on data from ten years of groundbreaking research on the genetics of eating disorders sponsored by the Price Foundation.

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Link ID: 9864 - Posted: 01.23.2007

The binge-eating disorder bulimia may, in some cases, be linked to a sex hormone imbalance, research suggests. Bulimia is normally viewed as a mental condition and treated with psychological therapies. However, Dr Sabine Naessén, from the Karolinska Institutet suggests some women with the condition may have too much of the male hormone testosterone. Half the bulimics treated for this imbalance reported less hunger, and fewer cravings for fatty, sugary food. Dr Naessén claims that three out of 21 bulimics treated this way became completely free of the eating disorder. Bulimia involves compulsive overeating, and is probably the most common form of eating disorder. It is approximately 10 times more common in women as men. Normal treatments involve cognitive behavioural therapy, psychological counselling which looks to uncover deep-rooted causes for problems. Antidepressants are often prescribed for the illness. However, some outward signs of hormonal imbalance were apparent in a group of 77 bulimics examined by Dr Naessén. The bulimics were more likely to report menstrual problems, excess body hair, and polycystic ovarian syndrome than women without the eating disorder. The theory was tested in 21 women who had outward signs of hormone imbalance, and were given the a version of the contraceptive pill containing the female sex hormone oestrogen. (C)BBC

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Link ID: 9825 - Posted: 01.09.2007

By BENEDICT CAREY One of the most widely used treatments for the eating disorder anorexia nervosa, the antidepressant Prozac, works no better than dummy pills in preventing recurrence in young women who have recovered from it, researchers are reporting today. The study, the most rigorous to date to test the use of medication for anorexia, should alter treatment for an illness that is often devastatingly chronic and that has a higher mortality than any other psychiatric disorder, experts said. Fewer than a third of the study's participants, who also received regular psychotherapy, remained healthy for a year or more, whether they received drug treatment or not, the study found. An estimated 1 percent of Americans, or about three million people, mostly young women, will at some point suffer from the self-starvation and obsessive anxiety about weight that characterize anorexia, and surveys find that about two-thirds of them receive treatment with Prozac or similar antidepressants, which are considered generally interchangeable. Research suggests that the drugs can be useful in helping people recover from bulimia nervosa, an eating disorder involving bingeing and purging that causes less dramatic weight loss than anorexia. But the new findings put to rest hopes from earlier work that these benefits might carry over to anorexia, experts said. Copyright 2006 The New York Times Company

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Related chapters from MM:Chapter 9: Homeostasis: Active Regulation of the Internal Environment; Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 9039 - Posted: 06.15.2006

By Denise Winterman Nearly half of the British children with an eating disorder feel unable to talk about their problem, says a report from the Eating Disorders Association (EDA). It is estimated that more than a million people in the UK have anorexia or bulimia and many of them are young. The report says eating disorders are still misunderstood and mistaken, sometimes seen as trivial and self-inflicted when they are actually serious and life-threatening mental illnesses. Early treatment is vital if people are to avoid long-term consequences to their physical and mental health, but many youngsters keep their condition secret - including one such teenager who has kept a diary of her relationship with food. Sarah - not her real name - lives in Manchester with her mother and sister. The 18-year-old student has had an eating disorder for four years. Here she details how food dominated her last week. MONDAY Monday usually starts with a list of resolutions about what food I am not going to allow myself to eat in the next week. I want to control what I eat and get a feeling of excitement at the strict targets I set myself. When I am at college it is easy to do. The hard part starts when I get home from college. My family know I have a problem and insist on family meal times. (C)BBC

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Link ID: 8502 - Posted: 02.07.2006

Feeling thin or fat is an illusion constructed in the brain, according to a new study published in the journal Public Library of Science Biology. The collaborative study led by UCL (University College London) used a trick called the Pinocchio illusion to scan people's brains while they experienced the sensation that their waists were shrinking. The study reveals which parts of the brain are involved in body image and may shed some light on anorexia and body dysmorphic disorder, where sufferers are overly concerned by a small or imagined defect in their body, and frequently overestimate or underestimate their actual body size. The study, led by Dr Henrik Ehrsson of the UCL Institute of Neurology, used the Pinocchio illusion in combination with functional magnetic resonance imaging to study volunteers' brains. For each volunteer, a vibrating device was placed on their wrist to stimulate the tendon and create the sensation that the joint was flexing, even though it remained stationary. With their hand touching their waist, volunteers felt their wrists bending into their body, creating the illusion that their waists were shrinking. During the tendon exercise, all 17 participants felt that their waist had shrunk by up to 28 per cent. The researchers found high levels of activity in the posterior parietal cortex, an area of the brain that integrates sensory information from different parts of the body. Volunteers who reported the strongest shrinking sensation also showed the strongest activity in this area of the brain.

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Link ID: 8225 - Posted: 11.29.2005

Childhood sex abuse increases the risk of women developing eating disorders - and can even impact on their children, a study says. Researchers found girls abused before the age of 16 were twice as likely to develop eating disorders later in life. The University of Bristol team also said these women were likely to have weight concerns while pregnant and that had a knock-on effect on the child. The findings were published in the British Journal of Psychiatry. The team studied 10,000 women - one in five of whom had being abused. Researchers involved in the university's Children of the 90s project found 79% of the women recalled happy childhoods. The report said these women were less likely to worry about their weight or develop conditions such as bulimia and anorexia later in life. But of those who were sexually abused, 15% showed symptoms of an eating disorder and 30% showed concern about their weight during pregnancy. The researchers said this was a cause for concern, as maternal eating problems after childbirth interfered with parenting and child growth. Women with excessive fears about weight and shape are less likely to breast feed. But the report accepted other distressful experiences during childhood could also trigger problems. Previous research has shown that eating disorders may be connected to a wide range of unhappy childhood influences including parental alcohol misuse, physical or emotional cruelty and other family problems. (C)BBC

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Link ID: 8145 - Posted: 11.09.2005