Archive for the ‘statistics’ Category

Eating Disorders and Pregnancy

February 29, 2008

Eating disorders and pregnancy

Having an eating disorder can have serious consequences on one’s health. When the body is not getting significant nutrition, it may respond by stunting bone growth and allowing it’s muscles to waste away. One of the most important muscles in the body is the heart, and unhealthy weight loss can result in an irregular heartbeat, low blood pressure, and the very real possibility of cardiac arrest. While these problems affect one’s health to a great degree, there can be an even greater strain placed on the body when one is pregnant and has an eating disorder such as anorexia or bulimia. In this article, we’ll discuss the problem and offer some help when it comes to dealing with it.

The damage that is done to the human body through an eating disorder can truly have a negative effect on a woman’s endocrine system. This system is crucial when it comes to proper pregnancy, as it regulates the hormones that are responsible for proper development. For that reason, some women who have had eating disorders that they’ve successfully treated in the past may still be threatened with the aspect of having a risky pregnancy. Sadly, roughly twenty percent of all female visits to fertility clinics are made by women who have had an eating disorder in the past.

If you currently have an eating disorder and you’ve become pregnant, it’s important to do all that you can to save yourself from the disorder before the baby’s health is threatened. You should immediately seek the help of a physician or a counsellor in order to bring your body back to where it needs to be. Unfortunately, women who have eating disorders face a much higher risk of miscarriage. There is also a greater chance of having the baby prematurely, which can result in a host of developmental problems. Also, those with eating disorders need to consider how pregnancy works. Babies sap much of the nutrition that their mothers eat, so if your own health is not stable, your child’s life can be threatened as well as your own. Women with eating disorders often have low levels of calcium, and when the foetus begins to demand calcium, osteoporosis may occur, causing your bones and teeth to become weak and brittle.

Another thing to consider is the mental state that you are in. If you are busy being concerned about your self-image due to an eating disorder, you may be unable to give your growing child the attention that it needs. Before making any decision about becoming pregnant, be sure to consider all of the facts when it comes to the child’s development. Do your best to get yourself back to a healthy way of living before considering bringing a child into the mix; the resulting stressors can heavily outweigh your desires for having a child. Make a responsible decision before you do anything rash, and be sure that you’ll be able to provide a loving and peaceful setting for a child should you decide to have one.

Article by Mike Serov

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EDAW… failing families?

February 24, 2008

EDAW’08 Report:

Failing Families?

No one who loves and cares for someone with an eating disorder should feel ashamed; no one should feel so responsible and so alone. Yet time after time, families tell us that is exactly what they feel.

BEAT are launching Eating Disorders Awareness Week with a damning report, Failing Families?

“It has devastated us all. We have lost someone so precious because we were trying to do our best but did not have enough information or knowledge. It is difficult to bear the guilt and to carry on.”

We ask a simple question. Why are so many families being failed by services that should support them?

To read the report in full please go to the national eating disorder association’s web page: www.b-eat.co.uk

The Globalization of Eating Disorders

February 24, 2008

This is a wonderful short essay  by Susan Bordo which was originally posted by Patsy Clairmont on her blog:

Butterflies are just around the corner… adventures of a starving artist.

It is so interesting, insightful and filled with common sense, I just had to re-print it here.

“The young girl stands in front of the mirror. Never fat to begin with, she’s been on a no-fat diet for a couple of weeks and has reached her goal weight: 115 lb., at 54–exactly what she should weigh, according to her doctor’s chart. But in her eyes she still looks dumpy. She can’t shake her mind free of the “Lady Marmelade” video from Moulin Rouge. Christina Aguilera, Pink, L’il Kim, and Mya, each one perfect in her own way: every curve smooth and sleek, lean-sexy, nothing to spare. Self-hatred and shame start to burn in the girl, and envy tears at her stomach, enough to make her sick. She’ll never look like them, no matter how much weight she loses. Look at that stomach of hers, see how it sticks out? Those thighs–they actually jiggle. Her butt is monstrous. She’s fat, gross, a dough girl”.

 

As you read the imaginary scenario above, whom did you picture standing in front of the mirror?

If your images of girls with eating and body image problems have been shaped by People magazine and Lifetime movies, she’s probably white, North American, and economically secure. A child whose parents have never had to worry about putting food on the family table. A girl with money to spare for fashion magazines and trendy clothing, probably college-bound.

If you’re familiar with the classic psychological literature on eating disorders, you may also have read that she’s an extreme “perfectionist” with a hyper-demanding mother, and that she suffers from “body-image distortion syndrome” and other severe perceptual and cognitive problems that “normal” girls don’t share. You probably don’t picture her as black, Asian, or Latina.

Read the description again, but this time imagine twenty-something Tenisha Williamson standing in front of the mirror.

 

Tenisha is black, suffers from anorexia, and feels like a traitor to her race. “From an African-American standpoint,” she writes, “we as a people are encouraged to embrace our big, voluptuous bodies. This makes me feel terrible because I don’t want a big, voluptuous body! I don’t ever want to be fat–ever, and I don’t ever want to gain weight. I would rather die from starvation than gain a single pound.”

 

Tenisha is no longer an anomaly. Eating and body image problems are now not only crossing racial and class lines, but gender lines. They have also become a global phenomenon.

 

Fiji is a striking example. Because of their remote location, the Fiji islands did not have access to television until 1995, when a single station was introduced It broadcasts programs from the United StatesGreat Britain, and Australia. Until that time, Fiji had no reported cases of eating disorders, and a study conducted by anthropologist Anne Becker showed that most Fijian girls and women, no matter how large, were comfortable with their bodies. In 1998, just three years after the station began broadcasting, 11 percent of girls reported vomiting to control weight, and 62 percent of the girls surveyed reported dieting during the previous months.

 

Becker was surprised by the change; she had thought that Fijian cultural traditions, which celebrate eating and favour voluptuous bodies, would “withstand” the influence of the media images. Becker hadn’t yet understood that we live in an empire of images, and that there are no protective borders.

 

In Central Africa, for example, traditional cultures still celebrate voluptuous women. In some regions, brides are sent to fattening farms to be plumped and massaged into shape for their wedding night. In a country plagued by AIDS, the skinny body has meant–as it used to among Italian, Jewish, and black Americans–poverty, sickness, death.

An African girl must have hips,” says dress designer Frank Osodi. “We have hips. We have bums. We like flesh in Africa.” For years, Nigeria sent its local version of beautiful to the Miss World competition. The contestants did very poorly. Then a savvy entrepreneur went against local ideals and entered Agbani Darego, a light-skinned, hyper-skinny beauty. (He got his inspiration from M-Net, the South African network seen across Africa on satellite television, which broadcasts mostly American movies and television shows.) Agbani Darego won the Miss World Pageant, the first Black African to do so. Now, Nigerian teenages fast and exercise, trying to become “lepa”–a popular slang phrase for the thin “it” girls that are all the rage. Said one: “People have realized that slim is beautiful.”

 

How can mere images be so powerful? For one thing, they are never “just pictures,” as the fashion magazines continually maintain (disingenuously) in their own defence. They speak to young people not just about how to be beautiful but also about how to become what the dominant culture admires, values, rewards. They tell them how to be cool, “get it together,” overcome their shame. To girls who have been abused they may offer a fantasy of control and invulnerability, immunity from pain and hurt. For racial and ethnic groups whose bodies have been deemed “foreign,” earthy, and primitive, and considered unattractive by Anglo-Saxon norms, they may cast the lure of being accepted as “normal” by the dominant culture.

In today’s world, it is through images–much more than parents, teachers, or clergy–that we are taught how to be. And it is images, too, that teach us how to see, that educate our vision in what’s a defect and what is normal, that give us the models against which our own bodies and the bodies of others are measured. Perceptual pedagogy: “How to Interpret Your Body 101.” It’s become a global requirement.

 I was intrigued, for example, when my articles on eating disorders began to be translated, over the past few years, into Japanese and Chinese. Among the members of audiences at my talks, Asian women had been among the most insistent that eating and body image weren’t problems for their people, and indeed, my initial research showed that eating disorders were virtually unknown in Asia. But when, this year, a Korean translation of Unbearable Weight was published, I felt I needed to revisit the situation. I discovered multiple reports on dramatic increases in eating disorders in China, South Korea, and Japan. “As many Asian countries become Westernised and infused with the Western aesthetic of a tall, thin, lean body, a virtual tsunami of eating disorders has swamped Asian countries,” writes Eunice Park in Asian Week magazine. Older people can still remember when it was very different. In China, for example, where revolutionary ideals once condemned any focus on appearance and there have been several disastrous famines, “little fatty” was a term of endearment for children. Now, with fast food on every corner, childhood obesity is on the rise, and the cultural meaning of fat and thin has changed.

When I was young,” says Li Xiaojing, who manages a fitness centre in Beijing, “people admired and were even jealous of fat people since they thought they had a better life….But now, most of us see a fat person and think ‘He looks awful.’”

 

Clearly, body insecurity can be exported, imported, and marketed–just like any other profitable commodity. In this respect, what’s happened with men and boys is illustrative. Ten years ago men tended, if anything, to see themselves as better looking then they (perhaps) actually were. And then (as I chronicle in detail in my book The Male Body) the menswear manufacturers, the diet industries, and the plastic surgeons “discovered” the male body. And now, young guys are looking in their mirrors, finding themselves soft and ill defined, no matter how muscular they are. Now they are developing the eating and body image disorders that we once thought only girls had. Now they are abusing steroids, measuring their own muscularity against the oiled and perfected images of professional athletes, body-builders, and Men’s Health models. Now the industries in body-enhancement–cosmetic surgeons, manufacturers of anti-aging creams, spas and salons–are making huge bucks off men, too.

 

What is to be done? I have no easy answers. But I do know that we need to acknowledge, finally and decisively, that we are dealing here with a cultural problem. If eating disorders were biochemical, as some claim, how can we account for their gradual “spread” across race, gender, and nationality? And with mass media culture increasingly providing the dominant “public education” in our children’s lives–and those of children around the globe–how can we blame families? Families matter, of course, and so do racial and ethnic traditions. But families exist in cultural time and space–and so do racial groups. In the empire of images, no one lives in a bubble of self-generated “dysfunction” or permanent immunity. The sooner we recognize that–and start paying attention to the culture around us and what it is teaching our children–the sooner we can begin developing some strategies for change.

The Reality of Bulimia…..

February 10, 2008

 

Bulimia

The true horror of eating disorders is minimised. Whilst the media and social forums glamorise anorexia as being “heroin chic” ~ bulimia nervosa is almost completely ignored as socially taboo.

Adding to the problem is the fact that the Welsh medical community still diagnose the severity of an eating disorder in terms of bmi (low body weight). This entirely inadequate diagnostic tool all but disqualifies severe bulimics from accessing a level of help appropriate to their need.

Bulimia does not always cause low body weight. In fact, severe bulimics who consume huge quantities of high calorie, sugary food before purging are more likely to be slightly over-weight. This is because their body digests a percentage of the food they consume almost instantly.

Bulimia kills

Bulimia kills. It causes a range of chemical imbalances in the body which trigger cardiac arrest (stopping the heart) or brain damage.

Bulimia can also cause gastric rupture (rupture of the stomach), leading to death. Lung collapse, internal bleeding, stroke, kidney failure, liver failure; pancreatitis and perforated ulcers. Depression and suicide are a high cause of fatality in bulimics. The affects of binging and purging on an unborn child are brutal and irreversible.

This short film documents some of the fatalities resulting from bulimia nervosa. (There is another, far more brutal film at the end of this blog entry).

minimised

The physical affects of

 

Bulimia Nervosa

Malnutrition
Dehydration
Electrolyte imbalance (Can lead to cardiac arrest, which can also result in brain damage by stroke.)
Hyponatremia
Damaging of the voice
Vitamin and mineral deficiencies
Teeth erosion and cavities, gum disease
Sialadenosis (salivary gland swelling)
Potential for gastric rupture during periods of binging
Esophageal reflux
Irritation, inflammation, and possible rupture of the esophagus
Laxative dependence
Peptic ulcers and pancreatitis
Emetic toxicity due to ipecac abuse
Swelling of the face and cheeks, especially apparent in the lower eyelids due to the high pressure of blood in the face during vomiting.
Callused or bruised fingers
Dry or brittle skin, hair, and nails, or hair loss
Lanugo
Edema
Muscle atrophy
Decreased/increased bowel activity
Digestive problems that may be triggered, including Celiac, Crohn’s Disease
Low blood pressure, hypotension
Orthostatic hypotension
High blood pressure, hypertension
Iron deficiency
Anemia
Hormonal imbalances
Hyperactivity
Depression
Insomnia
Amenorrhea
Infertility
High risk pregnancy, miscarriage, still-born babies
Diabetes
Elevated blood sugar or hyperglycemia
Ketoacidosis
Osteoporosis
Arthritis
Weakness and fatigue
Chronic Fatigue Syndrome
Cancer of the throat or voice box
Liver failure
Kidney infection and failure
Heart failure, heart arrhythmia, angina
Seizure
Paralysis
Potential death caused by heart attack or heart failure; lung collapse; internal bleeding, stroke, kidney failure, liver failure; pancreatitis, gastric rupture, perforated ulcer, depression and suicide.

 

 

 

Bulimia in the UK: Fast facts

 

Approximately 1-2 percent of women in the UK suffer from bulimia.


Every year there are as many as 18 new cases of bulimia nervosa per 100,000 population per year.

Between 1 and 3 percent of young women are thought to be bulimic at any given moment in time.

According to some studies, as many as 8 percent of women suffer from bulimia at some stage in their life, and it affects about 5 percent of female college students.

People who have close relatives with bulimia are four times more likely to develop the disease than people who do not.

Studies indicate that about 5 out of 10 people with bulimia are healthy 10 years after diagnosis; while 2 out of 10 still have bulimia and 3 out of 10 are partially recovered.

Approximately 5 percent of bulimia sufferers go on to develop anorexia nervosa.

 

The final film/audio here really brings home the horror of death by of bulimia nervosa.
Please be aware that this film contains some graphic imagery and is explicit re. details of death. Although I am familiar with reading about stomach rupture and organ failure, I personally find the narrative deeply upsetting.
I spent a long time considering the merits of including such a film, and have decided to do so; because the majority of people who access this blog are sufferers and for them it may be of benefit. That said, I do not reccomend that everyone watch it.

 

 

suicide, eating disorders and self-injury links

February 5, 2008

Suicidal Young Girls Need More Help

Monday, February 26th, 2007business-card-imagejpg.jpg

BBC on-line

Young girls are crying out for help – last year one in six calls to a 24 hour mental health helpline came from young girls considering suicide. Depression, eating disorders sexual abuse and bullying seemed to be some of the main problems affecting young girls – according to the article on the BBC website, rates of depression and anxiety have increased among young people in the UK by 70% in the last 25 years. That’s a huge percentage, and an extremely worrying one.

Joelle Leader, assistant director of ChildLine said “At the moment, there are simply not enough therapeutic services for children with these problems, and we are urging the government to give this issue urgent attention.”

More doctors

Eating problems also featured high on the list of mental health concerns, with 1,854 girls and 158 boys ringing for help and advice.

Marjorie Wallace, chief executive of SANE, said the charity had recorded an increase in the number the number of calls to its helpline from young people who self-harmed – sometimes in a brutal fashion.

“Those young people calling about self-harm report an almost doubled rate of suicidal thoughts than non self-harmers, and a significantly higher incidence of past suicide attempts.

“What is alarming is the numbers of those taken to A&E departments who are sent home without any follow-up help.

“We need doctors and teachers to be more alert to the potential risks, and many more therapists available, to prevent the vicious cycle of relief by painful self-harm.”

 

 

eating disorders: latest theories…

February 3, 2008


Some interesting re-search

published in

 

The Independent

Thursday, 23 November 2000

 

Religion: Some researchers have found an increased prevalence of eating disorders among Catholics and Jews, while others discovered such problems were unheard of among young Amish people.

 

Culture: Research among teenagers in Saudi Arabia shows those who could speak English, had higher education and whose parents had above-average jobs, were more likely to diet. The incidence of anorexia in Iran is the same an in Western societies.

 

Premature babies: Babies born prematurely are more likely to develop anorexia later in life, according to a Swedish study. Researchers say women born eight weeks premature were three times more likely to be anorexic.

 

Abuse: Abuse may result in anorexia in both boys and girls, according to a study in Minneapolis. Strong family ties may reduce the risk.

Mothers: Researchers found that girls with eating disorders were more likely to have had abnormal mother-daughter relationships.

 

Dieting: People who develop anorexia after 25 are more likely than younger patients to have followed longer periods of dieting, say researchers at St George’s Hospital.

 

 

Brain size: Researchers say they found the brains of young anorexic girls appeared different to the norm, suggesting a biological cause for the illness.

 

Models: An obsession with painfully thin models has contributed to the growth in eating disorders among girls and women, say researchers.

Not models: Researchers found cases of anorexia in rural Ghana, belying the model theory. The girls gave various reasons, including religious fasting, as well as dieting for a greater sense of self-control.

Mmmm…… Food for thought?

eating disorders and men…

February 2, 2008

Eating disorders: Who do you think of? …Frail teenaged girls?

Fair enough… the majority of people with an eating disorder are young and female. BUT many men suffer too…

 

I personally happen to know more than ten men who have had or still do suffer from anorexia or bulimia. It’s likely that well over 5000 men in Wales are suffering today. Most researchers don’t even include men because they think it will schew the statistics!

Men tend to be older than women when they develop an eating disorder… and they are more likely to exercise obsessively. But doctors and health care professionals are less likely to diagnose them, which is worrying because… let’s face it… the statistics for the correct diagnosis of an e.d. in women are not very good 😦

Men find it hard to ask for help – this is because there are additional, particular barriers to overcome. For example, eating disorders are viewed as a female illness so men may feel emasculated and ashamed of confessing to a “girl’s illness”.

Also, men might worry that their hetro-sexuality will be compromised (that people will think they are gay). Actually, a high percentage of men with eating disorders are gay (up to 20% compared to 10% of the general population) – and eating disorders in men are often linked to sexual distress; but most are still straight.

 Finally, if you are a man in Wales with an eating disorder and you want help – where do you go?

Some facts

 Pre-puberty, the same amount of boys suffer from eating disorders as girls.

 Post-puberty, one in ten sufferers are male. (These statistics are primarily based on self-disclosure so the real number may be far higher).

Recent studies suggest up to 16% of people being treated for anorexia are men and the numbers may be even higher with bulimia

 Eating disorders (particularly anorexia nervosa) have the highest fatality rate of any mental illness and men are far more likely to commit suicide than woman, so  male sufferers are particularly at risk.

Follow up:

…If you are a man who has or does suffer from an eating disorder we would appreciate your comments. How can we support you? What do you need?

If you are a service provider running specialist therapy for male sufferers – please let us know!

Interested in this subject? Copy and paste the following links to read more:

http://www2.jsonline.com/alive/news/aug00/eat14081300.asp

http://www.abcnews.go.com/Health/Diet/story?id=3948347&page=1

http://www.b-eat.co.uk/AboutEatingDisorders/Mengeteatingdisorderstoo

http://www.b-eat.co.uk/AboutEatingDisorders/Mengeteatingdisorderstoo/Howeatingdisordersdevelop

 

 

Dual diagnosis (evidence and statistics)

January 23, 2008

the_alcoholic.jpg

It is commonly accepted that eating disorders often co-exist or co-present alongside mental illness or addiction. Associated problems include depression, anxiety disorder and suicidal behaviour.(1) In addition, sufferers are highly vulnerable to developing substance misuse problems or alcohol dependency(2). The national Eating Disorder Association actually identify self harming behaviour, drug addiction, alcohol abuse and tranquilliser addiction as being consequences of an eating disorder.
So how do we “take due account of ordinarily confounding issues including contemporary patterns of co-morbidity and co-occurrence of problems and disorders…” (3)

The Graham Menzies Foundation and Cyswllt Contact Ceredigion have compiled a proposal for a dual diagnosis pilot service in Ceredigion, with both local and national reach. If you are developing similar plans or placing funding bids in this area then the following evidence and reading may be of use. Please contact me if you need more information or support.

Rowenna

Some Statistics

The prevalence of non-lethal self-injury among ED patients is approximately 25%, regardless of the type of eating disorder or the treatment setting(4)

About 25% of self-harming individuals with ED (eating disorders) appear to meet the criteria for borderline personality disorder (BPD). (4)

Co-morbid major depression or dysthymia has been reported in 50%–75% of patients with anorexia nervosa and bulimia nervosa.(3)

Estimates of the prevalence of bipolar disorder among patients with anorexia nervosa or bulimia nervosa are usually around 4%–6% but have been reported to be as high as 13%).(3)

The lifetime prevalence of obsessive-compulsive (OCD) among anorexia nervosa cases has been as high as 25%, and obsessive-compulsive symptoms have been found in a large majority of weight-restored patients with anorexia nervosa treated in tertiary care centres.(3)

OCD is also common among patients with bulimia nervosa.(3)

Co-morbid anxiety disorders, particularly social phobia, are common among patients with anorexia nervosa and patients with bulimia nervosa.(3)

Substance abuse has been found in as many as 30%–37% of patients with bulimia nervosa; among patients with anorexia nervosa, estimates of those with substance abuse have ranged from 12% to 18%, with this problem occurring primarily among those with the binge/purge subtype).(3)

Co-morbid personality disorders are frequently found among patients with eating disorders, with estimates ranging from 42% to 75%.(3)

Eating disordered patients with personality disorders are more likely than those without personality disorders to also have concurrent mood or substance abuse disorders.(3)
(1) KCL Anorexia Nervosa, The physical Consequences
(2) Eating disorders and psychiatry, Kings College London. By professor Janet Treasure and Dt Anna Crane, 2008.

(3) All Wales Eating Disorder Special Interest Group, report comissioned for Health Commission Wales.

(4) The Prevalence of SHB (self harming behaviour) Among Eating Disorders Patients

Eating Disorders and Self-Harm: A Chaotic Intersection Eating Disorders Review

Randy A. Sansone, MD is a Professor at Wright State University School of Medicine, Dayton, OH.
John L. Levitt, PhD is Clinical Director of the Eating Disorders Program at Alexian Brothers Behavioral Health Hospital, Rolling Meadows, IL.
Lori A. Sansone, MD is in private practice with Alliance Physicians, Dayton, OH

Interested in this subject? Suggested further reading:

‘Self Harm and Eating Disorders’ (edited by John L. Levitt, Randy A. Sansone and Leigh Cohn).
This book explores the prevalent but largely uncharted relationship between self-injury behaviours and eating disorders symptoms. (available from Amazon).

And check out… a related construct; “multi-impulsive bulimia”, which also involves impulsive self harm behaviour (e.g. suicide attempts), in addition to other forms of impulsivity such as substance abuse and sexual promiscuity. Compared with BPD, considerably less is known about multi-impulsive bulimia in terms of etiology. It may be that this syndrome is actually made up of a subset of individuals with BPD. (4)