Many heas the issues will pass in time, but that is easy to say and might not be correct. After years of unhealthy eating the body will have a hard time digesting larger amounts of healthy food. I found a great article about FOD MAP and acne. Some foods cause problems, some don't. Try to eliminate certain foods and eat others and see if your problems are solved this way. Take a look at this article:http://supernaturalacnetreatment.com/fodmaps-a-hidden-cause-of-acne-in-seemingly-clean-fruits-and-vegetables/
Viser innlegg med etiketten article. Vis alle innlegg
Viser innlegg med etiketten article. Vis alle innlegg
20. nov. 2016
13. nov. 2016
15. juli 2016
9. juli 2016
Pictures before, during and after (not me)
It is not easy to find pictures of people in the beginning and middle of their recovery when the water weight makes the body look strange and the fat is not yet evened out. I found an article with pictures that show a girl before, in the middle and after. If you look closely at the "in the middle picture" where she is standing inside looking depressed you can see the curves are very different from the curves on the body on the beach. I find it reassuring to see this because how I look now I know is not how I will look later, and to see this makes me sure of it.http://blog.asiantown.net/-/42026/girl-makes-amazing-recovery-to-anorexia-after-doctors-told-that-she-only-had-a-few-days-left-to-live-pics
22. mai 2016
Great article!
First I have added some excerpt from it:
(About the teenage years:) With all of the attention, we don’t have much time (or the privacy) to connect to our own sexuality because we are now sex objects, and our focus shifts from our own desires, to our desirability.
“She buys into the myth that her sexuality comes from being ‘beautiful’ rather than understanding that her beauty comes from her sexuality.”
When people say they want to lose weight, they often mean I want to be respected. I want to be loved. I want to be seen. I want liberation from fear and self-loathing. Weight-loss culture will never give us those things because it is founded on fear/hate-based systems like sexism, racism, classism and ableism.
We don’t know — as a culture, as a gender, as individuals, you and I. The fact that we don’t know is feminism’s one true failure. We claimed the agency, we granted ourselves the authority, we gathered the accolades, but we never stopped worrying about how our asses looked in our jeans. There are a lot of reasons for this, a whole bunch of big sexist things we can rightfully blame. But ultimately, like anything, the change is up to us.
Read the whole article here: http://www.huffingtonpost.com/hilary-kinavey-dana-sturtevant/the-not-so-sexy-origins-of-body-shame_b_7185210.html?fb_action_ids=707478887384&fb_action_types=og.shares
(About the teenage years:) With all of the attention, we don’t have much time (or the privacy) to connect to our own sexuality because we are now sex objects, and our focus shifts from our own desires, to our desirability.
“She buys into the myth that her sexuality comes from being ‘beautiful’ rather than understanding that her beauty comes from her sexuality.”
When people say they want to lose weight, they often mean I want to be respected. I want to be loved. I want to be seen. I want liberation from fear and self-loathing. Weight-loss culture will never give us those things because it is founded on fear/hate-based systems like sexism, racism, classism and ableism.
We don’t know — as a culture, as a gender, as individuals, you and I. The fact that we don’t know is feminism’s one true failure. We claimed the agency, we granted ourselves the authority, we gathered the accolades, but we never stopped worrying about how our asses looked in our jeans. There are a lot of reasons for this, a whole bunch of big sexist things we can rightfully blame. But ultimately, like anything, the change is up to us.
Read the whole article here: http://www.huffingtonpost.com/hilary-kinavey-dana-sturtevant/the-not-so-sexy-origins-of-body-shame_b_7185210.html?fb_action_ids=707478887384&fb_action_types=og.shares
18. mai 2016
17. mai 2016
Extreme hunger in recovery is not binge eating disorder.
It's really important that the extreme hunger is recognized as a result
of starving and accept it, and not interpret it as a if you have
switched to a binge eating disorder, because if you think you have got a
binge eating disorder you may start restricting, purging or strain
yourself in exercise and then what may happen is that you overshoot your
set point weight way more than you would if you didn't. I just read
about a girl this happened to, and I have experienced it myself as well.
It happened because we hadn't heard about the things written at
youreatopia. We didn't know what to expect in recovery and
misunderstood. When we think about those who end up as obese after
recovering from anorexia or bulimia, this is probably what happened to
them. To solve this and get to the set point weight they must eat the
minimum calories (meaning enough) and eat more if they are hungry and
not restrict at all so the body has the energy to do the last part of
the healing process. Then they will stop eating more than minimum when
the body has got what it needs to do it and the weight will fall to set
point by it self without restricting at all.
http://www.youreatopia.com/blog/2012/5/22/extreme-hunger-what-is-it.html
http://www.youreatopia.com/blog/2013/4/9/extreme-hunger-profoundly-disturbing.html
http://www.youreatopia.com/blog/2012/5/22/extreme-hunger-what-is-it.html
http://www.youreatopia.com/blog/2013/4/9/extreme-hunger-profoundly-disturbing.html
15. mai 2016
7. mai 2016
Leptin changes in recovery.
In the malnourished, underweight anorexic, leptin levels are typically
very low, due to low fat reserves. Usually, leptin levels reach normal
levels during weight restoration. However, when weight is gained too
quickly, leptin levels rise too quickly and may exceed the normal range. As a result, it becomes increasingly difficult for the patient to eat, often interfering with the refeeding process.
Low leptin plays a significant role in many of the physical complications and behaviors that are typically associated with anorexia nervosa; amenorrhea, hypothyroidism, hypercortisolism, osteopenia, immune changes, and increased physical activity.
Although there are other endocrine changes that contribute to osteopenia, low leptin levels appear to play a significant role.
Individuals with anorexia nervosa, often experience a compromised immune system. This could also be due, in part to low leptin levels although most of the compromised immunity is due to increased cortisol levels. Cortisol is the hormone that we associate with stress. Patients who are gaining weight too rapidly, are under considerably more stress, and may also be experiencing increased cortisol levels.
The lower the leptin levels, the more drive there is to exercise excessively, which causes more weight loss or less weight gain. One study demonstrated that patients reported a decreased feeling of restlessness or hyperactivity (need to exercise) as leptin increased during the refeeding/weight restoration phase of treatment.http://www.eatingdisorderpro.com/2012/08/24/why-rapid-weight-gain-decreases-treatment-success-rates/
In some studies, weight regain in individuals with anorexia nervosa increased leptin concentrations much more rapidly than in weight-matched controls, which may contribute to early satiation and a possibly increased metabolic rate. If this is confirmed in future studies, it may be one of the factors that frustrate attempts to achieve and maintain a more normal weight in individuals afflicted with anorexia nervosa.http://eatingdisordersreview.com/nl/nl_edr_13_5_1.html
Low leptin plays a significant role in many of the physical complications and behaviors that are typically associated with anorexia nervosa; amenorrhea, hypothyroidism, hypercortisolism, osteopenia, immune changes, and increased physical activity.
Although there are other endocrine changes that contribute to osteopenia, low leptin levels appear to play a significant role.
Individuals with anorexia nervosa, often experience a compromised immune system. This could also be due, in part to low leptin levels although most of the compromised immunity is due to increased cortisol levels. Cortisol is the hormone that we associate with stress. Patients who are gaining weight too rapidly, are under considerably more stress, and may also be experiencing increased cortisol levels.
The lower the leptin levels, the more drive there is to exercise excessively, which causes more weight loss or less weight gain. One study demonstrated that patients reported a decreased feeling of restlessness or hyperactivity (need to exercise) as leptin increased during the refeeding/weight restoration phase of treatment.http://www.eatingdisorderpro.com/2012/08/24/why-rapid-weight-gain-decreases-treatment-success-rates/
In some studies, weight regain in individuals with anorexia nervosa increased leptin concentrations much more rapidly than in weight-matched controls, which may contribute to early satiation and a possibly increased metabolic rate. If this is confirmed in future studies, it may be one of the factors that frustrate attempts to achieve and maintain a more normal weight in individuals afflicted with anorexia nervosa.http://eatingdisordersreview.com/nl/nl_edr_13_5_1.html
30. apr. 2016
25. apr. 2016
15. apr. 2016
A must-read about starvation
http://www.madsciencemuseum.com/msm/pl/great_starvation_experiment
Loved this: In between the two meals, Keys allowed them unlimited chewing gum, water, and black coffee, and the men took full advantage of these privileges, chewing as many as 40 packs of gum a day and downing up to 15 cups of coffee.
According to folklore, starvation had one positive physiological effect. It supposedly sharpened the senses.
Despite all these changes, the men, in their own minds, didn't perceive themselves as being excessively skinny. In fact, they began to think that everyone else looked too fat, rather than they themselves being too thin. Researchers later noted that this is the same mindset displayed by anorexics.
Loved this: In between the two meals, Keys allowed them unlimited chewing gum, water, and black coffee, and the men took full advantage of these privileges, chewing as many as 40 packs of gum a day and downing up to 15 cups of coffee.
According to folklore, starvation had one positive physiological effect. It supposedly sharpened the senses.
Despite all these changes, the men, in their own minds, didn't perceive themselves as being excessively skinny. In fact, they began to think that everyone else looked too fat, rather than they themselves being too thin. Researchers later noted that this is the same mindset displayed by anorexics.
16. mars 2015
If the set-point theory is true why do people get over and under it?
1 Because body fat isn’t your only set point.
You have a body fat “set point.” But Paul Jaminet also hypothesizes that your body has an even more important set point for maintaining the health of your lean tissue. If your body isn’t getting the micronutrients it needs, it will try to get more nutrients using the same mechanisms that it uses when you fall too far below your body fat set point: increasing your appetite and extracting more energy from your food. If you’re eating nutrient-poor processed foods all the time, you’ll just stay hungry, because your body is desperately looking for nutrients by driving you to eat more food.
2 Because you eat more than your body needs. Pleasurable food overwhelms your body’s natural message of “OK, I’ve had enough now,” so if you don't control your self it is very easy to eat more than the body needs. Stimulating food is also easy to be addicted to.
2 Because you eat more than your body needs. Pleasurable food overwhelms your body’s natural message of “OK, I’ve had enough now,” so if you don't control your self it is very easy to eat more than the body needs. Stimulating food is also easy to be addicted to.
3 Sometimes insulin stays elevated all the time. This prevents you from running off your stored energy reserves, because you’re constantly in “storage mode” and never switch over to burning those stored calories. In this situation, you’re eating enough calories, but they’re not available for energy, so your body is starving (and you still feel hungry) even though you’re gaining fat. It’s the worst of both worlds.
All kinds of things affect insulin levels. Just to name a few: sleep deprivation, chronic stress, exposure to environmental toxins, menopause, genetic factors, vitamin deficiencies, and the composition of your gut flora. It’s true that eating more carbs than your body can handle is one factor affecting insulin levels, but it’s far from the only problem!
Regardless of how it starts, though, chronically high insulin can overwhelm the body’s “set point” and cause weight gain. Problems with insulin also affect another hormone called leptin, which regulates appetite and metabolism. The ultimate result is that your body is now “defending” a higher weight, making it very difficult to get (or stay) lean.
What to do to maintain a healthy weight:
Eat nutrient-dense food.
1 Avoid food that is hard to stop eating or drinking. (Things with honey, syrup, sugar, chips, beer, wine etc.)
2 Avoid sweeteners that make you hungry. (I get hungry from Pepsi max (aspartam).
3 Make sure you have healthy levels of hormones like insulin and leptin so the calories gets burned for energy, not stored as fat by eating low-carb or carbs in moderation. (Read details in the article below.)
4 Avoid chronic inflammation because it elevates hunger and impairs carbohydrate metabolism. ( A recipe for overeating and storing those calories as fats.) Reduce inflammation by getting enough sleep, managing your stress, avoid extreme and punishing exercise, make sure you recover properly from your workouts, limit nuts and seeds, and eat plenty of fish (omega 3).
5 Intermittent fasting. Intermittent fasting mimics the benefits of carbohydrate restriction: it lowers insulin and raises the levels of several other fat-burning hormones like growth hormone and adrenalin, prompting your metabolism to use stored body fat for fuel and lowers you calorie intake.
6 Exercise
7 Be careful with the consumtion of nuts, seed butters, dried fruits and fruit juices.
All except the mentioning of alcohol is taken from the article below.
http://paleoleap.com/weight-loss-on-paleo-diet/
I continue adding more interesting stuff about addiction to stimulating food.
Our brains are wired to respond to the stimuli with which they evolved. For example, our natural taste preferences tell us that fruit is good. But what happens when we concentrate that sugar tenfold? We get a superstimulus. Our brains are not designed to process that amount of stimulation constructively, and it often leads to a loss of control over the will, or addiction.
It's a very similar process to drug addiction. Addictive drugs are able to plug directly into the brain's pleasure centers, stimulating them beyond their usual bounds. Food superstimuli do this less directly, by working through the body's taste reward pathways. In fact, sweet liquids are so addictive, rats prefer them to intravenous cocaine. You can't take just one hit of crack, and you can't have just one Hershey's kiss.
This chapter was taken from the article below.
http://wholehealthsource.blogspot.no/2008/03/superstimuli.html#uds-search-results
A Curious Finding
It all started with one little sentence buried in a paper about obese rats. I was reading about how rats become obese when they're given chocolate Ensure, the "meal replacement drink", when I came across this:
Experiments in rats and humans have outlined some of the qualities of food that are inherently rewarding:
Industrially processed food, which has been professionally crafted to maximize its rewarding properties, is a superstimulus that exceeds the brain's normal operating parameters, leading to an increase in body fatness and other negative consequences.
http://wholehealthsource.blogspot.no/2011/04/food-reward-dominant-factor-in-obesity.html
Here is a link to a article about leptin:http://paleoleap.com/managing-leptin-levels/
I continue adding more interesting stuff about addiction to stimulating food.
Our brains are wired to respond to the stimuli with which they evolved. For example, our natural taste preferences tell us that fruit is good. But what happens when we concentrate that sugar tenfold? We get a superstimulus. Our brains are not designed to process that amount of stimulation constructively, and it often leads to a loss of control over the will, or addiction.
It's a very similar process to drug addiction. Addictive drugs are able to plug directly into the brain's pleasure centers, stimulating them beyond their usual bounds. Food superstimuli do this less directly, by working through the body's taste reward pathways. In fact, sweet liquids are so addictive, rats prefer them to intravenous cocaine. You can't take just one hit of crack, and you can't have just one Hershey's kiss.
This chapter was taken from the article below.
http://wholehealthsource.blogspot.no/2008/03/superstimuli.html#uds-search-results
A Curious Finding
It all started with one little sentence buried in a paper about obese rats. I was reading about how rats become obese when they're given chocolate Ensure, the "meal replacement drink", when I came across this:
...neither [obesity-prone] nor [obesity-resistant] rats will overeat on either vanilla- or strawberry-flavored Ensure.The only meaningful difference between chocolate, vanilla and strawberry Ensure is the flavor, yet rats eating the chocolate variety overate, rapidly gained fat and became metabolically ill, while rats eating the other flavors didn't (1).
Experiments in rats and humans have outlined some of the qualities of food that are inherently rewarding:
- Fat
- Starch
- Sugar
- Salt
- Meatiness (glutamate)
- The absence of bitterness
- Certain textures (e.g., soft or liquid calories, crunchy foods)
- Certain aromas (e.g., esters found in many fruits)
- Calorie density ("heavy" food)
Industrially processed food, which has been professionally crafted to maximize its rewarding properties, is a superstimulus that exceeds the brain's normal operating parameters, leading to an increase in body fatness and other negative consequences.
http://wholehealthsource.blogspot.no/2011/04/food-reward-dominant-factor-in-obesity.html
Here is a link to a article about leptin:http://paleoleap.com/managing-leptin-levels/
15. mars 2015
How to build true confidence
1. It’s not about having to tell yourself stories in order to have confidence. You simply remove the stories that are making you feel like you don’t have confidence.
2. Certain things are going to take time to learn, and that’s OK. Be aware that things will unfold as they need to and give yourself the space to learn, try, and explore through the journey. You don’t have to be perfect right away and so confidence shouldn’t be an issue.
3. If you are looking for physical confidence in how you look, first ask yourself why you don’t have confidence to begin with. What story are you telling yourself about your appearance that takes away your innate knowledge that you are perfect just as you are?
The idea of “building confidence” is ultimately an illusion we buy into in order to experience temporary spurts of feeling OK about ourselves and what we are doing. Ultimately, it comes down to bringing it within vs looking outside for validation of your “confidence.”
11. mars 2015
A conversation about BED (binge eating disorder).
Me: I think many people are afraid of this illness, and some of those who has it are treated badly. Because people don't understand it, fear it and some think it is to be ashamed of. I think that is a tragedy and a huge burdon for the people who has this illness to carry. I think many have found comfort in food, so the fear is perhaps based on that, but I wonder if it is biological reasons to why they start as kids to eat extra amounts. I wonder if it in fact is first of all a physical reason for the need for more food than normal. Is it an unbalance or do these people really need extra food and have a higher BMI than avarage? May the unbalance of hormones, or is it inflammation?, be caused by emotions? I would like to know these things so the misunderstanding can be treated by knowledge.
I understand that the whole picture will never be finished, but how much is understood till now?
Can emotions effect hormones and hormones effect emotion?
Can emotions effect hormones and hormones effect emotion?
Gwyneth:
Yes people don't understand it. Primarily they are unaware that it is not an eating disorder at all and that its inclusion in the DSM-5 was not based on any science that it is an eating disorder either.
Many of the questions you have surrounding binge eating disorder are covered off in the blog post Binge Eating Disorder and Night Eating Syndrome
There is no single cause for these symptoms appearing, but the they are very rare and involve a lot of other psychological distress and symptoms.
BED is essentially non-purging 'bulimia' in its current iteration within the DSM-5. In its definition prior to DSM-5 it was not a standalone eating disorder. It was rather a set of symptoms that could arise for those with serious Axis II disorders (psychosis, schizophrenia, and several personality disorders) and that was based on 30 years' worth of work done by Albert Stunkard and his colleagues. It was also very rare.
And whenever this question is asked on these forums it's usually because yet another new member is anxious and concerned that he or she has binge eating disorder.
Binge eating disorder is not associated with restrictive eating disorders at all. If you restrict, then you cannot have binge eating disorder. At all.
It's not about eating extra amounts as a kid. It's about serious mental illness. These individuals are often not able to reside in the community and if they do they have many points when they need 24/7 psychiatric care.
It's not about comfort in food, imbalanced hormones, emotions or inflammation. And frankly, their eating behaviours are usually the least worrisome of their symptoms associated with their overall serious mental illness.
It's commendable that you have empathy and consideration for their plight, but these forums are designed for those dealing with the restrictive eating disorder spectrum. Restrictive eating disorders are standalone eating disorders and they are all treated with rest, unrestricted re-feeding and brain retraining.
Those with binge eating symptoms have nothing in common with those with restrictive eating disorders and they usually require much higher levels of psychiatric support and intervention than most with restrictive eating disorders will ever require.
We would want anyone who has binge eating disorder to be free from shame and abuse however there are no binge eating disorder patients on these forums. Of more immediate concern to me is that those with restrictive eating disorders who are active on these forums do not end up anxious about a condition that they have no chance of developing.
Me: I was hoping you would answer. Thank you very much. The link: "more details found here" is not working. I come to "page not found". Hope to be able to read it.
I am surprised to read in the article about BED and NES that BED maybe should not be called an eating disorder. Is that because those with BED don't have much in common, have different body size and different mental conditions?
I am very greatful that I read years ago that you think one can not go from anorexia to a binge eating disorder, because I got very disappointed and scared thinking that I had become a binge eater when eating much after a long time with no or almost no food. I felt I could trust my body even less when it was possible ( as I thought) that I was changed so much in a sudden. I don't think it is too bad or very wrong to say we can go from anorexia to a binge eating disorder, but it is important to know it is not permanent, that we in recovery will not feel the need to eat a lot forever. I remember I found it extremely difficult to throw up when I was in a period of eating a lot after restriction contrary to before. It was like my body was holding on to the food so hard in hunger.
This says a lot: The bulimia nervosa group scored high on the features of binge eating and fear of fatness/compensatory behaviors but not on drive for thinness. The binge eating disorder group scored high on binge eating but not on the other two features. And:
Fear of fat/compensatory behaviors and drive for thinness are not present for those with clinical BED.
Fear of fat/compensatory behaviors and drive for thinness are not present for those with clinical BED.
What i don't know is why the BED's don't try to be thin when they hate their body. Do they feel helpless, thinking they can not do it? Is that it? Or are they destructive and feel they deserve to be "big and bullied"? I know some use their big body as a shield towards the world and therefor don't want to be thin.
Gwen: Fixed the link -- sorry about that.
No, it is important to be accurate. You do not go from anorexia to binge eating disorder.
In recovery, you experience hyperphagia (extreme eating) and that is to rectify the huge energy deficit in your body.
Binge eating disorder facets must necessarily involve no energy deficit within your body. It must involve consumption of food in excess of your energy requirements. And that is not happening in recovery.
Eda -- you likely don't know anyone personally who has binge eating disorder. It is an extremely rare condition.
It might be better to analyze why you are worried about how those with BED may think and feel. Your more immediate concern is presumably taking care of your own recovery needs right now.
BED has about as much in common with a restrictive eating disorder as Alzheimer's does. That's not to say that BED is related to Alzheimer's (it's not) but I think you may want to disengage yourself from the topic -- it has no bearing on your recovery efforts and it has no bearing on anyone you likely know in your own life either.
G.
Me: "Binge eating disorder facets must necessarily involve no energy deficit within your body. It must involve consumption of food in excess of your energy requirements. And that is not happening in recovery." Interesting.
Ok, it was just that I read about a girl being called a whale and I felt sorry for her and thought that it is so unnecessary , and i thought about the lack of knowledge and misconseption underneth the behaviour. We either try to find the truth or think and act like a fool. But it's really hate that causes namecalling like that so I rest my case. We need wisdom, but also love to be nice to each other.
More i found on the forum about the subject written by Gwen:
I got the following by e-mail:
I was wondering if you have any scientific evidence to back up your claims that REDs and BED cannot occur in the same person (or very rarely occur in the same person) due to the genes being completely different? I've gone through YE but haven't been able to find anything. Thank you!
Here's the response I gave:
Thank you for your inquiry. Perhaps you would like to provide the direct reference to the claims you say I have made? Given that the genotype associated with restrictive eating disorders has not been fully identified and we only have some likely gene candidates that may be implicated in the onset of restrictive eating disorders, I doubt that I made the claim that restrictive eating disorders are unrelated to binge eating disorders due to genetic variation. If I have done so, then I would like to know where because I will need to correct such an assertion!
However, I do provide the clinical data that identify BED as an extremely rare condition wherein absolutely no compensatory behaviours are applied (they don’t try to get back on a diet etc.). An individual with BED is not suffering from a distinct eating disorder, but rather symptoms of bingeing that are actually indicative of a serious psychopathology. Albert Stunkard and his colleagues provide heaps of solid clinical data on the topic — the condition does not arise from restrictive eating disorders. The condition is rather a sign of Axis II psychological disorders [Wilfley DE, Friedman MA, Dounchis JZ, et al. Comorbid psychopathology in binge eating disorder: relation to eating disorder severity at baseline following treatment. J Consult Clin Psychol 2000; 68:641-649]. Axis II disorders are where a patient can lose touch with consensus based reality — things like borderline personality disorder, bipolar disorder, schizophrenia and the like. Restrictive eating disorders are Axis I disorders — like anxiety and depression where the patient is still grounded in reality even as behaviours and thoughts might be causing distress or even denial for the patient.
For a patient to develop an Axis I disorder first and then progress into an Axis II disorder is certainly feasible, but will be extremely rare. Axis II disorders tend to have quite an early onset in childhood development.
As for evidence that binge eating disorder cannot occur in someone with a restrictive eating disorder, you simply have to look at the criteria for diagnosing binge eating disorder: namely, that anorexia nervosa and bulimia nervosa have been excluded as a possible alternate diagnosis. As per the direct language from the Diagnostic and Statistical Manual (V5): "recurrent binge eating [disorder] is much less common, far more severe, and is associated with significant physical and psychological problems” [emphasis mine].
Binge eating disorder is rare and cannot involve any compensatory behaviours. Compensatory means any attempt to try to restrict in response to having “binged”.
Having had the opportunity recently to discuss the current inclusion of BED in the DSM V with one of the psychiatrists who formed part of the ED committee drawing up the DSM V [Dr. Steven Wonderlich], I can also confirm from the recent trial data he and his colleagues have published show individuals with BED are actually most commonly under-eating but will self-identify as having a bingeing problem. In essence, the inclusion of BED in the DSM V was applied because the psychiatric community identified that a portion of the community actually need help to eat enough food to support their energy needs, but they believe their issue is actually one of over-eating.
The inclusion of BED in the DSM V is not actually being applied in the community as the same BED that Stunkard and his colleagues studied for some 30 years to make the following conclusion on its existence in the population: BED is a marker for underlying psychopathology and not a standalone eating disorder. [Stunkard, Albert J., and Kelly C. Allison. "Binge eating disorder: disorder or marker?." International Journal of Eating Disorders 34.S1 (2003): S107-S116l; Stunkard, Albert J., and Kelly Costello Allison. "Two forms of disordered eating in obesity: binge eating and night eating." International journal of obesity 27.1 (2003): 1-12].
The BED classified within the DSM V is actually being used out in the community (for treatment purposes) as indistinguishable from non-purging bulimia nervosa — attempts to constantly under eat followed by cycles of reactive eating as the body attempts to redress the energy deficit.
And finally, I would encourage you to look out any clinical data that would confirm patients with a remitted restrictive eating disorder history subsequently develop confirmed cases of binge eating disorder as it is defined within the DSM (not as it is applied within treatment). So far, I have yet to even find a single case study in the literature, let alone any kind of broad prospective or retrospective review of patients with restrictive eating disorders who develop binge eating disorder. And as I said, I am speaking of binge eating disorder in its original classification — where the patient does not attempt to compensate for a binge with either going back on her diet or exercising or swearing off of “bad” foods again.
There is of course more than enough clinical data to confirm that approximately 62% of patients with anorexia nervosa will develop bulimia nervosa within 8 years of the onset of the anorexia (if untreated) [Eddy, Kamryn T., et al. "Longitudinal comparison of anorexia nervosa subtypes." International Journal of Eating Disorders 31.2 (2002): 191-201]. As the body is depleted of energy progressively through years of restrictive eating behaviours, eventually there is an increased drive to rectify the energy deficit with reactive eating sessions (bingeing). In the absence of the patient developing subsequent purging behaviours, then she will have moved from anorexia nervosa to non-purging bulimia nervosa now also indistinguishable from binge eating disorder within the treatment community.
The treatment for the BED is the same as for bulimia nervosa — the patient is encouraged to begin eating enough to support her actual energy requirements in a constant daily process which subsequently lowers the instances of reactive eating (often called “bingeing”).
I will be discussing all these recent clinical findings (delivered at the UCSD Eating Disorders Conference 2014) in an upcoming blog post.
Essentially (and the involved psychiatrists are still in hot debate on the topic) the inclusion of BED in the DSM V appears to be driven by an attitude of “if you can’t beat them join them”. The treatment community recognized that a portion of predominantly average or above-average weighted men and women would remain utterly untreated if they have self-identified as having a problem with over-eating and therefore believe that classifications of restrictive eating disorders do not apply to them at all. The inclusion of BED allows for these patients to be treated for actual under-eating issues but they will readily seek treatment because the condition is identified as one of “bingeing”—which they can relate to. I am not entirely sure if I agree with this “ends justify the means” approach to clinical care, but it is nonetheless what is happening.
Best wishes, Gwyneth.
The content of this entire e-mail is provided for general informational purposes only and should not be considered a substitute for professional medical advice. Do not use the information provided for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your healthcare provider.
7. mars 2015
Quotes from Gwen and youreatopia
Fat is a hormoneproducing organ.
All those subjects in the Minnesota Starvation Experiment temporarily overshot their pre-study weights and all returned to their pre-study weights in the 12-18 months following the end of the study [A. Keys et al., 1950]. For most subjects they initially gained about 10% above their pre-study weights in the re-feeding period.
We also know from numerous other studies that anorexics often maintain a higher proportion of fat mass post-re-feeding [CI Orphanidou et al., 1997; M Probst et al., 2001; C Mantzoros et al., 1997] and this is likely due to the prevailing attitudes that hyperphagia must be avoided during recovery at all costs as it is considered a marker of “bingeing”. Instead, what these post-recovery data may show is that the prohibition of hyperphagia in recovery from restrictive eating disorders serves to halt the body’s ability to return to an optimal fat mass to fat-free mass ratio.
Furthermore researchers have shown there is a significant increase in trunk adiposity (fat deposits around the mid-section of the body) in recovery [S Grinspoon et al., 2001; L Mayer et al., 2005] and this fat mass is evenly redistributed in the optimization period after weight restoration only if the patient continues to eat in an unrestricted fashion [ibid.
Finally, women eat more in the post-ovulation phase relative to the pre-ovulation phase of the menstrual cycle [SP Dalvit, 1981]. This too does not result in progressive weight gain [ibid.] and it appears the extra energy is involved in serotonin modulation [SE Møller, 1992]. Basal metabolic rate varies significantly throughout the menstrual cycle [SJ Solomon et al., 1982] and carbohydrates (serotonergic nutrients) are the preferred nutrient that increases in the post-ovulation period [SP Dalvit-McPhillips, 1983].
Binge eating as a clinical disorder involves an inability to apply any restriction. That means, if you are on the restriction eating disorder spectrum, you are unable to develop BED. Your bingeing experience is an expression of required energy needs in reaction to restrictive eating behaviors. It is why I call this behavior reactive eating and not bingeing.
, ibid.]http://www.youreatopia.com/blog/2012/10/31/bingeing-is-not-bingeing.html
Out of 19 prospective studies under scrutiny in the systematic review here’s what the data show:No correlation between inactivity and weight gain, waist gain, BMI increase or the prevalence of overweightness or obesity.http://www.youreatopia.com/blog/2015/2/26/systematic-review-of-weight-gain-correlates-in-literature-pa.html
BMI 25-30 is a range that offers the lowest rate of disease and death for human beings [KM Flegal et. al., 2007, 2008 and 2010], so its classification as "overweight" in our cultures is a ridiculous and dangerous misrepresentation of what health actually looks like.http://www.youreatopia.com/blog/2013/1/16/common-questions.html?currentPage=2#comments
Here is a good article about the criteria for being a binge eater and not just someone eating a lot after starvation. http://www.youreatopia.com/blog/2011/11/3/binge-eating-disorder-and-night-eating-syndrome.html
Here is a good article about the criteria for being a binge eater and not just someone eating a lot after starvation. http://www.youreatopia.com/blog/2011/11/3/binge-eating-disorder-and-night-eating-syndrome.html
28. feb. 2015
Den spirituelle årsak til anoreksia.
http://www.youreatopia.com/blog/2014/12/30/target-weight-recover-but-not-too-much.html
Her sier Gwen at spiseforstyrrelser skifter form fra en tid til en annen og fra en kultur til en annen, men er i essens det samme. Når hun bringer frem eksempelet om den religiøse begynner jeg å grine og mister helt lysten på de jordbærene jeg spiser, og får assosiasjoner i fleng. Av magre kropper som ofrer seg i fengselsceller og nonner som utpiner seg i trange rom i ensomhet og forestillinger om Gud, og jeg føler et sug etter den hellige anoreksia (igjen). Men den hellige anoreksia feiler fordi den kun viser uselviskhet symbolsk, og blir kun selvutslettelse.
Man må gi kroppen næring for å være uselvisk og tjenende. Vi trenger ikke være redde for at vi av Gud skal bli oppfattet som identifisert med kroppen, kjødet, selv om vi mater denne delen og føler de lave følelser, og til og med noen ganger mister besinnelsen og gir uttrykk for disse lave følelser og drifter. Vi trenger ikke å vise at vi tar avstand til den om vi er løsrevet på ordentlig. Vi trenger ikke å bevise noe for Gud eller mennesker. Det er kun oss selv vi trenger å overbevise om er guddommelig, for å være det, gi uttrykk for det.
Årsaken til anoreksia har jeg oftest tenkt er at jeg har følt meg sviktet av foreldre og venner, og delvis pga objektivisering (menns sex-fokus og mine foreldres materialistiske syn) jeg opprørsk sultestreiket mot, men innerst inne er årsaken spirituell. Og denne er av størst betydning. Den handler om det jeg nevnte ovenfor; min higen etter det guddommelige jeg ønsker å identifisere meg med og avstandstaken til kjødet. Som sagt feilet jeg ved å velge anoreksia fordi man får ikke avstand til det man hater og ikke vil vedkjenne seg. Kun ved å elske, akseptere, kroppen (ta vare på den) føler man seg løsrevet fra den. Da er man det man vil være. Da er man kjærlig. Da er man omsorgsfull og tjenende.
Dette er anoreksiens essens. Det handler om en feilslått måte å gi uttrykk på sin sanne identitet på.
Her sier Gwen at spiseforstyrrelser skifter form fra en tid til en annen og fra en kultur til en annen, men er i essens det samme. Når hun bringer frem eksempelet om den religiøse begynner jeg å grine og mister helt lysten på de jordbærene jeg spiser, og får assosiasjoner i fleng. Av magre kropper som ofrer seg i fengselsceller og nonner som utpiner seg i trange rom i ensomhet og forestillinger om Gud, og jeg føler et sug etter den hellige anoreksia (igjen). Men den hellige anoreksia feiler fordi den kun viser uselviskhet symbolsk, og blir kun selvutslettelse.
Man må gi kroppen næring for å være uselvisk og tjenende. Vi trenger ikke være redde for at vi av Gud skal bli oppfattet som identifisert med kroppen, kjødet, selv om vi mater denne delen og føler de lave følelser, og til og med noen ganger mister besinnelsen og gir uttrykk for disse lave følelser og drifter. Vi trenger ikke å vise at vi tar avstand til den om vi er løsrevet på ordentlig. Vi trenger ikke å bevise noe for Gud eller mennesker. Det er kun oss selv vi trenger å overbevise om er guddommelig, for å være det, gi uttrykk for det.
Årsaken til anoreksia har jeg oftest tenkt er at jeg har følt meg sviktet av foreldre og venner, og delvis pga objektivisering (menns sex-fokus og mine foreldres materialistiske syn) jeg opprørsk sultestreiket mot, men innerst inne er årsaken spirituell. Og denne er av størst betydning. Den handler om det jeg nevnte ovenfor; min higen etter det guddommelige jeg ønsker å identifisere meg med og avstandstaken til kjødet. Som sagt feilet jeg ved å velge anoreksia fordi man får ikke avstand til det man hater og ikke vil vedkjenne seg. Kun ved å elske, akseptere, kroppen (ta vare på den) føler man seg løsrevet fra den. Da er man det man vil være. Da er man kjærlig. Da er man omsorgsfull og tjenende.
Dette er anoreksiens essens. Det handler om en feilslått måte å gi uttrykk på sin sanne identitet på.
Abonner på:
Innlegg (Atom)