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This Week's Blogs
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Eating Disorders Weaken Men's
Bones
June 02, 2000
- NEW YORK (Reuters Health) - Eating disorders like anorexia
and bulimia are known to weaken bones in women, but the
results of a new study suggest that the same may be true
in men. And while eating disorders disproportionately affect
women, their impact on bones may be more severe in men,
researchers report.
- In a study of 380 people treated for eating disorders
at the University of Iowa in Iowa City, 46 (14%) were men.
Compared with the bones of men who did not have eating disorders,
bone density in the spine was substantially lower in men
with eating disorders, Dr. Arnold E. Andersen and colleagues
report in the June 3rd issue of The Lancet.
- And compared to women with eating disorders, men with
eating disorders--particularly those with bulimia--tended
to have a greater bone deficiency, according to the report.
The number of men with eating disorders who had diminished
bone density suggests not only that the condition is a common
complication of eating disorders, but a serious one as well,
the authors note.
- It is estimated that about one out of every six cases
of eating disorders occur in men, Andersen told Reuters
Health in an interview. Unfortunately, many physicians and
men are unaware that eating disorders affect men as well
as women. In fact, some eating-disorder clinics do not even
treat male patients, Andersen added.
- The best way to treat bone deficiency caused by an eating
disorder is uncertain, he explained, but there are a few
steps to take that may help restore bone strength. Consuming
more calcium and vitamin D can help boost bones, as can
weight-bearing exercise. However, it is important for men
with low bone density to avoid contact sports or other high-impact
physical activities, which might increase the risk of bone
fracture, Andersen advised.
- The investigators also found that men with eating disorders
had below-normal levels of the male sex hormone testosterone,
which may affect bone density. Currently, Andersen and his
colleagues are testing the effects of testosterone therapy
in men with eating disorders to see whether the hormone
helps restore bone density while men are gradually returning
to a healthy weight.
Eating Disorders are Linked
to Aggressive Conduct
- NEW YORK (Reuters Health) -- Eating disorders in adolescent
girls appear to be linked to aggressive conduct, a greater
risk of drug use and a higher rate of attempted suicide,
report US researchers.
The findings suggest that "individuals working with adolescents
who may display aggressive behavior... may also wish to
ask about the presence of bingeing, purging, and food
restriction," suggest Dr. Kevin M. Thompson from North
Dakota State University in Fargo, and colleagues. Their
report is published in the October issue of the Journal
of the American Academy of Child and Adolescent Psychiatry.
- In a study of 3,630 girls in grades 6 through 12, a survey
identified 498 girls (13.9%) with some level of binge eating
and purging. A somewhat higher percentage (17.2%) endorsed
dietary restriction in their questionnaires.
- Girls endorsing either binge eating/purging or dietary
restriction were 2 to 4 times as likely as their peers to
engage in such aggressive behaviors as group fighting, assault,
robbery with a weapon, battery, and violent conflict resolution,
according to the report.
- Highly aggressive adolescent girls who reported eating
disturbance behaviors were 3 times more likely to attempt
suicide, the investigators note, and more than twice as
likely to use illicit drugs.
- "Our findings indicate that adolescents who report engaging
in eating disturbance behaviors are significantly more likely
to also report a number of aggressive behaviors than adolescents
who do not have eating disturbances," Thompson and colleagues
conclude. "This finding runs counter to the typical clinical
description of the average eating-disturbed adolescent,
who is often viewed as passive, compliant, and seldom aggressive."
- The study results suggest several clinical implications,
according to the authors. Adolescents with eating disorders
should also be assessed for aggressive behavior, and vice
versa. Furthermore, doctors need to recognize the increased
risk of suicide and drug use among their patients who display
both eating disturbances and aggressive behavior.
- "As we learn more about predictors of the co-occurrence
of eating disturbance and aggressive behavior," Thompson's
team suggests, "high-risk groups for this combination of
behaviors may be identified, which will enhance assessment."
August 20, 2002
Women with Eating Disorders
Have Difficulty Coping with Stress
NEW YORK, Aug 20 (Reuters) -- Women with eating disorders
have more difficulty coping with stress than other women,
according to a study.
These women were much more likely to either avoid thinking
about the source of their stress, or become so obsessed
with the crisis that they were unable to think about anything
else, write researchers in the International Journal of
Eating Disorders.
The findings suggest that the treatment of eating disorders
ought to focus more on the mental aspects of coping during
a crisis than the standard approach of focusing on problem
resolution techniques, say the research team.
The small study, led by Dr. Nicholas Troop of the Institute
of Psychiatry in London, UK, compared 56 women having
treatment for eating disorders with 33 "control" subjects
-- women with no history of eating disorders recruited
from university campuses. The eating disorder group included
19 women with anorexia nervosa, a disorder characterized
by markedly reduced food intake, and 37 women with bulimia
nervosa, in which the patients regularly gorge with food
and then induce vomiting.
The researchers interviewed the women to assess how they
dealt with a crisis in three areas: practical problem
solving; mental responses; and the attribution of responsibility.
They found the most significant differences in the mental
responses of eating disorder groups. Both the anorexic
and bulimic women were more likely to push negative information
out of their minds (cognitive avoidance), and to worry
about problems than other women. The women with eating
disorders also tended to be less optimistic.
Bulimic women were much less likely to turn to others
for help in the face of a crisis, and were more likely
to blame themselves than either the anorexic or the "control"
groups.
But the researchers also report that women with eating
disorders "were no more likely to blame others or to feel
that others were responsible than women without eating
disorders."
Overall, the results showed that women with eating disorders
were significantly less likely to take purposeful and
appropriate action to cope with stress than other women.
The study team concludes that "this result does suggest
that there is a place in treatment for improving the coping
abilities of women with eating disorders."
Stress Disorder Linked to
Anorexia, Bulimia
August 19, 2002
- NEW YORK, Aug 19 (Reuters) -- More than half of patients
with serious eating disorders also exhibit the symptoms
of post-traumatic stress disorder (PTSD), researchers report.
- PTSD symptoms "may be common among women with eating disorders,
especially among those severe enough to require residential
or inpatient treatment," conclude investigators at Texas
A&M University in College Station, Texas. Their findings
are published in the current issue of the International
Journal of Eating Disorders.
- PTSD is an abnormal or extreme psychological response
to trauma that results in long-term depression, anxiety,
flashbacks and avoidance behaviors. The illness was first
brought to US public attention when soldiers returning from
the Vietnam War exhibited such symptoms.
- The Texas researchers conducted psychological tests aimed
at detecting PTSD among a group of 294 women diagnosed with
anorexia nervosa, bulimia, or nonspecific eating disorders.
- "Of this sample, 74% reported having experienced at least
one traumatic event" that might trigger PTSD, the authors
say, "and 52% reported symptomatology consistent with the
diagnosis of PTSD."
Closer examination revealed that a PTSD diagnosis did
not seem to be associated with either the severity or
type of eating disorder. PTSD symptoms were predicted
by other patient diagnoses, however, such as depression,
anxiety and dissociation (a feeling of being disconnected
from oneself).
- The Texas study results agree with those of prior research.
In fact, one 1994 study concluded that anorexics especially
resistant to treatment were more likely to suffer from PTSD
than those who responded favorably. The authors of that
study speculated that these "high-risk" patients might require
PTSD therapy before their anorexia could be brought under
control.
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The
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Karen Dougherty MS -
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