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Based on media representation, awareness efforts, and our daily conversations, it would be easy to assume anorexia or bulimia would be the most common eating disorder. We reference them when we see celebrities that appear “too thin.” TV shows and movies use anorexia or bulimia as a common trope. Most importantly, we make an effort to help when we recognize someone lives with one of these disorders.

However, bulimia and anorexia are not, in fact, the most common eating disorder. According to several studies, binge eating disorder far outpaces any other eating disorder as one of the most significant health issues facing America and the world.

The difference is, we as a society simply don’t think or talk about binge eating disorder. When celebrities gain weight, the tabloids proclaim they have gotten “fat”. No one suggests they may be struggling with binge eating disorder. We are more likely to assume someone is depressed when they pack on the pounds, rather than worry about binge eating.

And, as Bustle writer Dana Schwartz shows, this casual dismissiveness or ignorance or binge eating disorder has huge implications for how society responds to a person living with the eating disorder.

In a recent article, Schwartz explains the huge difference in reaction and perception when she dealt with anorexia, and later, binge eating disorder. Or, as she puts it simply, “When I fought anorexia, I got help. When I fought binge eating disorder, I just got embarrassed.”

Read her full story on Bustle here.

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When people think about eating disorders, they typically think of thin people – usually women. However, this is forgetting the most common eating disorder in society today: binge eating disorder.

Now, a new study reminds us that, despite the stereotypes, overweight or obese individuals are more likely to show signs of disordered eating behaviors compared to normal weight or underweight individuals. In most cases, these disordered eating behaviors (DEBs) were signs of binge eating disorder.

In the study, published in the Journal of General Internal Medicine, researchers found a higher rate of DEBs among young adults 18- to 24-years-old compared with those who were underweight or normal weight.

More so, those who were obese were more than 2.4 times more likely to engage in DEBs such as unhealthy weight control practices and binge eating, the team of researchers led by Jason M. Nagata, MD., wrote. This group showed the highest rate of DEBs compared to all weight categories.

Troublingly, this information does not translate to increased treatment or awareness of eating disorders among the overweight or obese. In fact, overweight and obese individuals were half as likely to receive a clinical diagnosis for an eating disorder from a healthcare provider compared to both those who were normal or overweight.

“Using a large nationally representative data source, we found that disordered eating behaviors are actually three times more common in young adults with obesity than those who are underweight,” explained Nagata and his colleagues from the University of California San Francisco.

Nagata also noted that these behaviors were more common among men than some previously believed, as 15% of the young men in the study who were obese or overweight reporting DEBs.

“Clinicians should be aware that disordered eating behaviors occur in young adults with overweight or obesity,” Nagata recommended. “They should ask if, and how, young people are trying to lose weight, and discourage unsafe practices such as vomiting, fasting, or non-prescribed weight loss medications.”

In the report, the group explained that DEBs account for some of the most critical criteria for diagnosing an eating disorder, including behaviors like binge eating, vomiting, fasting, or skipping meals.

The findings did support many past estimates of eating disorder prevalence. For example, young women were more likely to engage in these behaviors compared to men, and LGBT individuals were more likely to report DEBs than heterosexual peers. Interestingly, the report found that those with less education were also less likely to participate in DEBs compared to those who had more than a high school education.

For the study, the team used data from Wave III of the National Longitudinal Study of Adolescent to Adult Health study, which included data from 14,322 young adults who participated in face-to-face interviews on weight control behaviors.

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Despite the misperception that eating disorders are only an issue for young, white, affluent women, there is plenty of evidence that eating disorders affect people of every gender, race, ethnicity, culture, size, socioeconomic status, or sexual orientation.

Sadly, this misconception has real consequences for those who don’t fit the stereotype.

The myths around eating disorders make those who don’t fall into the category of “wealthy young white women” feel more confusion and shame about their disorder. Even worse, there is evidence these misconceptions prevent many from seeking or receiving treatment for a dangerous eating disorder.

To help raise awareness about the marginalized voices of eating disorder sufferers, the National Eating Disorder Association shared an infographic revealing how eating disorders actually affect older individuals, African-Americans, and LGBT individuals.

You can see the infographic below or on the NEDA website here.

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Source: Bebeto Matthews / CNN

This week, the world lost not one, but two highly successful celebrities to suicide.

From the outside, no one would have guessed Kate Spade or Anthony Bourdain were contemplating taking their lives in the last few days leading up to their deaths. Both had built sizable business empires, were well-respected, and were living what appeared to be stable and happy lives.

As you often hear in the wake of surprising deaths, we could never have seen their deaths coming.

As more information comes in about the time leading up to these shocking suicides, one thing has become clear; both Kate Spade and Anthony Bourdain lived with depression and anxiety that were not satiated by success.

Source: FilmMagic

The husband of the fashion designer, Andy Spade, explained that Kate lived with depression and anxiety “for many years” and was seeking treatment.

“She was actively seeking help and working closely with her doctors to treat her disease, one that takes far too many lives,” Andy Spade told PEOPLE. “We were in touch with her the night before and she sounded happy. There was no indication and no warning that she would do this. It was a complete shock. And it clearly wasn’t her. There were personal demons she was battling.”

Source: WireImage

While Kate kept her demons private, renowned chef and food-writer Bourdain openly talked about his struggles with depression and substance abuse. His books frequently talked about his experiences with drugs, alcohol, and mental illness. Even his hit shows like “Parts Unknown” could occasionally detour into explorations of how travel and isolation can affect someone’s mental state.

In one particular 2016 episode, Bourdain specifically delved into mental health while visiting Argentina. At one point, he notes he chose the country because it embraced psychoanalysis and mental health treatment more strongly than the majority of countries he has visited.

The episode is framed with scenes of Bourdain speaking with a psychiatrist. While at first, it seems like the discussions Bourdain is having could just be TV drama, it gradually becomes clear that he is sharing very personal struggles.

When asked by the psychiatrist what brought him to treatment, he explains, “I will find myself in an airport, for instance, and I’ll order an airport hamburger. It’s an insignificant thing, it’s a small thing, it’s a hamburger, but it’s not a good one. Suddenly I look at the hamburger and I find myself in a spiral of depression that can last for days.”

Bourdain also talks about the isolation of his career and status, saying “I feel kind of like a freak and I feel very isolated. I communicate for a living, but I’m terrible at communicating with people I care about.”

The public eye can often seem glamorous, and fame or fortune seem like they may be able to fix the pains or struggles of depression, anxiety, or loneliness. However, as both Kate Spade and Anthony Bourdain reveal, all the success in the world cannot defeat mental illness. The only way to truly prevent suicidal thoughts or depression is with professional care.

If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255 for 24-hour support. You can also call Brookhaven at 888-298-HOPE (4673) to discuss treatment options or find answers to any questions you may have.

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Dhruv Khullar, MD in an article in the New York Times of June 7, 2018 described the serious health disparities that Americans living with serious mental illness face. According to Dr. Khullar people living with serious mental illness die 15-30 years earlier than those without a serious mental health condition. That is an enormous reduction in life expectancy when we consider the general statistics that people live longer. It’s a myth that people living with serious mental illness are more likely to die from suicide, overdoses and accidents. In fact, they are more likely to die from diseases like cancer, heart disease, stroke, diabetes and respiratory problems. They are less likely to enter into doctors’ offices and hospitals and when there the treatment options may be limited and the problems they are presenting may be attributed to their mental health problem. Their ability to follow a diet or health regime, take medication, maintain appointments or remember to take prescribed medications may be effected by symptoms related to their mental health condition. If we add the realities of high rates of homelessness, poverty and social isolation experienced by people with serious mental health problems to higher rates they experience of obesity, physical inactivity, poor nutrition and tobacco use we can begin to identify how their health problems are accelerated.

Brendan Reilly, MD in a recent article in The New England Journal of Medicine commented on his late brother’s journey through the health care system where is spinal cord damage and resulting quadriplegia was ascribed to his mental health condition. For physicians, family members and people living with serious mental illness the most serious aspects of the person’s mental health problems may be where treatment is focused and other diseases and conditions may be neglected.

How can the gap be narrowed between life expectancy for people living with severe mental illness and those without those problems? Can healthcare professionals learn to make accommodations through changes in treatment delivery or supports offered to individuals with severe mental health problems when they are experiencing health issues? And, can we help people living with severe mental illness maintain their physical health and wellness through specialized prevention programs geared to their needs. To accomplish change the role of the primary care physician or internist as a valuable member of the professional team needs to be reconsidered.

Key words: health disparities and mental illness, serious mental illness, disease and mental illness, life expectancy and mental illness

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A nation-wide increase in accidental deaths, homicides, and suicides among the youth of America has experts on alert and calling for increased efforts to treat mental health issues in the young.

After a 14-year period of decline in the death rate for 10- to 19-year-olds in the US between 1999 and 2013, a new report from the National Center for Health Statistics at the US Centers for Disease Control and Prevention (CDC) found that the death rate suddenly leaped by 12% between 2013 and 2016.

According to the report, the bulk of this increase is attributed to injury-related deaths, including traffic collisions, drug overdoses, homicides, and suicide, rather than illness.

“When I first conceded to do this report 2½ years ago, I thought that we would be documenting a decline,” Sally Curtin, a statistician at the CDC in Washington and lead author of the report, told CNN.

“We were surprised that there was such a broad increase across so many causes of death,” she said. “There wasn’t just one that was contributing.”

Among all adolescents between 15- and 19-years old, the leading cause of death remained unintentional injuries like car crash fatalities. However, these were followed by deaths from suicide and homicide, according to the CDC.

The report relied on data collected from death certificates filed in all 50 states and the District of Columbia between 1996 and 2016. While this provided a nationwide view of the teen death rate, the researchers note this brings in inherent inconsistencies, as some states vary in how they classify specific forms of death.

“Accurate recording of the circumstances surrounding the death as well as classifying the death obviously would be a limitation, and especially within the context of a drug overdose,” Curtin said. “Oftentimes, it’s hard to tell, unless there’s a suicide note, whether it was a suicide or unintentional.”

Based on the data, unintentional injuries or accidents were the leading cause of injury-related deaths for adolescents between 10 and 19-years old, followed by suicide, and then homicide.

Overall, the rate of accidental deaths for 10- to 19-years old declined nearly 50% between 1999 and 2013, before rising 13% between 2013 and 2016.

Suicide rates showed a similar trend, declining by 15% between 1999 and 2007. Since then, the rate has increased by 56%, accounting for 6.1 deaths per 100,000. The leading methods of suicide in 2016 were suffocation, firearms, and poisoning.

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If you’ve read about eating disorders in the past 10 years or so, you’ve probably read the same set of statistics which estimate approximately 30 million people in the US live with an eating disorder. That isn’t a coincidence.

Despite how widespread eating disorders are, how dangerous they can be, and the commonly accepted notion that most estimates significantly underestimate just how widespread these disorders really are, the surprising fact is that eating disorder rates haven’t been significantly studied since 2007.

That means the estimates have not been updated since long before the release of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5, the widely used “guidebook” for clinically diagnosing mental health issues.

This changed this week, with the publishing of a new study in Biological Psychiatry which updates the outdated estimates of the prevalence of eating disorders in America.

The new study developed this new estimate using a nationally-representative sample of 36,309 adults. According to the researchers, that represents the largest national sample of US adults ever studied.

The new estimate suggests that approximately 0.8% of US adults will be affected by anorexia nervosa during their lifetime, 0.28% will be affected by bulimia nervosa, and 0.85% will be affected by binge eating disorder.

“Our study confirms that eating disorders are common, are found in both men and women and across ethnic/racial groups, occur throughout the lifespan, and are associated with impairments in psychosocial functioning,” said first author Tomoko Udo, PhD, of University at Albany, New York. Dr. Udo conducted the study alongside Carlos Grilo, PhD, of Yale University School of Medicine.

“The prevalence and impact of eating disorders continues to be underestimated in society. This definitive study should guide both research and policy development,” said John Krystal, Editor of Biological Psychiatry.

For the study, the researchers used data from the 2012-2013 National Epidemiologic Survey Alcohol and Related Conditions (NESARC-III).

Along with providing lifetime estimates of being impacted by an eating disorder, the study also found that 12-month estimates for anorexia, bulimia, and binge eating disorder were 0.05%, 0.14%, and 0.44% respectively.

The researchers noted that while the anorexia rates were similar to what was expected from past studies, the rates of bulimia and binge eating disorder were lower than past findings.

“Many researchers and clinicians expected higher estimates than earlier studies as a result of ‘loosening’ of diagnostic criteria for eating disorders,” said Dr. Udo, referring to the changes made to criteria in the DSM-5. Udo believes more research will be needed to accurately explain these shifts, as well as the overall implications of the new estimates.

As expected, the eating disorders occurred across different age groups and were persistent, typically lasting for years. The researchers also say the findings reinforce the understanding that eating disorders can significantly interfere with normal daily activities and social relationships.

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Experts are sounding the alarm about the risk of accidental ingestion or overdose from attention-deficit hyperactivity disorder medications, following the release of a recent study published in the journal Pediatrics.

According to the findings, US Poison Control Centers are receiving approximately 29 calls every day – totally more than 200 per week –  related to children and teenagers consuming ADHD medications.

Across the country, these calls accumulated to be more than 156,000 calls related to ADHD medicine among those 19 or younger between 2000 and 2014.

Most worryingly, approximately three-quarters of these calls involved children under 12 years of age. Many of these cases included children six years old or younger ingesting someone else’s medication, as well as older children taking too much of a medication prescribed to them.

However, the majority of cases (82%) were the result of unintentional exposure to the drug, rather than the result of children taking an excessive amount of their ADHD medication.

This suggests parents and older children are likely leaving their medication in easy to access places, where younger children can find them.

The researchers also note that the majority of the calls were about boys. They also largely involved two classes of ADHD medication: methylphenidate (known by brand names such as Ritalin and Concerta), and amphetamines (recognized by brand names like Adderall).

Accidental ingestion or overdose of these medications can lead to a number of dangerous symptoms, including rapid heart rates, irritability, drowsiness, high blood pressure, and even death.

The high number of calls across the 14 year period represented a 61% increase, but the researchers note that this correlated with the national increase in ADHD diagnoses and therapy prescriptions during this time period.

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When Iris Ruth Pastor was a 19-year-old college student, she thought she found a secret shortcut to maintain her body shape while also developing a social standing within her school and achieving high grades. It all seemed to be working perfectly for her.

Unfortunately, that shortcut was actually a destructive eating disorder that she would be unable to shake for nearly 50 years. It would stick by her side through her career advancements as a successful journalist and author, through her marriage and birth of 5 children, and through every other up and down along the way.

In her recent book, The Secret Life of a Weight-Obsessed Woman: Wisdom to Live the Life You Crave, Pastor looks back on her decades-long experience with eating disorders as an abusive relationship. When she succeeded, it felt like her binging and purging were contributing to this success as a writer, mother, and wife. When she failed, it helped her cope.

“An eating disorder is like an unruly, disparaging lover that wreaks havoc, interlaced with moments of sheer, self-destructive ecstasy,” Pastor writes. “My life, routine, and stress levels were all wrapped around my need for him. He was what kept me coping, but also he was what kept me in a state of perpetual angst and misery.”

Pastor’s story touches on something very rarely addressed in eating disorder communities – the flashes of happiness and confidence as well as the perceived emotional support that can make it hard to “give up” an eating disorder.

“With ED by my side, I believed I could be the best version of me – as a writer wife, mother, daughter, and friend.”

However, as she shows, these short-lived pangs of “ecstasy” are surrounded by a seemingly never-ending anguish.

Even this realization was never enough for her to escape her eating disorder. It wasn’t until she had grandchildren and recognized she was living a risky lifestyle that would likely end in tragedy that she admitted she needed help.

“I had been writing, blogging and motivationally speaking for over thirty years. I had quite a legacy of work I was proud to leave my grandchildren,” she says. Even worse, she knew what alternative was likely awaiting her if she continued down her path.

“I realized that if I died in a pool of my own vomit while purging, that would be my overriding legacy. And that, for me, was intolerable.”

Most importantly, in Pastor’s eyes, was the recognition that she wouldn’t be able to beat bulimia on her own. She needed professional help and support.

“Hope is not a plan, but hope fuels a plan. So first you need hope. You can’t do it alone. So next seek professional help. If the fit is not right, keep searching until you find a professional or an eating disorder treatment centre that intuitively feels like a good fit. When you do, allow yourself to be vulnerable, nurtured, challenged and victorious”

Pastor also notes that recovery is rarely an easy path. There are setbacks and hard moments, but she encourages other sufferers to keep fighting and not give in.

“It’s important to realise that the road to recovery is made up of incremental progress,” she writes. “Small sustainable mouse steps are preferable to kangaroo leaps. Patience and self-compassion are key, but also staying resolute: meaning a dedication to getting healthy and remaining open to new ways of looking at food as fuel for the body not as something to be feared and dangerous.”

Despite living with an eating disorder for 46 years, Pastor has achieved recovery and wants others to know they can too.

“My main message is that recovery is possible at any age and at any stage.”

You can buy Iris Ruth Pastor’s book The Secret Life of a Weight-Obsessed Woman: Wisdom to Live the Life You Crave here.

If you are living with an eating disorder, give Brookhaven a call at (888) 298-4673. We can answer any questions you have and help you find the best treatment option for you.

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For people living with or recovering from eating disorders, the grocery store can be an intimidating place. Being surrounded by nothing but food, many proclaiming they are “low-carb” or “low-fat”, can be overwhelming and cause intense anxiety, even years after recovering from a clinical eating disorder.

Thankfully, a new form of telemedicine is aiming to help by providing on-the-go video-chat with nutritional counselors while shopping for food.

The apps provide a form of exposure therapy that allows people to face their triggers or anxieties by gradually introducing them to feared stimuli.

“The eating disorder treatment world has adapted exposure therapy to help people face their food fears. Grocery store therapy can be beneficial by allowing individuals to confront their anxieties with the support of a trusted health-care provider,” Kelsey Latimer told Juli Fraga of the Chicago Tribune.

Latimer is a clinical psychologist at the Center for Discovery, a treatment facility for eating disorders in Palm Beach Gardens, Florida.

In the past, some dieticians and counselors would provide similar forms of exposure therapy by accompanying individuals with eating disorders to the store. However, this type of treatment was relatively rare, and practically impossible to access for individuals living in rural areas.

Anecdotal evidence from patients and medical professionals suggest telemedicine exposure therapy could potentially make a highly-useful but hard to access form of therapy into a widely used treatment for eating disorders. But, there has been relatively little research into the recent practice’s effectiveness.

One of the most notable recent studies on the subject, presented at the International Conference on Eating Disorders in April, included just 34 participants.

In the study, clinical psychologist and eating disorders researcher at Stanford University connected 34 participants with individual and group therapists, as well as nutritionists, using a similar video conference platform.

“Our initial results show a clinically significant reduction in eating disorder symptoms,” Robinson said. She added that future research will examine long-term effectiveness.

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