Walden Shows Progress Being Made in Treatment of Eating Disorders At Day-Long Conference

WALTHAM, Mass. – While anorexia, bulimia and binge-eating disorder continue to be challenging, life-threatening diseases, during a day-long conference sponsored by Walden Behavioral Care at Bentley University, leading experts showed that progress is being made in treating them.

James Greenblatt, M.D., Walden’s Medical Director of Eating Disorder Services, discussed, “Food Addiction: The Biology of Appetite and Binge-Eating Disorder.”  While there is disagreement about whether binge-eating disorder is an addiction to food, he said that whether it’s an addiction is not important, but “what is important is that there is a neurochemical basis for binge-eating disorder and obesity.”

Progress is being made in understanding the “neural and biochemical systems that drive feeding behaviors,” he said, and this improved understanding of eating disorders will lead to more effective treatment.

Addiction to refined sugar, inadequate digestion of glutin (wheat) or dairy products, and heavy consumption of monosodium glutamate (MSG) may each play a role in binge-eating disorder and obesity, according to Dr. Greenblatt.  MSG is an ingredient in most processed foods.  Binge eating disorder can be triggered in some people by genetic factors, and also occurs frequently in those who have mood disorders or anxiety disorders, issues with substance abuse or attention deficit hyperactivity disorder (ADHD).

He said that no drugs are available that were specifically developed to treat anorexia or binge-eating disorder, while Fluoxetine is the only drug available for treating bulimia.  However, he said that some drugs, and combinations of drugs, are showing great promise for treating binge-eating disorder.

While Topamax has been criticized, because it can cause memory loss and other symptoms, it can be very effective for treating binge-eating disorder if administered in low doses.  Naltrexone, which is used to treat alcohol dependency, is also proving effective in treating binge-eating disorder and bulimia, especially when it is used in combination with the anti-depression drug Prozac.

One issue with treating eating disorders is that everyone is different, and what works for one person may not work for another.

Low Carb Mania

Ralph E. Carson, Ph.D., R.D., Executive Director of FitRx, spoke about, “Low Carb Mania – Facts and Fantasies,” and said that Americans need to eat healthy and exercise to maintain a proper body weight, instead of following fad diets.

“Americans want to figure out a way to lose weight by eating,” he said, and have tried gluten-free diets and other methods, but overall average weight has increased even though Americans have among the lowest percentage of calories from carbohydrates in their diets in the world.

Gluten sensitivity or gluten intolerance is based on “unfounded theories, biased reasoning and poor science,” he said, resulting in 1.6 million people being on a gluten-free diets when they may not need to be.

According to an analysis of 116 studies, “The majority found no association between the intake of refined grain foods and cardiovascular disease, diabetes, weight gain or overall mortality or an association with increase disease risk.”

The average female’s weight has increased 24.7 pounds since 1960, but carbohydrates are not the cause, he said.  Since 1950, consumption of soda has increased 500%, chocolate bars, 1,233%, and hamburgers, 223%.

Body Image and Anorexia

Margo Maine, Ph.D., co-founder of the Maine & Weinstein Specialty Group in West Hartford, spoke about, “The Weight-Bearing Years: Eating Disorders and Body Image Despair in Adult Women,” and said that the cultural focus on thinness being a reflection of a person’s self-worth has led to an increase in anorexia.

While the first runway models weighed 155 pounds or more, today the average fashion model is 5 feet, 10 inches tall, weighs 107 pounds and has a body mass index (BMI) of 15.4, Dr. Main said.  That’s lower than the BMI cutoff for anorexia, which is 18.5.

“Weightism is the politically correct form of prejudice,” according to Dr. Maine.

Women are obsessed with their weight, she said, and when they get together and have a conversation, it almost always includes a discussion about weight, food, body image or personal appearance.  While males also develop eating disorders, given the importance placed on a woman’s weight, she said, it’s no wonder that women develop eating disorders far more often than men.

In adult women, an eating disorder is often triggered by a life-changing event, such as pregnancy, menopause, divorce, infidelity, work issues or retirement.

Dr. Maine said that when adult women have an eating disorder, they often feel shame about developing what they may consider to be a “teen ager’s problem.”  They often find it more difficult to admit the need for help and to be motivated to receive treatment.

They have increased anxiety about their appearance because of the natural aging process, she said, but there are more obstacles to seeking treatment because of their responsibilities; they are too busy raising children and advancing their career and taking care of their family to deal with their eating disorder.

She said it is natural for women to gain eight to 12 pounds during menopause, adding that moderate weight gain at mid-life is associated with longer life.

Kamryn T. Eddy, Ph.D. and Jennifer J. Thomas, Ph.D., co-directors of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, who presented, “CBT for Body Image: Breathing Life into the Manual,” and Karen Milller, Ph.D., director of the Neuroendocrine Research Program in Women’s Health at Massachusetts General Hospital, who presented, “New Hormone Treatments for Anorexia Nervosa.”

Miller said that research by Massachusetts General Hospital shows that hormone treatment may be effective in preventing osteoporosis, depression and other medical issues resulting from anorexia.