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Eating Disorders (Holistic)

Eating Disorders (Holistic)

About This Condition

Counseling and nutrition management are both needed to effectively treat eating disorders such as anorexia, bulimia, and binge eating. According to research or other evidence, the following self-care steps may be helpful.
  • Talk to a therapist

    Work with a qualified professional to help you resolve any emotional issues that may contribute to your eating disorder

  • See your healthcare provider

    Get a checkup to find out if your eating disorder has resulted in any health problems that may require medical care

  • Mix in a multi

    Add a complete multivitamin to your daily diet to help prevent deficiencies, especially if you are anorexic or bulimic

  • Think zinc

    If you have anorexia, help improve your appetite by taking 50 mg a day of this essential mineral, along with 1 to 3 mg per day of copper

About

About This Condition

Eating disorders are complex conditions involving psychological factors and nutritional deficiencies. The term eating disorders includes anorexia nervosa, bulimia, and binge-eating.

The psychological factors may include an inability to cope with stress, problems with family and other relationships, feelings of deprivation, and experiences of physical, sexual, or emotional abuse. Psychotherapy is an essential part of the treatment for eating disorders, along with nutrition counseling and medical care as needed.1

A person with anorexia does not eat enough to maintain a healthy weight; she views herself as overweight and is anxious about gaining weight. Anorexia typically begins in early adolescence, mainly among girls, though the numbers of boys developing this condition is increasing. People with anorexia weigh less than 85% of the normal weight for their age and height. Excessive exercise, vomiting, and abuse of laxatives and/or diuretics may also occur. Severe anorexia can be life threatening.

Bulimia, also known as bingeing and purging, is more common than anorexia, and usually affects teenage girls and women in their twenties. It involves a recurring, emotionally driven cycle of compulsive consumption of large quantities of high-calorie food in a short period of time, followed by induced vomiting. Some individuals also use laxatives, drugs that induce vomiting, diuretics, or excessive exercise in an attempt to purge. About 50% of anorexics also purge, and both bulimia and anorexia can coexist in the same person.2 Unlike those with anorexia, some people affected by bulimia maintain normal or even excessive body weight.

Binge-eating disorder is similar to bulimia but no purging is done. It is more common than either bulimia or anorexia nervosa, and people with binge-eating disorder are usually overweight.3

Symptoms

People with eating disorders may have a preoccupation with weight and food, anxiety about their body image, and/or a feeling that they lose control over how much they eat. They may also exercise compulsively and, in women, experience missed menstrual periods. They may also frequently use laxatives, diet pills, and medicines designed to induce vomiting or reduce fluid retention.

Healthy Lifestyle Tips

Although regular, moderate exercise offers important health benefits, for many people excessive exercise is a common component of eating disorders, especially anorexia nervosa.4 In one controlled trial, a majority of the people with eating disorders reported that participation in competitive sports and exercise performed as part of a weight loss plan contributed to their condition.5 For people with eating disorders, it is important to establish and maintain healthy exercise habits; these individuals should consult with a healthcare professional skilled in eating disorders.

Holistic Options

Psychological counseling, for both the individual and her family, and behavior modification training are also commonly used for people with eating disorders, often as part of a team approach that also includes nutrition counseling and medical care. Numerous preliminary and controlled studies have shown that the psychotherapy technique known as cognitive-behavioral therapy is effective in reducing the symptoms of bulimia.6 , 7 For example, one study found 69% of a group receiving cognitive-behavioral therapy were abstaining from binge-eating and purging six months later compared to only 15% of a group keeping a diary of their behavior.8 Preliminary studies9 and one controlled trial10 suggest another technique, interpersonal psychotherapy, is equally effective for people with bulimia. Cognitive behavioral therapy and interpersonal psychotherapy have also been effective for people with binge-eating disorder in controlled trials,11 , 12 resulting in cessation of binge-eating in almost half of the subjects in one report.13

The effectiveness of psychotherapy for anorexia nervosa is less clear.14 , 15 One controlled trial found that psychotherapy (type unspecified) significantly improved weight gain compared to no treatment, and complete or nearly complete recovery occurred in 60% of the patients.16 Two other studies comparing different types of psychotherapy for anorexia nervosa found comparable improvement from all types;17 , 18 one of these studies reported moderate improvement in 63% of cases.19 Long-term effectiveness of psychotherapy for eating disorders has not been studied.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Avoid foods that alter your mood
In one study, bulimic women became binge-free after avoiding alcohol, caffeine, refined sugar, and foods containing white flour, added salt, monosodium glutamate, and flavor enhancers.

Individuals with both bulimia and anorexia are likely to report a craving for sugar; people with bulimia eat more sweets and carbohydrates, particularly during binges, than do healthy individuals.20 , 21 , 22 , 23 In a double-blind study, bulimic subjects were reported to have significantly more mood changes after receiving glucose (corn sugar) injections compared to placebo injections.24 Preliminary evidence suggests that purging results in low blood sugar, which might increase the incidence of repeated bingeing and purging by stimulating appetite or altering mood.25

Get enough calories
The most important dietary change for people with eating disorders is to eat a sufficient amount of calories without purging. To accomplish this, most will need psychological as well as nutrition counseling.

The most important dietary change for people with eating disorders is to eat a sufficient amount of calories without purging. To accomplish this, most will need psychological as well as nutrition counseling.

Eat a balanced diet
People with both bulimia and anorexia are likely to report a craving for sugar, which may lead to mood swings. Eating healthier foods may stabilize blood sugar, which may decrease the urge for bulimic binges.
Individuals with both bulimia and anorexia are likely to report a craving for sugar; people with bulimia eat more sweets and carbohydrates, particularly during binges, than do healthy individuals.26 , 27 , 28 , 29 In a double-blind study, bulimic subjects were reported to have significantly more mood changes after receiving glucose (corn sugar) injections compared to placebo injections.30 Preliminary evidence suggests that purging results in low blood sugar, which might increase the incidence of repeated bingeing and purging by stimulating appetite or altering mood.31

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Multivitamin
Take as directed on label
Taking a multivitamin-mineral provides the body with much-needed nutrients that are often lacking in people who restrict their food intake.

People with eating disorders who restrict their food intake are at risk for multiple nutrient deficiencies, including protein, calcium , iron , riboflavin , niacin ,32 folic acid ,33 vitamin A , vitamin C ,34 and vitamin B6 ,35 and essential fatty acids.36 A general multivitamin-mineral formula can reduce the detrimental health effects of these deficiencies.

1 Star
5-HTP
Refer to label instructions
5-HTP has been shown to reduce appetite in weight-control and diabetes trials. However, what effect 5-HTP has on people with eating disorders is unknown

A serotonin precursor, 5-HTP (5-hydroxytryptophan), has been shown to reduce appetite in weight-control and diabetes trials.37 , 38 , 39 However, what effect 5-HTP has, if any, on people with binge eating disorder, bulimia, or anorexia is unknown. Unlike L-tryptophan, 5-HTP is available from health food stores and some pharmacies without prescription.

References

1. Zerbe KJ. Anorexia nervosa and bulimia nervosa. When the pursuit of bodily ‘perfection’ becomes a killer. Postgrad Med 1996;99:161–4, 167–9 [review].

2. Garner DM, Garner MV, Rosen LW. Anorexia nervosa “restricters who purge”: implications for subtyping anorexia nervosa. Int J Eat Disord 1993;13:171–85.

3. Spitzer RL, Yanovski S, Wadden T, et al. Binge eating disorder: its further validation in a multisite study. Int J Eat Disord 1993;13:137–53.

4. Davis C, Katzman DK, Kaptein S, et al. The prevalence of high-level exercise disorders: etiological implications. Compr Psychiatry 1997;38:321–6.

5. Davis C, Kennedy SH, Ravelski E, Dionne M. The role of physical activity in the development and maintenance of eating disorders. Psychol Med 1994;24:957–67.

6. Peterson CB, Mitchell JE. Psychosocial and pharmacological treatment of eating disorders: a review of research findings. J Clin Psychol 1999;55:685–97 [review].

7. Mitchell JE, Raymond N, Specker S. A review of the controlled trials of pharmacotherapy and psychotherapy in the treatment of bulimia nervosa. Int J Eat Disord 1993;14:229–47 [review].

8. Thackwray DE, Smith MC, Bodfish JW, Meyers AW. A comparison of behavioral and cognitive-behavioral interventions for bulimia nervosa. J Consult Clin Psychol 1993;61:639–45.

9. Agras WS. Nonpharmacologic treatments of bulimia nervosa. J Clin Psychiatry 1991;52 Suppl:29–33 [review].

10. Fairburn CG, Norman PA, Welch SL, et al. A prospective study of outcome in bulimia nervosa and the long-term effects of three psychological treatments. Arch Gen Psychiatry 1995;52:304–12.

11. Peterson CB, Mitchell JE, Engbloom S, et al. Group cognitive-behavioral treatment of binge eating disorder: a comparison of therapist-led versus self-help formats. Int J Eat Disord 1998;24:125–36.

12. Wilfley DE, Agras WS, Telch CF, et al. Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: a controlled comparison. J Consult Clin Psychol 1993;61:296–305.

13. Carter JC, Fairburn CG. Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study. J Consult Clin Psychol 1998;66:616–23.

14. Pike KM. Long-term course of anorexia nervosa: response, relapse, remission, and recovery. Clin Psychol Rev 1998;18:447–75 [review].

15. Eisler I, Dare C, Russell GF, et al. Family and individual therapy in anorexia nervosa. A 5-year follow-up. Arch Gen Psychiatry 1997;54:1025–30.

16. Gowers S, Norton K, Halek C, Crisp AH. Outcome of outpatient psychotherapy in a random allocation treatment study of anorexia nervosa. Int J Eat Disord 1994;15:165–77.

17. Treasure J, Todd G, Brolly M, et al. A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behav Res Ther 1995;33:363–7.

18. Robin AL, Siegel PT, Koepke T, et al. Family therapy versus individual therapy for adolescent females with anorexia nervosa. J Dev Behav Pediatr 1994;15:111–6.

19. Treasure J, Todd G, Brolly M, et al. A pilot study of a randomised trial of cognitive analytical therapy vs educational behavioral therapy for adult anorexia nervosa. Behav Res Ther 1995;33:363–7.

20. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442–50.

21. Casper RC, Pandy GN, Jaspan JB, Rubenstein AH. Hormone and metabolite plasma levels after oral glucose in bulimia and healthy controls. Biol Psychiatry 1988;24:663–74.

22. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442–50.

23. van der Ster Wallin G, Norring C, Holmgren S. Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatr Scand 1994;89:376–81.

24. Blouin AG, Blouin J, Bushnik T, et al. A double-blind placebo-controlled glucose challenge in bulimia nervosa: psychological effects. Biol Psychiatry 1993;33:160–8.

25. Johnson WG, Jarrell MP, Chupurdia KM, Williamson DA. Repeated binge/purge cycles in bulimia nervosa: role of glucose and insulin. Int J Eat Disord 1994;15:331–41.

26. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442–50.

27. Casper RC, Pandy GN, Jaspan JB, Rubenstein AH. Hormone and metabolite plasma levels after oral glucose in bulimia and healthy controls. Biol Psychiatry 1988;24:663–74.

28. Drewnowski A, Halmi KA, Pierce B, et al. Taste and eating disorders. Am J Clin Nutr 1987;46:442–50.

29. van der Ster Wallin G, Norring C, Holmgren S. Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Acta Psychiatr Scand 1994;89:376–81.

30. Blouin AG, Blouin J, Bushnik T, et al. A double-blind placebo-controlled glucose challenge in bulimia nervosa: psychological effects. Biol Psychiatry 1993;33:160–8.

31. Johnson WG, Jarrell MP, Chupurdia KM, Williamson DA. Repeated binge/purge cycles in bulimia nervosa: role of glucose and insulin. Int J Eat Disord 1994;15:331–41.

32. Thibault L, Roberge AG. The nutritional status of subjects with anorexia nervosa. Int J Vitam Nutr Res 1987;57:447–52.

33. Abou-Saleh MT, Coppen A. The biology of folate in depression: implications for nutritional hypotheses of the psychoses. J Psychiatr Res 1986;20:91–101 [review].

34. Beaumont PJ, Chambers TL, Rouse L, Abraham SF. The diet composition and nutritional knowledge of patients with anorexia nervosa. J Hum Nutr 1981;35:265–73.

35. Rock CL, Vasantharajan S. Vitamin status of eating disorder patients: relationship to clinical indices and effect of treatment. Int J Eat Disord 1995;18:257–62.

36. Langan SM, Farrell PM. Vitamin E, vitamin A and essential fatty acid status of patients hospitalized for anorexia nervosa. Am J Clin Nutr 1985;41:1054–60.

37. Ceci F, Cangiano C, Cairella M, et al. The effects of oral 5-hydroxytryptophan administration on feeding behavior in obese adult female subjects. J Neural Transmission 1989;76:109–17.

38. Cangiano C, Ceci F, Cascino A, et al. Eating behavior and adherence to dietary prescriptions in obese adult subjects treated with 5-hydroxytryptophan. Am J Clin Nutr 1992;56:863–7.

39. Cangiano C, Laviano A, Del Ben M, et al. Effects of oral 5-hydroxy-tryptophan on energy intake and macronutrient selection in non-insulin dependent diabetic patients. Int J Obes Relat Metab Disord 1998;22:648–54.

40. Kaye WH, Weltzin TE. Serotonin activity in anorexia and bulimia nervosa: relationship to the modulation of feeding and mood. J Clin Psychiatry 1991;52 Suppl:41–8 [review].

41. Smith KA, Fairburn CG, Cowen PJ. Symptomatic relapse in bulimia nervosa following acute tryptophan depletion. Arch Gen Psychiatry 1999;56:171–6.

42. Weltzin TE, Fernstrom MH, Fernstrom JD, et al. Acute tryptophan depletion and increased food intake and irritability in bulimia nervosa. Am J Psychiatry 1995;152:1668–71.

43. Oldman AD, Walsh AES, Salkovskis P, et al. Biochemical and behavioural effects of acute tryptophan depletion in abstinent bulimic subjects: a pilot study. Psychol Med 1995;25:995–1001.

44. Anderson IM, Parry-Billings M, Newsholme EA, et al. Dieting reduces plasma tryptophan and alters brain 5-HT function in women. Psychol Med1990;20:785–91.

45. 31. Mira M, Abraham S. L-tryptophan as an adjunct to treatment of bulimia nervosa. Lancet 1989;ii:1162–3 [letter].

46. Krahn D, Mitchell J. Use of L-tryptophan in treating bulimia. Am J Psychiatry 1985;142:1130 [letter].

47. Brewerton TD, Murphy DL, Jimerson DC. Testmeal responses following m-chlorophenylpiperazine and L-tryptophan in bulimics and controls. Neuropsychopharmacology 1994;11:63–71.

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