May 29, 2007

Taste buds and mood

Remember when the classic doctor's visit began with "stick out your tongue?"

"A Taste of Depression" describes research that may reveal underlying mechanisms of depression and help determine what medicines may work better for each individual.

This has obvious implications for eating disorder research. Could the loss or overactivity of the sense of taste be a contributing factor, a result, or could they feed one another? Could this test help diagnose EDs? Could the better understanding of serotonin and norepinephrine function in depression lead to earlier diagnosis and treatment of more mental illnesses? Could better depression treatment lead to underemployed clinicians who would then take on eating disorders?

Your thoughts?

May 24, 2007

How do you calculate a "target weight"

Do you wonder whether your child's weight goals are appropriate? There is a very simple and too rarely used tool.

Have your doctor chart your child's growth curve from childhood. It isn't hard to do:
For girls up to 20
For boys up to 20

You can do it yourself by plugging in the weights.

If a child has always been in the 50th percentile for weight, that helps figure out where they would be now, if not for the illness. If they are destined by their DNA to be in the 75th percentile it follows that your goal will be to get back there.

The actual weight goals will change over time into the 20s. The BMI will not remain stable.

Of course your child wants to be healthy at a 10th percentile for weight, a level some physicians settle for. But if they haven't been there all their lives, and your family's DNA isn't there either, why would we think that is healthy?

May 19, 2007

Hot, piping research fresh off the griddle!

I know: enough with the food analogies. But these are tasty items from the research menu:

Is your anorexic getting recombinant human growth hormone treatment? It's the latest thing!

Want to know what the research really says about anorexia treatment and bulimia treatment and binge eating disorder treatment?

Maybe they're telling the truth when they say: "This tastes funny?"

Impulse control and spending and dieting.

Are you curious about the mechanics of exercise addiction and EDs?

May 16, 2007

Colleges make terrible parents

My daughter attends a college in Virginia with many ties to Tech. Our community is affected, pained, and so saddened by the recent killings and suicide.

It is ironic, however, that my daughter's school has tried to reassure me, as a parent, with an email outlining "security" measures being taken at the school. "Extra law enforcement" will be deployed throughout the campus. We just don't get it, do we?

"Dear (campus administrator),

While I appreciate your concern about student safety, my concern as a parent is not about snipers and shooters. The young man at Tech had a mental illness, not a terrorist agenda or criminal intent. His acts do not increase any danger to anyone now that he is dead.

33 people died at Tech. Yet many, many more at our schools have crippling mental illnesses and untold suffering. Most will not become violent, but suffer silently. (Suicide is the third leading cause of death for those aged 15-24. )

I know from experience that getting help for an ill student at (your school) is nearly impossible. Our daughter's former roommate appears to be suffering from a life-threatening eating disorder and the other suitemates live in fear. Neither the housing office, counseling service, the RA, nor the dean of student's office have been able to offer any real help. Concerns for "privacy" and "choice" have kept this student and her fellow students hostage to a disease that is by its nature "anosognosic." She doesn't know she's ill, and can't ask for help. That is the nature of mental illness.

The Tech student's illness killed other people. My daughter's classmate is killing herself. Both situations are known to the school, but no one acts with the compassion and engagement necessary to make a difference. Despite available effective treatments, this student and many others live on campus and attend classes with the tacit approval of the university because no one behaves with appropriate alarm.

Part of this, of course, is a societal misunderstanding of the nature of mental illness - but colleges have an added responsibility to be leaders in this area.

If the school has concerns about the health of a student then immediate efforts should be made - and pursued with urgency - to bring family and other resources into the picture. If the school is unwilling to contact the family then the school needs to act as guardian - or unenroll the student for their own safety.

Please, please - instead of added police enforcement please put the school's resources behind changing mental health policies about privacy and parent involvement and change the definition of what is considered ill enough to intervene.

The danger is not outside with a gun, it is inside. And the damage isn't just measured by violent acts, but in wasted young lives ravaged by untreated mental illness."

May 11, 2007

Mother Nature doesn't diet

"Genes Take Charge, and Diets Fall By The Wayside" by Gina Kolata, is the kind of article that wails beautifully into the prevailing foul winds of "obesity epidemic" and "childhood obesity crisis."

Scientists know that dieting doesn't work. If you think about it, you know it, too. How many people do you know that have used food to manipulate their appearance (dieted) successfully? By success I mean: did they maintain that "goal" weight from then on and remain mentally and physically healthy? Can't think of any? Neither can I.

Dieting leads to ill health, ill temper, an erratic and unhealthy relationship with food, and - ironically - an insatiable appetite and bingeing. For those with the genes for it, dieting triggers life-threatening mental illness.

It is okay to be the shape, the color, and the personality that your genes custom-designed for you. Actually, it isn't just okay, its fantastic.

May 7, 2007

Posting from AED conference

(OK, I tried to blog from the Academy for Eating Disorders conference in Baltimore this week but computer troubles got in my way.)

If you had been there, you would have heard Dr. Thomas Insel of NIMH say that families have been ill-used for too long in the treatment of eating disorders. He said he almost felt a "day of atonement" was needed.

You would have heard Dr. Ivan Eisler say that the history of "parentectomy" in eating disorders treatment was simply wrong - and he symbolically threw quotes by Bruch and Minuchin and Gull and their ilk blaming and excluding parents into a recycling bin.

Fascinating work was presented on topics as varied as: "Eating Disorders and African American Women," "Eating for Dopamine - An Animal Model of Binge Eating and Bulimia," "Mindfulness-Based Eating Awareness Therapy," and "What to Do about EDNOS."

I felt as if I was backstage at the Oscars as I watched the leading lights of ED research pass by in the hallway. And, as usual, I felt sad as I talked with the many treatment centers with advertising booths at the conference who were unfamiliar with or dismissive of family-based treatment.

Here's what I heard from most of the clinicians and scientists I talked with: "We've changed." Some were even skeptical that the parentectomy and parent blaming concept is still being peddled out there. These are the good guys, mostly, the professionals who remain curious and engaged in the research and the application of modern mental health care theory. AED has my admiration for improving the worldwide treatment of eating disorders and for their true commitment to including carers and families in the conversation.

Thank you, AED, for inviting me and other parents to the conference and for listening to parents and caregivers.