UNDERSTANDING EATING DISORDERS

Individuals with eating disorders have the highest mortality rates out of all mental illnesses. In the U.S., as many as 10 million women and 1 million men battle anorexia or bulimia, and many more struggle with binge eating disorder or compulsive overeating. While eating disorders begin as preoccupation with food and weight, they ultimately become brain-based disorders of profound malnutrition with extreme physiological consequences. A common misperception in the medical community is that eating disorders are purely psychological and do not have a biological component. Treatment typically emphasizes psychotherapy and counseling with little attention to nutritional deficits that may underlie what appears to be entirely behavioral. Every treatment plan needs to be specific for each individual and should start with a comprehensive biochemical evaluation. Nutrition-based treatment can then be implemented in conjunction with traditional treatments, including individualized medications and therapy.


Priority Tests

Recommended Tests



RESOURCES

  • Changes in the immune system are conditioned by nutrition
    Undernutrition due to deficiencies in specific micronutrients impairs the immune system. The most consistent abnormalities are seen in cell-mediated immunity, complement system, phagocyte function, cytokine production, mucosal secretory antibody response, and antibody affinity. Underlying immunological impairments include obesity, eating disorders, food hypersensitivity, and gastrointestinal disorders. Marcos A et al., Changes in the immune system are conditioned by nutrition. Eur J Clin Nutr. 2003 Sep;57 Suppl 1:S66-9.
  • Abnormal L-tryptophan metabolism in patients with eating disorders
    The metabolism of L-tryptophan through the kynurenine pathway is dependent upon adequate nutrition. Cerebrospinal fluid levels of kynurenic acid were significantly reduced in underweight anorectics, but returned to normal values with restoration of normal body weight, indicating abnormal L-tryptophan metabolism in eating disorders. Demitrack MA et al., Abnormal tryptophan metabolism in patients with eating disorders. Biol Psychiatry. 1995 Apr 15;37(8):512-20.
  • Clinical Treatment of Anorexia Nervosa Merits More Attention – by James Greenblatt, M.D.

REFERENCES

  1. Birmingham CL et al., Controlled trial of zinc supplementation in anorexia nervosa. Int J Eat Disord. 1994 Apr;15(3):251-5
  2. Favaro A et al., Total serum cholesterol and suicidality in anorexia nervosa. Psychosom Med. 2004 Jul-Aug;66(4):548-52.
  3. Holman RT et al., Patients with anorexia nervosa demonstrate deficiencies of selected essential fatty acids, compensatory changes in nonessential fatty acids and decreased fluidity of plasma lipids. J Nutr. 1995 Apr;125(4):901-7.