From the Introduction:
My goal in writing this book is to help individuals with eating disorders, their families, and mental health professionals understand that anorexia nervosa is a brain-based disorder of profound malnutrition. The physiological factors are related to malnutrition.
I have treated more than a thousand patients with anorexia nervosa over many years. They are without exception profoundly malnourished. Yet, their most vividly articulated distress continues to be how fat they are and how they need to lose weight.
No issue of sexuality, parental conflict, or separation can cause such a distortion of perception and priority. What is going on in the anorexic is a physiological dynamic. The patient is literally starving herself to death. The pieces of the puzzle are diverse. Yes, there is a powerful psychological component to anorexia. But there is also a profound physiological one.
From Chapter 1:
A New Approach
Studies show striking evidence that a deficiency in the essential mineral zinc may play a key role in the development of anorexia. Symptoms of zinc deficiency include decreased appetite, weight loss, altered taste perception, depression, and missed menstrual periods—all symptoms associated with anorexia! Research also suggests that celiac disease, a genetic intolerance to the protein gluten, may lead to a predisposition to anorexia due to subsequent nutritional deficiencies like zinc, folic acid, B12, and essential amino acids. Correcting these, determining the underlying causes of nutritional deficiencies in an individual, and restoring a person’s nutrient balance are necessary for effective treatment.
From Chapter 1:
A New Approach
My approach has evolved over years of seeing many hundreds of patients. With every new patient I am reminded that not all individuals with anorexia are the same. Although a treatment plan needs to be specific for every individual, each plan starts with a comprehensive nutritional evaluation. Then, the nutrition-based treatment is implemented in conjunction with individualized medications. This approach transforms the treatment of anorexia from conventional hit-or-miss medication trials to focused interventions. Following my recommendations, testing for underlying conditions and implementing necessary treatments can and will result in clinical improvement in your child or loved one.
The five major aspects of this new approach to anorexia include:
- Optimizing zinc levels
- Evaluating deficiencies in digestive enzymes
- Correcting any underlying nutritional deficiencies
- Evaluating for celiac disease
- Choosing medications based on Referenced-EEG testing
From Chapter 2:
Anorexia 101
Anorexia nervosa is a life-threatening disorder that is poorly understood and often ignored by medical researchers. Anorexia is a complex, pernicious, and difficult-to-treat disorder. Those who have the disorder are masters at hiding it. Only when there are dramatic, outward manifestations do others become aware of the problem. Because our culture values thinness so highly, the anorexic generally receives praise in the earliest stages of the disorder. She is complimented for being thin and healthy, for eating properly and exercising. It’s not until she grows sickly thin that people begin to whisper that maybe this is no “ordinary” diet.
To most people, deadly illnesses are conditions like cancer, AIDS, and heart disease. But self-starvation? The thought might never cross your mind. Yet the death rate from anorexia nervosa is more than 12 times higher than the annual death rate from all other causes combined for young women ages 15 to 24. According to the National Association of Anorexia Nervosa and Associated Disorders, 5 to 10 percent of those with anorexia die within 10 years of diagnosis, a figure that increases to 18 to 20 percent by the 20-year mark. Suicide accounts for approximately 20 to 30 percent of these deaths—a painfully frightening statistic that is often ignored by professionals, families, and patients themselves.
From Chapter 5:
Therapy Is Not the Answer
For more than 200 years, anorexia nervosa has been considered a psychological illness. It seems logical, then, that psychotherapy would be a good way to treat it. Yet most kinds—whether traditional “talk” psychotherapy or behavioral therapy—have proven inadequate in treating and relieving anorexia and its accompanying depression, obsessive-compulsive behaviors, and other problems. That’s not surprising, considering there is relatively little information from randomized clinical trials to guide psychological treatment for anorexia and prevent the relapse which currently occurs in up to 35 percent of those who reach near-normal weight.
To be blunt, the current forms of psychological therapy—which form the basis of standard treatment for anorexia—are not nearly as effective as they should be, or as they could be. The sad truth is that well over half of all people with anorexia are at serious risk of relapsing, spiraling downward, and even dying because of over reliance on psychological therapies which, by their very nature, cannot help the anorexic until her brain is “ready to listen.”
From Chapter 26:
Avoiding Relapse
To help families whose loved ones are working toward full recovery but are thwarted by repeated relapses, I have developed a relapse prevention plan. Following these recommendations will give your child or other loved one an advantage in the recovery process—physically, mentally, and emotionally. The five steps for avoiding relapse include:
- Optimal nutritional support.
- Assessing and treating co-occurring mental health disorders and substance abuse.
- Monitoring, re-evaluating, and supporting during times of increased stress.
- Developing trust and honest communication through unconditional listening.
- Finding meaning in life beyond anorexia.