eating disorders

UNDERSTANDING EATING DISORDERS

Individuals with eating disorders have the highest mortality rates out of all the 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.



WHAT TESTS CAN I DO?

COPPER / ZINC PROFILE

Copper is required for synthesis of the neurotransmitters norepinephrine and dopamine, which are essential for overall mental health. Low copper in the blood can lead to symptoms of depression, while abnormally high copper has been associated with aggression, paranoia, and anxiety.

Strong evidence suggests that zinc deficiency 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.

Controlled trial of zinc supplementation in anorexia nervosa

In this randomized, double-blind, placebo-controlled trial of zinc supplementation for anorexia patients, the body mass index (BMI) increase of the zinc supplemented group was twice that of the placebo. Zinc supplementation should be considered in the treatment of patients with anorexia.[1]

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IGG FOOD ALLERGY + CANDIDA

Individuals with eating disorders and other neurological, gastrointestinal, and behavioral disorders often suffer from IgG food sensitivities. Symptoms of IgG food sensitivities may occur hours or days after the offending food has been eaten, and can cause profound behavioral changes and even psychosis. The 93 foods tested in the IgG Food Allergy Test w/ Candida can identify problem foods so they can be eliminated from the patient's diet.

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ORGANIC ACIDS TEST

A diet lacking in adequate nutrients affects mood as it does overall health. Many people with chronic illnesses and mental health disorders show significant deficiencies of important vitamins and other nutrients. In addition, Organic Acids testing can indicate abnormal levels of bacterial and yeast metabolites and neurotransmitter imbalances, which can cause or worsen symptoms such as anxiety, depression, immune dysfunction, obsessive thoughts, fatigue, and sleep deprivation.

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GLUTEN / CASEIN PEPTIDES

If the enzyme dipeptidyl peptidase IV (DPP4) is inactive or deficient, then foods containing dairy, wheat, or soy proteins cannot be fully digested and will circulate in the body and to the brain as opiates. This can trigger a number of psychiatric symptoms, including obsessive and intrusive thoughts that can lead to eating disorders. These peptides can also fuel addictions to foods containing wheat and dairy.

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ADVANCED CHOLESTEROL PROFILE

Low total cholesterol is often associated with depression, suicidal thoughts, and anorexia nervosa. Patients with anorexia or other eating disorders with high cholesterol should also be evaluated for low thyroid function (hypothyroidism), which causes excess accumulation of serum cholesterol.

Total serum cholesterol and suicidality in anorexia nervosa

Patients who reported previous suicide attempts, impulsive selfinjurious behavior, or current suicidal ideation show significantly lower cholesterol levels than those subjects without suicidality. The lower the cholesterol levels, the more severe the depressive symptoms were in the patients examined.[2]

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ESSENTIAL FATTY ACIDS

Essential fatty acids (EFAs) are critical for cell membrane structure and function, as well as regulating the inflammatory process. Fatty acid metabolism requires magnesium and zinc, which are often deficient in people with eating disorders.

Deficiencies of essential fatty acids in patients with anorexia.

Patients with anorexia nervosa showed polyunsaturated fatty acid deficiencies in plasma phospholipids. These results demonstrate that the patients have deficiencies of essential fatty acids, compensatory changes in nonessential fatty acids, and decreased fluidity of plasma lipids.[3]

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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.