Effectiveness of
Drugs in Treating
Eating Disorders
New Insights Into Eating Disorders
- Dana is 17, five feet tall, and weighs 84 pounds. She is thin, but always
seems to be on a diet. Dana obsessively reads food labels and carefully
calculates fat grams.
- In Patti’s home, food disappears rapidly from cabinets. Often at
dinner, Patti will eat quickly, then excuse herself to use the bathroom.
- Jennifer was never much interested in physical activity until she entered
high school. A sudden change in behavior led her friends to call Jennifer an
exercise freak.
These are some of the outward signs of eating disorders, which may affect as
many as one in 20 adolescent girls and young women. But eating disorders are
rarely the real problem. Rather, they can be triggered by a stressful life
event and are the expression of a deeper emotional issue. Such troubles usually
include a lack of self-esteem and may revolve around troubled relationships or
family problems. As many as two-thirds of eating disorders patients have been
sexually abused.
The most common eating disorders are anorexia nervosa, whose sufferers are
underweight but often think they are fat, and bulimia nervosa, which is
characterized by binge-purge cycles. Both disorders are predominantly found in
females between 12 and 25 years old.
According to Susan M. Ice, MD, medical director of the Eating Disorders Unit
at Belmont Center for Comprehensive Treatment, part of Albert Einstein
Healthcare Network, new research has shed light on the treatment of eating
disorders, and the behavior of those who suffer from them. "Studies have
shown that Prozac is very effective in treating bulimia," says Ice. The
FDA is about to sanction the use of Prozac for bulimia.
Prozac (and its pharmaceutical cousins, Zoloft and Paxil) increases levels
of serotonin, a chemical in the brain. Until recently, its use had been limited
to the treatment of depressive and obsessive/compulsive disorders. But like
many people with clinical depression, bulimics tend to have low serotonin
levels. Not surprisingly, many bulimics also suffer from some form of clinical
depression.
Other research is defining what may be an even more common disorder than
either anorexia or bulimia -- binge eating disorder. "This is distinct
from bulimia, in that it doesn’t involve purging," says Ice. "It
can also be called compulsive overeating." It is marked by uncontrolled
eating episodes and weight gain. It may or may not include the body image
distortion many bulimics experience.
The American Psychiatric Association is considering whether to classify
"binge eating disorder" as an official diagnosis. If it does, it
could spur the development of weight-control therapies which are more effective
than dieting.
Ice says recent sociological research has changed popular thinking about the
nature of eating disorders. Ice sees eating disorders "not so much as an
illness, but rather, an aberration in female development." Effective
treatment, she says, is achieved through "an understanding of female
behavior and of women and relationships."
Fortunately, there is more hope for eating disorders patients today than
ever before. Like many illnesses, however, early intervention is important.
Because many people with eating disorders are secretive about their rituals,
family members should pay attention to outward signs. "If caught early
enough" says Ice, "eating disorders are highly treatable."
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