Fighting Anorexia: No One to Blame

[HuckleB]

The age of their youngest patients has slipped to 9 years old, and doctors have begun to research the roots of this disease. Anorexia is probably hard-wired, the new thinking goes, and the best treatment is a family affair.

http://msnbc.msn.com/id/10219756/site/newsweek/

"Emily Krudys can pinpoint the moment her life fell apart. It was a fall afternoon in the Virginia suburbs, and she was watching her daughter Katherine perform in the school play. Katherine had always been a happy girl, a slim beauty with a megawatt smile, but recently, her mother noticed, she'd been losing weight. "She's battling a virus," Emily kept on telling herself, but there, in the darkened auditorium, she could no longer deny the truth. Under the floodlights, Katherine looked frail, hollow-eyed and gaunt. At that moment, Emily had to admit to herself that her daughter had a serious eating disorder. Katherine was 10 years old.

Who could help their daughter get better? It was a question Emily and her husband, Mark, would ask themselves repeatedly over the next five weeks, growing increasingly frantic as Katherine's weight slid from 48 to 45 pounds. In the weeks after the school play, Katherine put herself on a brutal starvation diet, and no one—not the school psychologist, the private therapist, the family pediatrician or the high-powered internist—could stop her. Emily and Mark tried everything. They were firm. Then they begged their daughter to eat. Then they bribed her. We'll buy you a pony, they told her. But nothing worked. At dinnertime, Katherine ate portions that could be measured in tablespoons. "When I demanded that she eat some food—any food—she'd just shut down," Emily recalls. By Christmas, the girl was so weak she could barely leave the couch. A few days after New Year's, Emily bundled her eldest child into the car and rushed her to the emergency room, where she was immediately put on IV. Home again the following week, Katherine resumed her death march. It took one more hospitalization for the Krudyses to finally make the decision they now believe saved their daughter's life. Last February, they enrolled her in a residential clinic halfway across the country in Omaha, Neb.—one of the few facilities nationwide that specialize in young children with eating disorders. Emily still blames herself for not acting sooner. "It was right in front of me," she says, "but I just didn't realize that children could get an eating disorder this young."

Most parents would forgive Emily Krudys for not believing her own eyes. Anorexia nervosa, a mental illness defined by an obsession with food and acute anxiety over gaining weight, has long been thought to strike teens and young women on the verge of growing up—not kids performing in the fourth-grade production of "The Pig's Picnic." But recently researchers, clinicians and mental-health specialists say they're seeing the age of their youngest anorexia patients decline to 9 from 13. Administrators at Arizona's Remuda Ranch, a residential treatment program for anorexics, received so many calls from parents of young children that last year, they launched a program for kids 13 years old and under; so far, they've treated 69 of them. Six months ago the eating-disorder program at Penn State began to treat the youngest ones, too—20 of them so far, some as young as 8. Elementary schools in Boston, Manhattan and Los Angeles are holding seminars for parents to help them identify eating disorders in their kids, and the parents, who have watched Mary-Kate Olsen morph from a child star into a rail-thin young woman, are all too ready to listen.

At a National Institute of Mental Health conference last spring, anorexia's youngest victims were a small part of the official agenda—but they were the only thing anyone talked about in the hallways, says David S. Rosen, a clinical faculty member at the University of Michigan and an eating-disorder specialist. Seven years ago "the idea of seeing a 9- or 10-year-old anorexic would have been shocking and prompted frantic calls to my colleagues. Now we're seeing kids this age all the time," Rosen says. There's no single explanation for the declining age of onset, although greater awareness on the part of parents certainly plays a role. Whatever the reason, these littlest patients, combined with new scientific research on the causes of anorexia, are pushing the clinical community—and families, and victims—to come up with new ways of thinking about and treating this devastating disease.

..."

http://msnbc.msn.com/id/10219756/site/newsweek/

[usregimechange]

1. Family therapy is the best treatment for a lot of disorders and

the old medical model idea of just throwing drugs at a psychological problem is being replaced with more effective treatment.

[aquart]

2. Little kids singing Spice Girls lyrics...

I remember being shocked by that. Then, seeing them dressed like Britney Spears? When an 8 year old is under the same pressure to be sexy as teenager, funny how the same symptoms appear.

[HuckleB]

3. Actually, the interesting thing is that most of the young ones...

that I've worked with are not inundated with that "culture." The genetic component is quite powerfully evident in those patients.

[LeighAnn]

4. No pressure here

That's what a lot of little pre-teens will be finding under their Xmas trees this year

from a somewhat difficult to read page I found about precocious puberty

http://people.bu.edu/celiag/index1.htm

[janedoe]

5. No one to blame?

Perhaps that is correct, if "one" refers to a single individual.
What is social conformity? What is peer pressure?

"Anorexia is probably hard-wired....."

Anorexia is probably as "hard-wired" as the human survival instinct. In our current media-driven culture, perceived survival may depend on physical attributes and perhaps little else. Obviously honesty, character, and independent intellect have lost all meaning and value in our "modern, new and improved" culture, so what's left? Spin.

"Spin" is the current term for creating an image of what you want the viewer to think they see. Reality is irrelevant. Image is everything.

Now, consider a child who's life depends on parental acceptance. The child picks up clues as to what will please the parent. The younger the child, the more dependent they are on this parental acceptance. For a toddler, abandonment equals death.

The fact that the common age for the young anorexia patients has "slipped to 9 years old" seems more like a report card for our culture.

We should be asking why knowledge, understanding, competence, innovation, and natural talent, have lost their meaning in our culture.

[HuckleB]

6. More information...

http://www.wpic.pitt.edu/research/angenetics/

http://www.wpic.pitt.edu/research/anbnbrainimaging/

http://serendip.brynmawr.edu/bb/neuro/neuro98/202s98-paper3/Hirst3.html

http://www.apa.org/monitor/mar02/genetic.html

http://www.sciencentral.com/articles/view.php3?article_id=218392011&language=english

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14623359&dopt=Abstract

http://www.kartiniclinic.com/

[HuckleB]

7. Specific regions of brain implicated in anorexia nervosa, U of Pitt Study

http://www.medicalnewstoday.com/newssearch.php?newsid=27094

[HuckleB]

8. Alterations in brain serotonin activity may be associated with anorexia

http://www.medicalnewstoday.com/newssearch.php?newsid=30238

[Nikia]

9. I think that it is both

It seems everything reienforces itself. Recovering from anorexia, I try to make sense of all this. The less that I ate and less frequent that I ate, the less that I wanted to eat. When I feel stress, I don't want to eat. I think that these tendencies are stronger in some individuals than others.
The negative self talk comes from somewhere though. If it were considered good to be overweight, we wouldn't be having negative thoughts about having some fat on our bodies. If it were a positive thing to eat large amounts of food, we wouldn't think negative thoughts about eating too much.
Instead every person exposed to normal media hears things like this: (parentes are how my mind has twisted it) "Fat bad." "Thin good." (One can never be too thin.) "Americans are too fat" (I'm an American, therefore I must be too fat.) "It is bad to eat a lot of fat and carbohydrates." (It must be even better not to eat any fat and/or carbohydrates.)
I am in an eating disorder support group. Everyone of those women is a perfectionist, usually a fallen perfectionist, and cares or has cared more about others needs than her own. Almost all of us have some type of anxiety disorder too. Perhaps this is related to the genetics of it (Anorexia could have been an adaptation to feed ones children, who were less able to survive, in times of famine by going without food oneself.), but I think that a lot of this is an expression of stress and feelings. We want to be perfect, but have been unable to be perfect at the things that we wanted to be perfect at so we seek to be perfect at something that we seem to have a naturual talent at. We feel that others, important people in our lives, will not accept us if we are not perfect so we become perfect in the way that we can, either quite innocently or even vengfully "Maybe, you don't really want me to be perfect, do you?" . Feeling that others are more important or that you are expected to defer to others can be expressed as an eating disorder too. "I am not important enough to waste food on." "I want to take up as little space as posssible or even just disappear so that I don't hurt or inconvience anyone." "I don't need anything at all." or the vengeful reverse psychology "You won't let me meet my needs. I won't meet my need for food. I'll show you what happens when my needs aren't met."
I do think culture is responsible in that thin=good and that there actually seems to be more black/white thinking. None of the women in my eating disorder support group are what I'd term "glamour girls" though. Some probably are, but probably even less than in the general population.
Just my thoughts as a recovering anorexic. Personally, I'd really want to get a PET scan to see if I really do have some of these chemical issues associated with anorexia and anxiety. I am considering medication, but have had had bad luck in the past and don't feel like I can afford to be any more messed up than I already am at this point.

[HuckleB]

10. Feeling fat can be 'in the mind'

http://news.bbc.co.uk/2/hi/health/4481000.stm