ANOTHER MURDERED HYPOIC - OR- SUICIDE BY DOCTOR
[Note: Notice the need for control ("fight" and "cure"); the psychobabble ("need to remain a child"); the rationalizations ("desperate situations call for desperate measures"); the absense of outrage; and the general language used in the discussion ignoring and denying their total ignorance about which they claim to have expertise. In the absense of a valid and realistic paradigm, the perception and "treatment" of this "disease" is right out of the dark ages. And, in second article, on the genetic basis of eating disorders, note that even with an 83% inheritance, they still need to find an etiologic role for environment. Geez!!! When will they see the reality of this stuff?]
By Bill Brewster ABCNEWS.com
Imagine living with the body-wasting disease anorexia nervosa for 22 years. Imagine being a 35-year-old woman struggling to keep your weight above 60 pounds. Imagine having tried all manner of therapies in a vain attempt to convince yourself it was OK to eat properly. How desperate would you be? Desperate enough to ask doctors to operate on your brain to treat
your anorexia? That's what one-time British child singing star Lena Zavaroni did last month when, it's believed, she underwent a procedure called a leukotomy at the University of Wales Hospital in Cardiff. Less than four weeks later, she was dead of an infection, never having left the hospital. The London tabloids were awash with headlines- "Lena dies at 50 lbs!" - that brought anorexia to the forefront of the national consciousness for a day or so. But the use of mind-altering surgery to "cure" Zavaroni's eating disorder recalls the discarded barbarisms of psychiatry's past, and raises the eyebrows of several doctors who say the operation should never have been performed.
Bad Trip to Never-Never Land. Zavaroni first captured Britain's fancy in 1974, as a 9-year-old. Her huge singing voice landed her on a nationally televised talent contest called Opportunity
Knocks. After winning for an unprecedented five consecutive weeks, she moved to London to pursue a stage and TV career. Soon after, Zavaroni sang for Queen Elizabeth and President Gerald Ford, and she performed at a charity concert with Frank Sinatra and Liza
Minelli. A great career seemed to lie ahead, but when she hit puberty and started to develop sexually and gain weight, her troubles began. Since her career had been predicated on the fact that she was a precocious pixie, she had to look the part. When she had trouble fitting into her costumes, her handlers started to talk about her weight in front of her. As a result, she said in an interview near the end of her life, she became anorexic at age 13. According to David Waller, director of child and adolescent psychiatry at the University of Texas Southwestern Medical Center, Zavaroni's is a classic case. Nearly all instances of anorexia,
he says, are rooted in "a dread of growing up."
Anorexia Not an Evil Voice. Besides being underweight, Waller says, anorexic patients also frequently suffer from bone-density and heart problems, a reduced response to infection, and a cessation of menstrual periods. (Most, though not all, anorexics are female.) The problem for physicians is that psychotropic drugs, used to treat most psychiatric ailments these days, don't work well on anorexia compared to their effect on other disorders. For example,
says Waller, a person with obsessive-compulsive disorder is paralyzed by recurrent thoughts that at least sometimes seem intrusive and inappropriate to them - evil voices in their heads. Drugs often diminish the intensity of these intrusive thoughts. But anorexics
almost never feel that their negative thoughts about eating are foreign to them. Their fundamental anxieties are about growing up and the increasing size of their bodies. Not eating helps "solve" these problems. Anorexics' thoughts, therefore, are on the same
wavelength as their disease.
Cutting Brain Connections. Thus, it's only when other medical problems arise, or when friends and family start to worry that the anorexic is too thin, that they seek medical attention. And many sufferers then embark on a long and often frustrating road through years of therapeutic treatments. When Zavaroni died, the tabloids barked about an "elective lobotomy." While the Cardiff hospital did not release any details about the exact procedure carried out on Zavaroni, "lobotomy" probably overstates the case. Lobotomy implies having gray matter (brain cells) removed, while a leukotomy involves having "white matter" connective fibers) cut, thus severing the connection between one part of the brain and another. Neurosurgical techniques are much more sophisticated now than they were 30 years ago in the heyday of lobotomies, so the doctors who operated on Zavaroni most likely made only a very small, precise cut, Waller says.
No Evidence for Leukotomy. Nonetheless, Paul Hamburg, associate director of the Eating Disorders Unit at Massachusetts General Hospital thinks the surgery was probably far too drastic a step. The problem, he says, is there's no medical evidence that leukotomy cures anorexia. A few case studies have appeared in journals, but they don't carry much predictive value for results. Says Hamburg, "I wouldn't want my skull opened on the basis of a testimonial." Two years ago, he was one of a handful of doctors asked to review a U.S. case in which a chronic anorexia sufferer wanted a similar operation. "No serious consideration was given to saying yes," he says. Treating anorexia by severing connections in the brain is at its core a dangerous, experimental procedure, according to Hamburg, with little chance of positive results.
Trying, and Trust. What are the treatment options for long-time anorexics? The most important weapon in fighting the disease, Hamburg says, is persistence, followed by the establishment of long-term trust relationships between the patient and one caregiver,
whether therapist, nutritionist, internist or other. Beyond that, doctors work to prevent medical complications and intervene appropriately when the patient's weight drops too low. While he concedes that many patients eventually die from the illness, including an alarming
number from suicide, Hamburg says he has seen several cases where anorexics finally beat it, even after decades. "Desperate situations call for desperate measures," he says. "But
when people say they've tried everything, it's usually not true." Even if behavioral options have been exhausted, there are always different relationships that can be built. Get another opinion, try another hospital, try another country, try more or different therapy techniques. Hamburg says he believes too many doctors are looking for a simple answer for anorexia, when, in fact, physicians still don't know very much about the disease. There's no drug to treat it, and there's no known "brain solution" that makes a specific type of surgery a reasonable option. That Lena Zavaroni's final solution for anorexia was to ask doctors to cut
into her brain only shows how insidious the disease can be. But in her case, that operation most surely wasn't the answer.
EATING DISORDER'S GENETIC BASIS - SURPRISE?
By Claudine Chamberlain ABCNEWS.com
Tracy was 20 years old before she realized how healthy, normal adult women eat. Hospitalized for anorexia, her body dangerously drained by her refusal to eat, she watched in awe as a group of nurses sat down nearby with trays full of cafeteria food and finished every bite.
"That's just not what I grew up with," she says now, 13 years later. "My mom has always been very weight conscious, and she's always been underweight. For lunch, she'd have black coffee. That's it. One time, a friend took her to lunch for her birthday, and she had salad with no dressing and coffee."
While Tracy (not her real name) has battled both anorexia and bulimia for more than half of her life, she knows she's not the only one in her family with an eating disorder. That's why she wasn't surprised when her doctor told her the problem may be in her genes.
Tracking Twins: Her doctor is Dr. Cynthia Bulik, an eating disorders expert at Virginia Commonwealth University whose research has shown that a woman's risk for bulimia nervosa is largely inherited. After studying nearly 2,000 identical and fraternal twins, Bulik
concluded that genes account for 83 percent of female susceptibility to the disorder. Other studies have clearly shown that eating disorders run in families, but until Bulik's research, it wasn't clear if that was because families share the same genes, or the same dysfunctional environment. Her findings appear in the latest issue of Biological Psychiatry. So, what about the conventional wisdom that girls starve themselves nearly to death, or binge and then force themselves to throw up, because of overwhelming societal pressure to be thin? "We're not letting society off the hook," Bulik says. "We like to say that the genes load the gun and environment pulls the trigger."
Identical twins have 100 percent identical genes, while fraternal twins have only half in common. So if bulimia in both twins is more common among identical pairs than fraternal pairs, Bulik says, you can deduce that the reason is genetic.
Parents Get a Break: And that's exactly what she did. Bulik and colleagues interviewed 1,897 female twins at age 30 and again at age 35 and then used that information to parse out genetic factors, shared environmental conditions like parenting, unique environmental influences (something that one twin experienced but not the other) and socioeconomic factors.
When all of those influences were analyzed, it turned out that only 17 percent of susceptibility could be traced to a twin's unique experiences. For example, a twin who becomes a gymnast might face more pressure to be thin than her sister. Parenting, Bulik says, didn't register at all.
Bulik didn't study anorexia, but says her hunch is that the same genetic connection would show up for that disorder as well. Taken with other studies that show altered brain chemistry and familial patterns of eating disorder patients, this latest research will help usher in a new attitude about anorexia and bulimia. It's a real and complex biological disease, Bulik says, not simply desperate girls wanting to look like supermodels.
No Change in Treatment Yet: Michael Strober, director of the eating disorders program at UCLA's Neuropsychiatric Institute, says that for now, this kind of research won't change how eating disorders are treated. "It adds weight to the idea that there are hereditary
influences that play a role," he says. "But we don't know what genes they are, or what combination of genes and environment [lead to an eating disorder]. At this point, there is no immediate implication for treatment. But in the long run, it may help identify biological abnormalities and may pave the way for drug treatments." Tracy, 33, has improved since the days when she wouldn't even lick a stamp or inhale the scent of a cookie for fear of ingesting phantom calories. But she wonders if she'll ever really be healthy. Since the age of 15 she's been hospitalized 15 times, taken to the emergency room 25 times and kicked out of her college dorm because her roommate was terrified of waking up one day and finding her corpse. Her mom, though, refuses to talk about her own problem. "I told my dad that she should get help," Tracy says. "She would say that she never had a problem, but she did, and we all know it."
Comment: Notice how the above study led to the typical expert response: "this kind of research won't change how eating disorders are treated." Of course, he means, mistreated. Why Michael Stober can't admit he hasn't a clue about the cause or treatment of eating disorders is beyond me. Not really. It's because he would be out of a job. That's INTEGRITY for you. Why these "experts" can't re-evaluate their premises and come up with Hypoism, or at least read my book and start appropriate research in the correct direction clearly shows their obstreperous bias toward the psychological model of behavior, a model that never was viable but is perpetuated out of blind personal prejudice, ignorance, superstition, and unwillingness to open their minds to reality. Psychology has no means to deal with inherited behavioral disorders like addictions. Hypoism is the only current biological premise capable of dealing with disorders of instinctive behavioral addictions. Hypoism is the only addiction etiology and recovery paradigm that is predicated on the biological and genetic basis of "against your will" behaviors.