Eating Disorders/Anorexia

[A.J. Mahari]

Eating Disorders are often also diagnosed in those who have been diagnosed with BPD. More often than not, (but not necessarily always) eating disorders result from sexual abuse. I will have more information on this here soon.

[A.J. Mahari]

Fading away
   

March 29, 2008
Anne Kelly
RECORD STAFF
www.therecord.com

The voice of Aimee Moore's eating disorder is all she hears after years of starving herself.

"And it screams at her," says Aimee's desperate mother, Pat.

Twenty-eight-year-old Aimee weighs just 63 pounds. During a recent appearance on TV's Dr. Phil show, she described herself as fat, ugly and evil. Show host Phil McGraw told the audience her case is the worst he's seen. Aimee has been battling anorexia and bulimia for 15 years.

Now, parents Dave and Pat Moore wait anxiously at their home in Stratford as Aimee enters her sixth week of treatment at an Alabama centre for eating disorders. The treatment was organized by the show.

Before that, Aimee routinely gorged on massive amounts of pasta, ice cream, cake, milk, sugar, ketchup and pickles. Her mother estimates Aimee consumed up to 15,000 calories a day, more than seven times the recommended amount for a woman her age. Then she'd throw it all up, purging as many as 150 times a day.

Aimee's potassium level is so low, her heart is in danger of stopping. She takes a daily potassium supplement, but when she can't keep it down, it makes her esophagus bleed on the way back up.

She's already been hospitalized for kidney failure. Advanced osteoporosis has left her bones as brittle as those of a 90-year-old and she's lost an inch and a half from her five-foot-five-inch frame.

She has no body fat; her muscles have eroded as her body feeds on itself. Her body mass index is just over 10. Normal is 19 to 24.

"She is like a skeleton with skin," Pat says in an interview at her home in Stratford.

Aimee's brain is so starved, it's as if she's brain dead, Pat says. She's made several failed attempts at treatment in Ontario and the United States. Dave and Pat are hoping intensive therapy at the Magnolia Creek Treatment Centre near Birmingham will put Aimee on the road to recovery.

The Dr. Phil segment, called Deadly Thin, was shown Feb. 25, the same day she entered Magnolia Creek, which is treating Aimee free of charge. An e-mail she sent to the show in December caught the attention of a producer.

"I am out of control and my physical and emotional health are very fragile," she wrote, inspired by another sick young woman, who gained 40 pounds in treatment after appearing on the show. "I have come to the end of myself and if I don't get help soon I don't think I'm going to survive."

It's unclear how long Aimee will be at Magnolia Creek and staff declined a request for interviews.

"She's doing everything she's been asked to do," says Pat, who visited Aimee recently during a parents' weekend.

The centre is proceeding cautiously while Aimee's body becomes used to a new regime. She is now keeping breakfast and an afternoon snack down. Though purging only once or twice a day, she has yet to gain any weight. She is experiencing severe stomach cramps and constipation, her mother says.

Sometimes Aimee calls Pat, saying she wants to quit the program. At the same time, she is attending more group therapy sessions. "It's up and down, moment to moment," Pat says.

The centre doesn't usually take patients as sick as Aimee but made an exception. Its medical director had initially asked that she enter hospital in Ontario to gain some weight before being admitted in Alabama.

But her treatment team in Stratford didn't feel the hospital there was equipped to treat her, and she would have waited months to get into the Toronto or Mississauga hospitals that treat eating disorders. She wouldn't have qualified for admission to Guelph's Homewood Health Centre, which also has a program, because her body mass index was too low and her health too unstable.

Disturbing behind-the-scenes footage, broadcast on the Dr. Phil show, portrays her vicious cycle of binging and purging. Her mother says the binges can last two or three hours with breaks to purge. The process continues through the night, since Aimee sleeps only about two hours at a time.

She's been in and out of hospital for treatment since age 14, including stays at the Hospital for Sick Children, Toronto General and Stratford General Hospital.

Two stints in American facilities in the past three years were funded by the Ontario Ministry of Health. She completed neither program, leaving one early and being discharged from another for non-compliance.

At about age 18, Aimee was referred to Homewood, which has a leading eating-disorders program. By the time a bed was available 18 months later, she'd moved to the United States.

Her family has spent thousands of dollars on private counselling. "We're kind of out of options," Pat says.

Aimee began life an outgoing, happy child. Her outlook changed when she was sexually abused at age seven by teenagers at a campground, Pat says. Dave's reaction, based on the limited information he had at the time, left Aimee feeling ashamed. Her self-esteem suffered, and at age 10, she began cutting her arms. Four years later, she was abused again, this time by an acquaintance at a party.

Shortly after the second incident, Aimee began eating less and over-exercising. She wore a hole in the carpet doing aerobics in front of the television. That year, she was diagnosed with anorexia.

Aimee didn't tell her mother about the sexual abuse until she was 17. At about that time, she started to binge and her weight climbed to 140 pounds. Disgusted by the weight, she began purging.

When she was 19, Aimee eloped with a San Francisco man she met on the internet. He had no health insurance, and her eating disorder was raging, Pat says. After three years, they split up and she moved home, feeling like a failure again.

In addition to the eating disorders, Aimee has been diagnosed with borderline personality disorder, post-traumatic stress disorder and obsessive compulsive disorder tendencies.

She's had periods of recovery from bulimia but they've never lasted more than six months. And after every stay in a treatment facility, her illness has worsened.

"I have over-medicated myself with sex, drugs and even my prescription medications," Aimee wrote to Dr. Phil.

She is now on a disability pension. When money runs out, she resorts to stealing food from stores or scrounging it from garbage cans, her mother says. She takes a baby bottle filled with a nutritional supplement to bed at night but often purges it later.

April Gates, co-ordinator of the eating disorders program at Homewood, says some people use food to comfort themselves because they have other emotional problems. "It becomes like an emotional anesthetic," Gates says. Mental illness or addictions make eating disorders particularly complex and challenging to treat, she says.

Aimee told Dr. Phil her eating disorder doesn't comfort her any more, that she feels overwhelmed. "It numbs me and occupies time so I don't have to think and feel. I've always thought people would care about me more if there was something wrong with me."

Aimee's illness is heart-breaking for her family. Last December, Dave suffered a heart attack, then a brain hemorrhage. He had angioplasty and has returned to work full time at his factory job.

"It's like our daughter has been abducted by a rapist or terrorist who is torturing her day after day," Pat says. "We get to see it, but we can't do anything about it.

"Food addiction is one of the most difficult to treat. It's not like drugs and alcohol. You can stay away from those and the people who do that. But everybody has to eat."


THE FACTS

4,000 to 5,000 females aged 16 to 24 in Waterloo Region are estimated to have anorexia or bulimia

27% of Ontario girls aged 12 to 18 are reportedly engaged in severely problematic food and weight behaviour

0.5% to 1.5% of Canadian females aged 16 to 24 have anorexia; 1% to 3% have bulimia

20% is the death rate in 30-year follow-up studies of those with eating disorders

STATISTICS CANADA AND NATIONAL EATING DISORDERS INFORMATION CENTRE

THE SIGNS

Low self-esteem.

Social withdrawal.

Claims of feeling fat when weight is normal or low.

Preoccupation with food, weight, counting calories and what people think.

Denial that there is a problem.

Wanting to be perfect.

Intolerance of others.

Inability to concentrate.

WHAT IS IT?

Anorexia nervosa

Intense and irrational fear of body fat and weight gain.

Body image distortion.

Significant weight loss not due to physical illness.

Bulimia nervosa

Cycles of uncontrolled, secretive binge eating and purging.

Purging can be self-induced vomiting, laxatives and excessive exercise.

Feeling out of control while eating.

Extreme concern with body weight and shape.

SOURCE: EATING DISORDERS AWARENESS COALITION OF WATERLOO REGION

CALL FOR HELP (Southwestern Ontario)

Trellis Mental Health and Developmental Services: 519-576-2333 www.trellis.on.ca

The Eating Disorders Awareness Coalition of Waterloo Region: 519-745-4875 www.edacwr.com.

Central West Eating Disorders program, crisis line: 1-866-366-4566 referral line: 1-800-471-1732 www.cwedp.ca

National Eating Disorder Information Centre: 1-866-633-4220 www.nedic.ca

[A.J. Mahari]

A race against time for bulimic woman



Aimee Moore has spent much of her time binge eating and purging since her early departure Thursday from an Alabama eating disorders treatment centre. Returning to her bulimic ways has relieved the unbearable pain in the Stratford woman’s belly, caused in treatment by food backing up in her stomach and forming gas pockets, rather than moving normally through her digestive system.

Mother fears anorexic daughter is relapsing
April 13, 2008
By Anne Kelly, Record staff

STRATFORD — Aimee Moore has spent much of her time binge eating and purging since her early departure Thursday from an Alabama eating disorders treatment centre.

Returning to her bulimic ways has relieved the unbearable pain in the Stratford woman’s belly, caused in treatment by food backing up in her stomach and forming gas pockets, rather than moving normally through her digestive system.

But the vomiting has also made her lose five of the 10 pounds she gained during seven weeks at the Magnolia Creek Treatment Center in Alabama, which offered to treat her for free after she appeared on the Dr. Phil show.

Show host Phil McGraw, said Moore’s 14-year struggle with anorexia and bulimia is the worst he’s seen.

She now purges up to 75 times a day, down from 150 before treatment.

She spends nights at the Stratford home of her parents, Dave and Pat, where she feels safer.  But she returns to her apartment daily to eat and throw up her "binge foods,” which include ice cream, grilled cheese sandwiches, pizza, canned pasta and chocolate bars.

Now, at 68 pounds, Moore hopes to see a Kitchener gastroenterologist this week to determine what can be done to fix the digestive problem, so she can return to Magnolia Creek.

Her mother said if the wait is long for the diagnosis and treatment here, she’ll take her daughter back to an Alabama hospital, even though the family’s finances have already been drained by years of private therapy and prescription drugs to help keep Moore alive.

With her health so fragile, it is a race against time. Moore said she’d rather die than eat normally and endure the crushing stomach pain.

"I’ll fundraise, I’ll make an appeal to the community,” Pat said. "I’m not going to stand by and do nothing."

The exhausted 28-year-old said in a late night interview at her parents’ home Saturday that Magnolia Creek is "the best place in the world.”

Her blue jeans hang on her skeletal frame and the hood of a sweater covers her thinning hair. She clutches a heated bag to her stomach because, with no body fat, she is always cold. Her vision is deteriorating and her once strong white teeth are eroded and discoloured.

At first, Moore answers questions eloquently, then becomes agitated and pulls out the medication she delays taking until just before bed, since she keeps nothing down all day.  She downs liquid potassium to keep her heart functioning and 14 other medications to battle a raft of problems, including anxiety, nausea, psychosis, depression, mood swings. Some of the pills cost $100 each and aren’t covered by her disability support program.

She apologizes for her moodiness, even though she can’t help it. Moore also suffers from borderline personality disorder, obsessive compulsive tendencies and post-traumatic stress disorder from past sexual abuse.

It was her decision to leave Alabama. A trip this week to an emergency department of a hospital determined that her stomach wasn’t emptying properly and more investigation was needed.  She had no insurance to cover a hospital stay there.

"I get really scared when I don’t know what’s going on with myself,” said Moore, who also missed her mother terribly. Parents are only allowed to visit Magnolia Creek every six weeks. A doctor at the centre is trying to find a way to have her mother stay nearby if Moore returns.

Holding her head in her hand, Moore said nobody understands her like her mother does.

"She keeps my focused on why I want to live.”

Moore wants a chance to return to Magnolia Creek and experience all that it has to offer. Therapists there determined what she needed most, besides nutrition, was sleep. She made progress, eating five healthy meals and snacks a day.  Her purging decreased to two or three times a day.

But since so much of her time was spent sleeping or "running around screaming in pain,” she missed out on experiences with the other nine residents, such as going out for a lunch once a week, getting pedicures and manicures, playing games, and shopping at a grocery store.

She also missed most of the group therapy sessions that could help her hope with the intense self-hatred that makes her want to starve herself.

"I want to disappear,” she said. "I want to be so small that nobody sees me because of everything I’ve done that has hurt people. I would like to be hidden. I’ve always felt like I was a failure. I can’t stick to anything. I can’t stay in treatment, can’t eat, can’t function normally.”

Moore longs for a normal life, to silence the voice of the eating disorder that constantly tells her what to do.

"I liked to experience things again — friendships, relationships, going out for coffee, going to the mall with my mom, going on trips.”

But now the disorder comes first. "If I’m hungry, get out of my way. I’m like a feral animal.”

Moore has been in and out of treatment over the years, having once undergone forced tube feeding, which was disastrous.  The Ontario Ministry of Health has paid for two stints at U.S. treatment facilities in the past few years. Moore left one early and was discharged early from another for non-compliance.

She would be willing to try a liquid diet, if it is determined this would be best, but she won’t undergo feeding by tube or intravenous line.

"I don’t want to get fat without the pleasure of being able to eat food.”

She is telling her story in hopes of warning others about the slippery slope of disordered eating.

"I don’t want other people to go through the same thing."

Source: The Kitchener-Waterloo Record - http://www.therecord.com

[A.J. Mahari]

By Anne Kelly, Record staff
April 14, 2008

STRATFORD— Aimee Moore has spent much of her time binge eating and purging since her early departure Thursday from an Alabama eating disorders treatment centre. Returning to her bulimic ways has relieved the unbearable pain in the Stratford woman’s belly, caused in treatment by food backing up in her stomach and forming gas pockets, rather
than moving normally through her digestive system.

Aimee Moore has returned early from an Alabama eating disorders treatment facility because of a digestive problem that causes her pain when she eats.[

But the vomiting has also made her lose five of the 10 pounds she gained during seven weeks at the Magnolia Creek Treatment Center in Alabama, which offered to treat her for free after
she appeared on the Dr. Phil show.

Show host Phil McGraw said Moore’s 14-year struggle with anorexia and bulimia is the worst he’s seen.

She now purges up to 75 times a day, down from 150 before treatment. She spends nights at the Stratford home of
her parents,Dave and Pat,where she feels safer. But she returns to her apartment daily to eat and throw up her “binge foods,”which include ice cream, grilled cheese sandwiches, pizza,
canned pasta and chocolate bars.

Now at 68 pounds, Moore hopes to see a Kitchener gastroenterologist this week to determine what can be done to fix the digestive problem, so she can return to Magnolia Creek. Her mother said if the wait is long for the diagnosis and treatment here, she’ll take her daughter back to an Alabama hospital, even though the family’s finances have already been drained by years of private therapy and prescription drugs to help keep Moore alive.

With her health so fragile, it is a race against time. Moore said she’d rather die than eat normally and endure the crushing stomach pain.

“I’ll fundraise, I’ll make an appeal to the community,” Pat said. “I’m not going to stand by and do nothing.”

The exhausted 28-year-old said in a late night interview at her parents’ home Saturday that Magnolia Creek is “the best place in the world.”

Her blue jeans hang on her skeletal frame and the hood of a sweater covers her thinning hair. She clutches a heated bag to her stomach because, with no body fat, she is always cold. Her vision is deteriorating and her once strong
white teeth are eroded and discoloured.

At first, Moore answers questions eloquently, then becomes agitated and pulls out the medication she delays taking until just before bed, since she keeps nothing down all day. She downs liquid potassium to keep her  heart functioning and 14 other medications to battle a raft of problems, including anxiety, nausea, psychosis, depression, mood swings.

Some of the pills cost $100 each and aren’t covered by her disability support program. She apologizes for her moodiness.

Moore also suffers from borderline personality disorder, obsessive-compulsive tendencies and post-traumatic stress disorder from past sexual abuse. She was assaulted at age seven by teenagers at a campground, and again at age 14 by an acquaintance at a party.

It was her decision to leave Alabama. Her stomach wasn’t emptying properly and more investigation was needed. She
had no insurance to cover a hospital stay there.

“I get really scared when I don’t know what’s going on with myself,” said Moore,who also missed her mother terribly. Parents are only allowed to visit Magnolia Creek every six weeks.

A doctor at the centre is trying to find a way to have her mother stay nearby if Moore returns.
Moore said nobody understands her as her mother does.

“She keeps my focus on why I want to live.”

Moore wants a chance to return to Magnolia Creek. Therapists there determined what she needed most, besides nutrition, was sleep. She made progress, eating five meals and snacks a day. Her purging decreased to two
or three times a day. But since so much of her time was spent sleeping or “running around screaming in pain,” she
missed out on experiences with the other nine residents, such as going out for a lunch once a week,
getting pedicures and manicures, playing games, and shopping at a grocery store.

She also missed most of the group therapy sessions that could help her cope with the intense self-hatred that makes
her want to starve herself.

“I want to disappear,” she said.

“I want to be so small that nobody sees me because of everything I’ve done that has hurt people. I would like to be hidden. I’ve always felt like I was a failure. I can’t stick to anything. I can’t stay in treatment, can’t eat, can’t function normally.”

Moore longs for a normal life, to silence the voice of the disorder that constantly tells her what to do.

“I’d like to experience things again — friendships, relationships, going out for coffee, going to the mall with my mom, going on trips.”

But now the disorder comes first.

‘“If I’m hungry, get out of my way. I’m like a feral animal.”

Moore has been in and out of treatment over the years, having once undergone forced tube feeding,which was disastrous.

The Ontario Ministry of Health has paid for two stints at U.S. facilities. Moore left one early and was discharged early from
another for non-compliance. Moore would consider a diet of liquid or pureed foods, but not being fed by a tube or intravenous
line.

It is the oral gratification that acts as a comfort to those with bulimia, Pat said.

“I don’t want to get fat without the pleasure of being able to eat food,” Moore said.

She is telling her story in the hopes of warning others about the slippery slope of disordered eating.

“I don’t want other people to go through the same thing.’’


Source: The Kitchener-Waterloo Record - http://www.therecord.com

[A.J. Mahari]

Anorexia rooted in a person’s genes, scientists say
By Megan Ogilvie

The insidious voice of anorexia nervosa is the most deadly of psychiatric disorders. Yet this slow slide into starvation
is not about aspiring to a cultural ideal and becoming supermodel skinny.

Scientists now say anorexia, which kills up to 15 per cent of those it afflicts, is likely rooted in a person’s genes.
Almost everyone is bombarded with pressures to be thin, but less than half a per cent of all women and a scant number of men develop anorexia.

Results of the first genetic studies, released in the past five years, reveal that genetic vulnerability for anorexia lies on
chromosome 1 of the human genome. Researchers are now digging down to find the exact genes, proteins and pathways involved in the disorder. This could lead to new options for detection, treatment and even prevention.

Right now doctors mainly try to help patients gain weight, says Dr. Allan Kaplan, at Toronto General Hospital.

Developing new therapies based on genetic research will likely take years, but Kaplan says understanding the role of genes will help ease the guilt and stigma that afflict patients and their families.

A genetic predisposition for anorexia means a person is at higher risk for developing the disorder, but does not guarantee a person will get anorexia.

Source: Record news services - http://www.therecord.com