Sunday Smörgåsbord

It's once again time for your weekly Sunday Smorgasbord, where I trawl the web for the latest in ED-related news, research, and more, so you don't have to.

Everything to Lose, Everything to Gain: An Alcohol Addiction Interview with Kendra of Voice in Recovery.

The Ravello Profile: Development of a global standard neuropsychological assessment for young people with anorexia nervosa.

"Be Bad. Snack Well." We don't need food morality, thanks. Also, the SnackWell cookies from 15 or so years ago weren't even that good, so "SnackWell" is not exactly a truthful name.

11 Dangerous Myths about Binge Eating Disorder. The food pics are a little annoying, but the info is good and written by my friend Sunny Sea Gold.

Olanzapine Use for the Adjunctive Treatment of Adolescents with Anorexia Nervosa.

Set Point: Your Body’s Take on Weight. A MUST read for those of us struggling with weight changes in recovery, myself included.

Unmet need for treatment in the eating disorders: A systematic review of eating disorder specific treatment seeking among community cases.

Neuroscience of the Gut: Strange but true- the brain is shaped by bacteria in the digestive tract.

Testing mediators hypothesized to account for the effects of a dissonance-based eating disorder prevention program over longer term follow-up.

Interesting study of food cravings: Eliminating some foods may eliminate cravings for them.

Hospitalizations for Eating Disorders in the US from 1999 to 2006.

Light Switches Brain Pathway On-and-Off to Dissect How Anxiety Works.

The Relationship Between Quality of Life, Binge-Eating Disorder, and Obesity Status in an Ethnically Diverse Sample.

Horses can be therapeutic, but is equine therapy a legitimate treatment for eating disorders? One therapist thinks so.

Not everything published tells the whole story - hierarchy of evidence explained.

50 things you should give up for a happier life.

The Emily Program opens treatment facility in Seattle, Washington.

Area of brain linked to harm avoidance may help explain anorexia risk.

A few extra Easter-related tidbits for you:

Five Ways To Eat Cadbury Crème Eggs.

Eggsperiments: Scientists crush and burn Cadbury Creme Eggs.

National Geographic Traveler's "Peeps in Places" Photography.

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Katie said...

The BED myths was a great piece - I agree that the photos were awful though, ugh. Way to decrease the shame of people suffering from BED, random editor person who chose images. I'm glad the myth that certain foods need to be avoided to maintain recovery was covered too, because food restriction as a solution to an eating disorder seems back to front to me - and I'm not just saying that as a recovered anorexic, but as someone who struggled enormously with bingeing in my teens. Although that myth is countered by the other article in this post on how restricting certain types of foods might help "dieters" avoid slipping up. Apparently opinion is divided on that one ;) is it a dangerous myth or a helpful tip? Although of course dieting and having an eating disorder are very different things, so maybe it is helpful for regular dieters but unhelpful for people with BED? Goodness knows. I am allergic to milk and I have found that I never crave dairy products after 3.5 years of being forced to avoid them, but that could just be because they were making me sick and wheezy by the time I gave them up, which might have conditioned me to not want them.

It's a shame that the olanzapine study didn't work out, because I would have been interested to see the results. I would be more interested to see a long term study on whether people treated with it show more/fewer ED symptoms than those who did weight restoration medication-free though. I am not anti-medication or anti-psychiatry, but I am very wary of the use of olanzapine for people with anorexia. It increases appetite and supposedly decreases anxiety yes - but it also decreases motivation to resist eating, which feels uncomfortably like the chemical version of punitive force feeding treatment, circa 1970s. I took a similar drug (quetiapine) when I was experiencing a hypomanic reaction to effexor four years ago, and it didn't actually decrease my anxiety at all - it made me feel horribly jittery but physically exhausted, so I felt like I was trapped in a perpetual state of desperation but unable to do anything about it. I am very sensitive to side effects but I do know that this is a legitimate one that more people than just delicate flowers like myself experience. My appetite increased drastically and I did gain weight, but that made me feel awful too, like I was out of control of the process and just randomly bingeing my way back up to a healthy weight. That could easily precipitate bulimia in someone so predisposed - luckily I have a severe phobia of vomiting, so that didn't happen. How can olanzapine or similar drugs teach people with eating disorders that food is safe and they won't balloon up out of control if it makes them starving hungry? It decreased my motivation too, so I felt unable to stop eating even though I hated myself for it, and it was very reminiscent of my struggles with non-purging bulimia as a teenager. Obviously quetiapine and olanzapine are different drugs but they share many side effects, and people I know who have been on olanzapine report the same problems with it as I had on quetiapine. And finally, it screws with your blood sugar/metabolism - how is that helpful in someone so physically compromised? I'm just not a fan :/

Um, epically long comment of doom there, sorry!

flaweddesign said...

I also would be interested in a differnt olanzapine study. it sounds like this one was fluffy and not taken too seriously. i was treated with olanzapine as an adult around the age of 25 and i definitely gained weight but it was a magical drug for my anxiety. however, i was IP at the time and as soon as i was OP and continued to gain weight i stopped the olanzapine.
@katie: i've been treatment with quetiapine for years now. at one point my dose got quite high and although i was eating the same amount every day (i know because it was ensure only) i continued to gain weight so i stopped it. it was amazing for me for sleep and i still use it for that although i'm scared of it. as a rule it doesn't help my anxiety much. like you said it makes me feel trapped in a sluggish body which makes things worse.

hm said...

Katie- I am on amitriptyline- yet another tricyclic drug- and can relate to your issues w/the quetiapine. It does increase my appetite while decreasing panic attacks, BUT that doesn't make me want to eat more. In some ways, that actually increases my mental conflict about eating and thus strengthens my resolve to avoid food. It also has effects on my blood sugar, pushing me towards hypoglycemia. But it alleviates the incapacitating panic attacks I was having. So every time I discuss wanting to go off the meds, my treatment team says it's not wise and pressures me back towards them. I've always struggled with anxiety, but not so much depression. Till being on these meds. These meds relieve my anxiety, but promote depression. I suppose depression for me isn't incapacitating, so perhaps it is the lesser evil. But it feels so shitty to have chemicals streaming into and around inside my body daily. Not a fan.

I too would be very interested in a study showing long-term effects of tricyclic drugs on anorexic patients. I keep feeling like this body and the hunger I feel are not my own, and the meds are just one more thing to resent for that. As I've tried to increase my appetite, I don't know how much of the hunger I feel is a result of my own work or is just chemically induced.

Of course, it's entirely possible I'd find some other place to put the blame and my resentment if I wasn't on meds.

It didn't help that the psychiatrist who prescribed these meds said this to me, knowing full well I have an ed: "These meds are known to cause weight gain. We'll have to keep our eye on that."


Katie said...
This comment has been removed by the author.
Katie said...

hm - quetiapine and olanzapine are atypical antipsychotics rather than tricyclics, and olanzapine is actually known to increase risk of patients developing diabetes - but the side effects do sound similar. I'm sorry you have trouble with side effects too. I can't actually take medication these days because I experience such extreme side effects, and I was very scared that I would never cope without it to begin with, but I have gradually learned coping mechanisms which help my anxiety and low moods. Of course if my illness had psychotic or bipolar features (the previous hypomania was medication induced, heh) I would reconsider, but I can just about cope without them for my current problems and my health thanks me for it. I do think they save the lives of some people - unfortunately I was just not one of those lucky people!

EvilGenius said...

regarding the olanzapine study - I was put on a high dose by a general psychiatrist with no ED experience while suffering restrictive anorexia aged about 15. I gained weight, sure, but I was barely staying awake, constantly lethargic, totally at the whim of my parents (they were offering me food constantly and I was too hungry and tired to say no) and I relapsed almost immediately after I figured it all out and stopped taking the pills. I've heard that lower doses are more effective but am still skeptical because of such a bad experience tbh...also I'm very surprised I didn't develop problems with purging earlier on, it seems like a huge risk with that kind of treatment.

hm said...

Katie- Yes, I see that they are in different families now. Interesting how similar the effects are- at least for me. I'm highly sensitive to meds also and take itty-bitty doses and receive full effect- in other meds even cutting them in quarters resulted in ridiculous intolerable side effects. This is the only med I've found with tolerable side effects. I am trying to cooperate with my treatment team and listen to their professional advice, but I hate these meds. They feel like poison. I cannot tell if that's b/c of my aversion to repeatedly putting things into my mouth and body or if it's a valid feeling. But I've developed an abnormal heart rhythm since being on amitriptylene, and also nerve tremors. The tremors are not listed as a side effect, but I was on this same dosage for panic attacks 12 years ago for a while and I developed the exact same tremors. Of course, the MD says the abnormal heart rhythm is from the ed or something else, not the meds. But I wonder. I wish there was an easy answer and that I had a conviction of certainty in one direction or the other.

C said...

I know this has nothing to do with this post, but I just really needed to say that your blog has inspired me to :
A. recover
B. start my own blog
You're great, keep it up !

littleleprechaun said...

LOVE the 50 things to give up and as a recovering anorexic I think particularly relevant ones to give up are: avoiding change, doing the wrong thing just because you can get away with it, comparing yourself to others and following the path of least resistance. Fab article. I'm a regular on your blog and would love if you'd read a few of my posts (it's my recovery told through poetry) or even link/follow me, that would mean the world to me :) the blog is

Keep writing and comment on my blog anytime x

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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