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An interesting study… 

This study shows that serum brain-derived neurotophic factor (BDNF) is significantly lower in women with anorexia nervosa (AN) compared with women without an eating disorder and women recovered from AN. While recovery from AN is difficult to define, BDNF may emerge as a useful biomarker of AN and of recovery from AN.

Finding biomarkers for AN and recovery from AN can help improve diagnostic accuracy and help better identify individuals who have recovered from AN. BDNF polymorphisms have not only previously been associated with AN {1}, but the BDNF-specific receptor neurotrophic tyrosine kinase receptor type 2 has also been associated with temperament characteristics and low BMI in individuals with eating disorders {2}. The current study evaluated serum BDNF levels in women with AN (n=29), women without an eating disorder (n=28) and women recovered from AN for 1 or more years (n=18). In addition, set-shifting ability was also evaluated in all 3 groups using the Wisconsin Card Sorting Task (WCST). Age was similar among all three groups, and women with AN and recovered women did not differ in lowest lifetime BMI. Women with AN had lower serum BDNF than controls and recovered women. Overall, there was a positive association between BDNF and BMI. BDNF was inversely correlated with the eating concerns, shape concerns, weight concerns, and global scale on the Eating Disorder Examination Questionnaire and on the depression and anxiety sections of the Hospital Anxiety and Depression Scale. Women with AN made more mistakes on the WCST than control women, but BDNF level was not associated with performance on the WCST. Set-shifting was not impaired in individuals recovered from AN. The current study excluded healthy control women with a BMI below 19 or over 26 thereby excluding constitutionally thin and obese women. It is plausible that BDNF is related more to BMI or the starvation state than to AN per se. However, the relationship between BDNF and BMI is unclear as the results from one study indicate lower levels of BDNF in morbidly obese individuals compared with obese individuals {3}. Including constitutionally lean and obese women in future studies may help clarify the relationship among BDNF, BMI, and AN. BDNF may be a useful biomarker in the underweight AN state and in indexing recovery from AN. However, it is important to first ensure that BDNF is in fact associated with AN and not strictly BMI or other indices of starvation.

References: {1} Ribases et al. Mol Psychiatry 2003, 8:745-51 ]. {2} Ribases et al. Mol Psychiatry 2005, 10:851-60 ]. {3} Bullo et al. Eur J Endocrinol 2007, 157:303-10 ].

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The Klarman Family Foundation Grants Program in Eating Disorders Research whose long term goals are to accelerate progress in developing effective treatments for eating disorders has listed their 2008-2010 Award Recipients of outstanding scientists and researchers in the field :

 

  • Wade Berrettini, MD, PhD – University of Pennsylvania – Genome-wide Association Study of Anorexia
  • Catherine Dulac, PhD Harvard University – Genetic & Epigenetic Pathways Underlying the Neural Circuits of Feeding Behavior
  • Guido Frank, MD – University of Colorado Denver – The Brain Reward System Across the Major Eating Disorders & its Relationship to Genotype
  • Angela Guarda, MD – John Hopkins University School of Medicine- Role of the Cannabinoid (CBI) System in Bulimia Nervosa
  • Alvaro Pascual-Leone, MD, PhD – Beth Israel Deaconess Medical Center – The Role of the Right Prefrontal Cortex in Binge Eating Disorder: A Translational Research Study Using Transcranial Magnetic Stimulation (TMS) & Functional Magnetic Resonance Imagery (fMRI)
  • Maribel Rios, PhD – Tufts University School of Medicine – Examination of the Role of Brain-Derived Neurotrophic Factor in Binge Eating Disorder
  • Leslie Vosshall, PhD – The Rockefeller University – Identification of Novel Genes & Circuits in Animal Model of Binge Eating Disorder
  • Jeffrey Zigman, MD, PhD – U.T. Southwestern Medical Center – Mechanism by which Ghrelin & Orexin Defend Against Depression & Anxiety

 

Real scientists and genuine clinicians doing real work to make continued strides towards improved treatments, diagnostic tools, preventative modalities in treating eating disorders more of a reality along with further educating/training the medical community and wider public– CONGRATULATIONS!  Many of us wish you full-speed ahead as well!

-salut

 

 

While I’m playing with WP Themes -my creative side itches- I’ve been curious what other parents and those who have found their path towards healing, recovery and well being from their eating disorder find gives them greatest support and sustains them throughout? At your most difficult times, what has buoyed and held you steady, lifted you up and got you through (like my friend Ganesha up there)? 

Do you wish some things could have been done better in hindsight, wished clinicians, treatment providers, community resources, insurance, etc. could have known perhaps more than you, practicing with up-to-date, evidenced-based research and data vs rehashing false and painful stereotypes that can keep a family from getting the best care possible? And that  everyone worked more as a cohesive whole vs fragmented, inconsistent, and leaving too many gaps for uncertainty and misunderstanding– or worse barely any informative communication or basic follow up to keep focus on the best methods towards recovery and support?

And if you were/are a parent(s), caregivers, extended-family, siblings do you wish there would have been services that encompassed and included the entire family, and not just for weekly family therapy sessions, the once a month “Family & Friends” events held at treatment centers.  But further additional healing and supportive measures like what is comprised in most respite centers/facilities and typically standard for family members when a child has cancer, or any other major life-threatening illness. 

All of us know that ED’s are potentially life-threatening if proper treatment and nutritional support are not addressed, and the sooner diagnosis is made and intelligent, comprehensive action taken, the better the chances recovery can be, and less relapsing and monumental expenses for the revolving door of IP, OP, residential, IOP, etc. care.

Being a parent of an adolescent with an ED, there are unique aspects to what parents and family members need, your life and “time” seem to come to complete stops and starts depending on where the progression of the illness may be, how many extra hands there are to pitch in when you need time to take care of yourself, take care of other siblings, reconnect with spouses, get some perspective, and to keep centered and strong. 

If I were to draw a graph of how our family has progressed through our daughter’s illness, it would have some deep dips and high escalations, and many dotted straight lines– but not always clearly defined and consistent (thinking about this makes me want to create just such a map/graph!)  Sometimes things seem to just “click” and things move forward without much ado; but there are other times when it seems the cyclone of ED can just demolish the very health and Life of an entire household, leaving pulverized rubble and ruin that needs the utmost and gentlest of care and compassion– those are the moments when all your resources get pulled together and you roll up your sleeves and get down to business– you take action and you may find setbacks galore, but you also find incredible inner resilience, Hope, courage and more Love than you ever realized was always there. 

Moments like these can also be some of the most magnificent and humbling of points within our human experience …

 I feel a deep human need to collectively share these experiences, swap stories- like sharing a recipe!- connect with others who “get it” and aren’t going to be dismissive, discourteous, judgmental or even worse, think I’m a bit over-the-top… off my rocker… box ‘o crack ‘o jack, etc. 

And I think if it weren’t for the Internet of collective voices, fellow parental-comraderie and individuals such as an incredible Mom who hosts a forum for parents to find one another, along with so many of you whom I’ve met virtual-via email, your websites/blogs, etc. and found such amazing insight and resolve into this illness– I do feel I would have felt much more isolated and possibly a bit more despairing (I say a bit since my Finnish ancestry is laced with “SISU” = strength… so this would not have lasted long) but it also points to the reality of the importance to support and encourage one another through the recovery and healing process within eating disorders.  To make certain adequate treatment is delivered, proper support and resources are available in all demographics. 

Change is still quite snail-paced within ED’s, so I think our collective voices and efforts however big or small DO matter and make a difference.

Now if only I could get some of the ladoos (Indian sweet) that Ganesha is holding… my rant would be complete.

-shanti

 

 

Kar Men Shreshth Kamandalu Chakra Trishoodlharta

Jagkarta Jagkarta Jag Palankarta

    Om hara hara Mahaadevaa

virtaka

 

Facing the bluntness of reality is the highest form of

sanity and enlightened vision… Devotion proceeds

through various stages of unmasking until we reach

the point of seeing the world directly and simply

without imposing our fabrications… There may

be a sense of being lost or exposed, a sense of vulnerability.

That is simply a sign that ego is losing its grip

on its territory; it is not a threat.

 

-Chogyam Trungpa Rinpoche

It’s encouraging to know that some incredible clinicians are furthering the research and support of the efficacy of Family-Based Therapy within treatment of adolescents who suffer from eating disorders. 

As parents of eating disordered children we know how painful it is to watch our children succumb to this deadly disease.  And what makes things even worse is not having treatment incorporate the entire family to best help, educate, empower and support not only our loved ones, but ourselves as well; and also to help heal and guide the family through the journey we take on the road towards our child achieving full recovery.

Dr Walter Kaye with the University of California, San Diego is heading probably one of the largest research studies jointly with Stanford School of Medicine to find the most effective FBT, BFT, and placebo controlled trials including more studies into the use and efficacy of fluoxetine (Prozac) in the treatment of adolescents who suffer from Anorexia Nervosa.

Dr Kaye is certainly not the only clinician to take the lead in pioneering this momentum, Dr Daniel leGrange from the University of Chicago, Eating Disorders Program also has conducted a 5yr NIMH study of similar worth, and at this time the data that has been collected is being sent for publication.

Too many today still adhere to a very outdated, erroneous and unproductive notion that dysfunctional families/parents are the sole cause of eating disorders.  Yes, this is the 21st century, and when our daughter was diagnosed with AN last year, not only were we carrying very limited Karen Carpenter knowledge of ED’s, but to our complete shock and dismay,  the hospital where our daughter spent the next 20days- along with the next year of hit&miss follow-up outpatient treatment- had Dr’s, nurses and staff who seemed to be practicing a very draconian and almost at times inhumane form of ED treatment/care with even less experience and knowledge, and horrifyingly no real training and background in ED’s, and how to help sufferers and their families/carers beyond the basic “medical stabalization”.  I never would have imagined through our experience, how backwards and utterly frustrating this road to finding quality, intelligent, evidenced-based and compassionate care would be.

So there is continued reasons to be hopeful and remain optimistic that at some point ED treatment and standards of care will indeed get better, and our voices will be heard, blame will take a vaporizing exit, and efforts and focus will stay centered towards much more rational, ethical, affordable, and compassionate care for ED’s.

… I always say, especially when it comes to ED’s and medication- specifically anitdepressants and children/adolescents. 

It’s a call that I personally feel many clinicians make way too early before steady gains in weight, and full nutrition have been sufficiently addressed, and this takes time.  As parents, we see a significant change in mood with increased nutrition, as well as the opposite when our children are not eating enough or metabolizing properly during refeeding and recovery. 

Of course this will be an intimately personal and individualized decision, and antidepressants, without a doubt, have helped countless numbers of inividuals from seemingly endless and needless suffering. 

And you would want to have a physician who would have all the up to date, accurate, and forthright information in helping you make the best decision possible for your child, but after reading Dr Turner’s published report/study as well as the New England Journal of Medicine’s abstract about “selective reporting and clinical trials”, and “efficacy overstated for antidepressants” I’m convinced it’s vital to continue scrutinizing, as well as reseaching the use of antidepressants within the treatment of ED’s; and question why some clincians seem a tad overzealous to prescribe them.

And as some counterbalance, not completely overlooking how antidepressants have assisted many, CEO David Shern of Mental Health America shared a brief response.

The news of UNC’s study has been bustling about, but it’s worth posting this fine gem of a quote from senior author and director of UNC’s Eating Disorders Program, Dr Cynthia Bulik: “even a nugget of accurate biological information can influence how health care professionals preceive the illness” -and similarly can change the perceptions of others as well.

Nuggets of Information- Boulders of Truth… “POW!”

Extremely tragic news of a mother who “believed there was no hope” for her daughter who was suffering from anorexia and depression, which ironically she herself began battling around the same age- but seemed to be particularly well hidden from the rest of the family’s awareness– ends in the death of a promising young life.

This heartwrenching loss brings to mind many who struggle in silence and isolation, but what few still come to terms with is that this illness can indeed take lives not fully lived, and at any age.

Families, parents, and sufferers affected by disordered eating and self-starvation need and deserve compassion, effective treatment, and ongoing support.  Public awareness, insurance coverage and access to quality care, along with early intervention are still what we all need to keep pushing for so that HOPE becomes reality; and lives can be restored. 

As any writer knows, the power of words can be Herculean. 

Reuters Health  briefly highlights a ‘applied text analytic methods’ study carried out by Dr Markus Wolf at the University Hospital Heidelberg in Germany that can be helpful towards improved therapeutic treatments, and better understanding of the cognitive processing of the eating disordered brain.

Many of us, as parents with children suffering from an ED might also know how delicate, negative, and self-defeating our childs’ thoughts, behaviors, and words can be to themselves- especially when we know how this illness robs our children of their true selves during treatment and recovery. 

That’s why it’s even more vital to remind ourselves first and foremost: we are not to blame or at fault for our childs’ eating disorder; and secondly, to separate your child from the eating disorder/illness, especially at the most difficult moments through refeeding, treatment and recovery when it can be the most challenging thing to remind ourselves of.

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