eating-disorders

ANOREXIA-NERVOSA

and other Eating Disorders:

Due to some emetophobes' low body weights, it has sometimes mistakenly been assumed that the emetophobe is actually suffering from anorexia nervosa and there have been several cases of emetophobes being treated for such - despite their protestations.

Professor Walter Kaye of the University of Pittsburgh has a 20 year interest in anorexia nervosa and other eating disorders and has observed these tend to run in families - even when siblings are not brought up together. Those suffering from eating disorders tend to have obsessional personalities, are often perfectionists and highly sensitive people who confess to thinking about food throughout the day - every day.

Dr David Collier at London's Maudsley Hospital has been seeking the gene for anorexia nervosa in the serotonin 5HT^a receptor which regulates feeding. When this is blocked (e.g. by drugs) then weight gain results. Serotonin is linked to anxiety, worry and obsessionality. Anorectics and bulimics tend to be in a constant state of anxiety, which raises their level of serotonin further so that the patient is caught in a vicious circle. The anxiety can be relieved by obsessional behaviour. If anorectics do not eat then they say they feel better suggesting there could be a link between serotonin and food. This link could be confirmed: serotonin is produced from the amino acid tryptophan obtained from food, so if a person stops eating, then no additional tryptophan will be produced and therefore their serotonin levels will fall, thus reducing and relieving anxiety. Similarly, bulimics (who cannot bypass their need to eat) relieve their anxiety via vomiting and then say they feel so much better. Further, it has been noted that there is a variation in the gene for serotonin receptors in many anorectics that could mean their serotonin receptors are over-active and behaving as an appetite suppressant making them feel anxious.

There could also be links with the stress mechanism whereby their bodies are constantly 'tuned for action' with a raised pulse and blood pressure. The hypothalamus produces stress hormones - adrenaline and cortisol which also serve to switch off the appetite. ADP switches the appetite back on but it is thought this may not work in anorectics who are in a permanently aroused state with their bodies locked into chronic stress. In anorectics' brains the hippocampus can be damaged by this long-term excess of stress hormones so that the appetite loss becomes even more out of control and the hippocampus eventually shrinks making anorexia a chronic condition. Research and experimentation into these approaches, and treatments involving administration of ADP, is at a very early stage but it could illustrate a problem previously perceived as psychological may actually have a physical biological cause.

It is always important not to allow your blood sugar levels to fall too low as this can lead to unpleasant faintness, dizziness, sweating, shaking, feeling 'wobbly' and a 'hungry' type of nausea.

For emetophobes who feel totally unable to eat, medical help should be sought. In the shorter term, you may find you feel better if you nibble on a few 'low-risk' foods such as dry ginger nut biscuits, dry bread or toast, crisps and chocolate. While this is certainly not a healthy long-term diet, it is virtually impossible to contract food-poisoning from such foods and they can help you feel better and gain some confidence re eating.

Perhaps you could also try eating whilst distracted by television, radio or a good book and have a rest afterwards.

These might not be medically-recommended methods of helping an emetophobe to eat, but many emetophobes have felt better by adopting such an approach - which is probably more important.