Diplomate, Board Certification of Emergency Medicine
We are dealing with eating disorders. Young females --
actually in contradistinction to what was felt in earlier
times -- feel that being thin is more attractive and
healthier. Truth be told, obesity is a major disease that
affects many people in the Western world, and there is no
question as to the dangers of being grossly overweight.
However, there is a disease of a compulsion to lose weight,
where these young people -- overwhelmingly females -- can
look in the mirror and perceive they are fat even when their
weight approaches dangerous levels such as 80 pounds (35
kilo). They may accomplish this weight loss by purging or by
complete refusal to eat, but there is an intense fear of
gaining weight and a complete obsession with one's weight.
[Unfortunately, it has been affecting the religious
community, especially in chutz la'aretz, with
increasing frequency. - Editor]
There is usually a strong concurrent psychological component
to this disorder, such as obsessive-compulsive disorder,
personality disorder, severe lack of self-image or worth, and
depression. Girls raised in families that push for perfection
or require an overburden of flexibility can lead to this
disorder. Five percent of anorectics die of the disorder, but
those who receive early treatment have a reasonable chance of
complete recovery. I was personally involved in a case of a
young woman who weighed 60 pounds (25 kilo) and was admitted
to the ICU, where she subsequently passed away at the age of
25.
We cannot tell you what definitely helps. It is possibly a
combination of things, as this disorder is caused by a
combination of things. Outpatient therapy may be very
effective, as may be psychotherapy, but again not in all
cases. With the exception of possibly Prozac, there are no
medications that reliably work. However, the news on bulimia
is better. We'll discuss that next week.
Write me in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
column. Seroxat is Glaxo's antidepressant and its track
record is remarkable. It is from the new class of
antidepressants and the side effects are minimal -- leading
to ease in maintaining a normal life.
