Wait!!! You’re a male with an eating disorder?

By Dr. Tony Wendorf, Guest Blogger

In a culture that values image so much, women may feel a lot of pressure to look a certain way.  Over the last few decades the movement toward valuing “being thin” has progressed at an alarming rate. Eating disorders have also followed suit and increased over the last 10-20 years.

Perhaps society is to blame, or it may just be that we have gotten better at understanding and recognizing what an eating disorder looks like. For years we have placed so much clinical attention on females with eating disorders that we completely ignored similar symptoms in males when, in fact, The Academy of Eating Disorders recently released statistics demonstrating a 10:1 female to male ratio. This gap is only continuing to get closer and closer the more we learn about males with eating disorders.

Typically, men have a later age of onset (21 years old) versus women (18 years old). Men typically do not seek treatment as quickly as females (nearly four years later). When men do seek treatment, their hospital stays are typically almost three full weeks shorter than females. Not surprisingly, we also see that males tend to die sooner after hospitalization than females.

Men diagnosed with Anorexia Nervosa—Restricting Type are the most likely to die following treatment. It’s possible that this alarming notion is due to the fact that men are admitted and discharged based on a lower Body Mass Index (BMI), which contributes to quicker fatality. The older the male is for admission, the more likely they are to die sooner than someone who is admitted at a younger age.  And yet another contributing factor is poor social support, which naturally results in the likelihood of death.

Many of the clinical symptoms of an eating disorder are similar, if not identical between males and females.  However, there are a few significant differences. For one, many males with eating disorders have struggled with a history of being premorbidly overweight.  This is not the case with females. Additionally, males do not tend to attempt suicide nearly as frequently as females with eating disorders. Anecdotally speaking, many males with eating disorders are having or have actively dealt with struggles with their sexuality. This may also contribute to body image dissatisfaction and distortion. Lastly, a great number of men with eating disorders struggle with Binge Eating Disorder, which is not currently listed in the DSM-IV-TR, but clearly has a distinct clinical pattern that requires immediate attention—immediate attention that is often not received.

The message is clear. Eating disorders do not discriminate between males and females.  As a professional in the field, there is a greater push to treat men with eating disorders and far more training available to better address this population. If you believe that yourself or a loved one is struggling with an eating disorder, it is highly encouraged that you seek immediate evaluation. I highly recommend the following facilities:

Rogers Memorial Hospital: www.rogershospital.org
800-767-4411

Rosewood Ranch, Center for Eating Disorders: www.rosewoodranch.com
800-845-2211

My contact information:
Dr Tony Wendorf
Licensed Clinical Psychologist #2977-57
Specializing in Recovery for Eating Disorder Individuals
tonywendorf@gmail.com

 

 Author

Dr. Tony Wendorf is a Licensed Clinical Psychologist who specializes in the treatment of eating disorders and is a professor in the Masters of Counseling program at Mount Mary College in Milwaukee, WI for courses in Multicultural psychotherapy, Psychopathology, and Eating Disorders. Dr Wendorf is a psychologist at The REDI Clinic. Prior to joining the REDI Clinic, Dr. Wendorf completed his Doctoral Residency at Wheaton Franciscan Healthcare-All Saints in Racine. During this time he was part of the consultation-liaison team in the medical hospital, established an eating disorder therapy group, saw eating disorder patients for individual therapy and conducted psychological and neuropsychological evaluations.Dr. Wendorf gained specialty training in treating males with eating disorders during his time at Rogers Memorial Hospital as the primary therapist for the male program in the residential Eating Disorder Center. Additionally, he has specialized training in Maudsley Family Therapy (FBT).

Dr. Wendorf received his Bachelors Degree in Psychology from UW-Milwaukee, his Masters Degree in Clinical Psychology from the Wisconsin School of Professional Psychology and his Doctoral Degree in Clinical Psychology from Wisconsin School of Professional Psychology. He is a member of multiple professional organizations including the Academy for Eating Disorders (AED), National Association of Anorexia Nervosa and Associated Disorders (ANAD), the International Association of Eating Disorder Professionals (iaedp), the American Psychological Association (APA), National Eating Disorder Association (NEDA) and the Wisconsin Psychological Association (WPA).


Outrage Over the Tube Feeding Diet

Tube Feeding Diet

Searching for the perfect wedding dress can be stressful but in that one moment when all eyes are looking at you, the pressure  to  look beautiful and feel beautiful can escalate. Now more and more often, bride-to-be’s  are looking for quick and simple weight loss solutions. One diet that has recently grabed a lot of attention from the media is the Ketogenic Enteral Nutrition Diet—also known as the Feeding Tube Diet. Utilized by people who are looking for rapid weight loss, this procedure involves a constant flow of liquid nourishment that runs from the nose, through the esophagus and into the stomach. While people can lose a lot of weight in a short amount of time, there are many important factors to consider.

Misuse of Medicine: Tube Feeding is approved for gaining weight and providing nutrition. Tube Feeding is warranted in a state of malnutrition not to cause malnutrition One can still eat with NG tubes, so why not just eat less food? There are medical risks to tube feeding.

Eating Disorders: Tube feedings are used to in extreme cases to refeed people suffering from an eating disorder. Encouraging a tube feeding diet may trigger an eating disorder.

Temporary Weight Loss Extreme dieting is neither healthy nor permanent. Weight is quickly regained as fat after extreme diets.

Honeymoon Weight gain Brides are likely to puff up with swelling once they resume drinking fluids and eating on their honeymoon. At the end of a two week honeymoon, a woman is likely to have gained the weight back and not fit into the honeymoon clothes. What will happen then?

As a RD, CDE I am appalled by this diet and find it disturbing that women feel the need to go to such extremes for one day in their life. What are your thoughts? Would you do this?

Fresh Press Pickings for April

Click below to stay fresh on Laura’s recent media adventures:

  • The 5 E’s Of Easy Eating Healthy on PageDaily
  • Top Five Servingware Products for a HealthyKid-Friendly Kitchen on MomsTown
  • Laura Dishes on Kiss Feeding with HLN:
  • Meat Your Match: Does Beef Really Kill? on Zeel
  • 9 Ways to Sneak Nutrient-Dense Foods Into Your Diet on Zeel
  • Laura shares her expertise with May 2012 Cosmopolitan readers on page 236

Bariatric Surgery and Diabetes

Bariatric surgery can reverse Diabetes, but The Endocrine Society recommends people take caution before taking extreme actions.

 

Two points I found interesting include:

Remission in diabetes may be a result of the hormonal changes in the intestines after bariatric surgery.

“Observational studies have suggested that weight loss surgery can rapidly improve glycemic control and even produce remission of diabetes in severely obese patients with type 2 diabetes. This improvement and/or remission of diabetes is noted before meaningful weight loss occurs, and is thought to be due to a weight-loss independent change in the incretin hormone milieu as a result of the alteration in intestinal anatomy.  Complete remission is defined as a fasting glucose level below 101 mg per deciliter and a glycated hemoglobin level of less than 6.0% for at least 1 year without active pharmacologic therapy. Until now, however, there has been a paucity of randomized controlled trials showing greater efficacy for surgical versus medical therapy, and for the variety of weight loss procedures available.”

 

Bariatric surgery should involve decision making regarding the ability to make long term lifestyle changes and be supported by a multidisciplinary team.

“The Endocrine Society recommends that practitioners consider several factors in recommending surgery for their obese patients with type 2 diabetes. These include the patient’s BMI and age, the number of years of diabetes, and an assessment of the ability to comply with the long-term lifestyle changes that are required to maximize success of surgery and minimize complications. Importantly, shared decision-making is critical in making a decision about bariatric surgery. The success of weight loss surgery in patients with obesity and diabetes ultimately depends on the partnership of patient, endocrinologist, surgeon, and a support team in the continuum of the long-term care of the patient.”

 

Read the article at http://www.endo-society.org/advocacy/policy/upload/Bariatric-Surgery-and-Diabetes.pdf.

Happy Heart Month (and Day) Part 2

You need to love yourself, in order to take care of yourself. On this Valentine’s Day, learn to how to keep your heart healthy. Get you cholesterol and coconut questions answered!

By Laura Cipullo, RD, CDE

Laura Cipullo Whole Nutrition Services

www.MomDishesItOut.com

Q)   Does eating cholesterol really impact cholesterol level?

We have know for years that saturated fat is the true culprit to raising LDL production by our body. One should decrease their saturated fat intake to decrease their LDL (Low Density Lipoprotein- aka bad cholesterol). Many people have misunderstood this for years. The focus should not be on a cholesterol free product such as palm oil but rather a lower saturated fat and higher monounsaturated fat like almonds. Decreasing dietary cholesterol intake lowers your LDL about 3-5% where as decreasing your saturated fat intake decreases your LDL by 8-10% as reported by the National Cholesterol Education Program.

Q)   Will this depend on other nutrients that the food contains? If it’s not, what does impact cholesterol levels then?

Yes, levels of saturated fat, monounsaturated fats, polyunsaturated fats, exercise, stress and genetics all effect our cholesterol levels. A favorable fat profile of a food should look like this >Monounsaturated fats> Polyunsaturated Fats> Saturated Fats (need more research as to which saturated fats may be more beneficial).

 Q)   What about coconut oil and is it true it may help you to lose weight?  

The American Dietetic Association does not recommend consuming tropical oils such as Coconut oil. According to the Natural Medicines Database, ”there is insufficient evidence to rate the effectiveness of coconut oil for weight loss, hypercholesterolemia, diabetes, chronic fatigue, Crohn’s disease, irritable bowel syndrome and thyroid conditions.”

 Q)   From the types of saturated fats such as stearic acid, lauric acid, etc, are there any with health benefits?

Per the research I have found, there are not saturated fats with absolute health benefits. To be prudent, one should continue to limit their saturated fat intake at this time and replace them with unsaturated fats, fruits, vegetables and whole grains. For additional reference there is a chart that clearly identify the roles of saturated fat on medscape: Role of Different Dietary Saturated Fatty Acids for Cardiometabolic Risk, By David Iggman; Ulf Risérus Posted: 04/28/2011; Clin Lipidology. 2011;6(2):209-223. © 2011 Future Medicine Ltd.

 

 

Picture provided by: <p><a href=”http://www.freedigitalphotos.net/images/view_photog.php?photogid=982″>Image: graur codrin / FreeDigitalPhotos.net</a></p>

 

Happy Heart Health Month – Part One

OMGoodness there are so many mixed messages about heart health. Read on tho make sense of sugar and saturated fat as it pertains to our heart health. Lets prevent Cardiovascular Disease (aka CVD).

Q) There are experts who are now saying that the evidence between saturated fat and CVD may have been biased because research didn’t take into account the sugar content of the diet.  Is sugar the real culprit?

Added sugar is associated with increased TG levels and increased LDL cholesterol (hyperlipidemia being a risk factor for CVD). However, there is an inverse relationship with increased intake of healthier carbohydrates such as fruits, vegetables and whole grains, meaning the more you eat these foods, the less likely you are to increase your risk for CVD.  Saturated fat remains a part of the picture. Now the question is which type of SFA may be more closely associated with the increased cholesterol-raising effect of cardiovascular and metabolic risk factors. More research is needed to clarify. Most importantly focus on including fruits, veggies and whole grains and limit added sugars.

 

Q) What is the role of saturated fat in CVD risk?

Saturated fat is associated with CVD. Studies show an increase in total cholesterol and LDL cholesterol after eating a meal high in saturated fat. However, recent studies are examining the different roles of the specific types of saturated fats: Short chain, medium chain and long chain SFA.  This means continue to minimize your intake of saturated fat like the visual lard on a steak until more research is available. A simple guide: choose products with < 2 grams/ saturated fat per serving. Rather focus on including monounsaturated fats like olives and avocado. 

 

Q)  There are studies that show total blood cholesterol is not a reliable indicator of CVD. If it’s not, what are the indicators then?

Total Cholesterol is not a biomarker of CVD rather one’s ratio of Total Cholesterol to HDL ratio.  HDL also known as high density lipoprotein is the good cholesterol (h for helper) and LDL, low density lipoprotein (l for want less of) the bad cholesterol. The greater your HDL and the lower your LDL, the more favorable your cholesterol profile will be and the decreased chance of cardiovascular disease. Studies indicate a Low HDL, High LDL and High TG are associated with risk for CVD. You must ask the doctor for your cholesterol breakdown and the ratio with a goal < 5.  Always ask for a copy of your blood work.

 

Q)  If a higher sugar intake may be dangerous, why aren’t  triglycerides (blood levels) more important when assessing the risk of CVD, since this marker has a good correlation with simple carbohydrates intake?

TG’s are a good indicator of risk for CVD and it should be included in the lipid profile to assess for CVD risk. However, the ATP III report issued by the NIH, encourages using TG’s as a marker for other lipid and nonlipid risk factors that ultimately raise the risk for CVD. Ask Your medical doctor for your TG level and aim for < 150 mg/dl. 

 

Check back for Happy Heart Health Month Part 2 or like Laura Cipullo Whole Nutrition Services on Facebook to get weekly nutrition updates.

Picture compliments of <p><a href=”http://www.freedigitalphotos.net/images/view_photog.php?photogid=905″>Image: Pixomar / FreeDigitalPhotos.net</a></p>

Michelle Obama says Let's Move!

Laura’s Take on the Let’s Move! Campaign. Listen to Laura talk with Rita Cosby on wor710.com on 2/1/2012 or via podcast.

As a leader Michelle Obama is in a unique and powerful position to empower Americans to live healthier lives. She can influence food companies to provide less processed, higher quality foods to schools and to our supermarket shelves. She can raise the energy and spirit of health by advocating for health awareness and encouraging physical activity. Her celebrity status can help bring the USDA’s “MyPlate” to more families’ tables.  She can help spread the message to fill your plate with fruits, vegetables, whole grains and low fat dairy. Thankfully, Michelle Obama also stresses moderation and admits to eating her burgers and fries.

Let’s Move! is taking information that is already out there and bringing a greater awareness on how to access such health education. Many of the materials and guidelines are those developed by the USDA.

Michelle Obama has companies like Goya and California Fresh Work Funds trying to help initiative change.

Is this the right campaign?

At the end of the day, bringing awareness to health promotion and disease prevention needs to be the ultimate goal of someone like Michelle Obama. However, rather than fight obesity, the campaign may want to rephrase their negative spin and create a new positive tone to Let’s Move!

How about let’s move more, let’s move towards eating real wholesome foods and let’s move towards eating less processed food. Let’s move to building self esteem!!!

Can one person create change?

Yes, Jaime Oliver’s Food Revolution and The Biggest Loser are just two examples of how change happens. Even, the presidential chef is making change. In the Washington Post today, the presidential chef Cristeta Comerford reports losing 15 pounds and eating healthier with her own home garden. She was influenced by her boss, Michelle Obama!! That’s right, the White House has their own garden and serves seasonal garden veggies to their guests. Comerford now has her own garden too.

 

What can you do to make a difference? Can you change your language about health or perhaps just add a half cup of veggies to your dinner plate?

 

 

The Hollywood Image

The Hollywood image that’s plastered everywhere—online, on TV, in magazines– is simply not realistic and can be harmful. Yet, it’s what some women and men strive for. They may see how skinny Demi Moore or LeAnn Rimes have gotten and think this is the ideal. I want to remind everyone that most people do not have such bodies naturally!  Most people do not have the time or money to focus on their bodies the way the Hollywood stars do. Most people can’t afford a full staff of a dietitian, a trainer, an esthetician, a chef, and a dermatologist…. Plus, celebrities are getting paid A LOT of money to look this way and if they don’t meet the criteria there is always editing and airbrushing to attain the super skinny, youthful look. To meet the Hollywood ideal, most men and women need to restrict their intake to a caloric level that is equivalent with that of an eating disorder. Most stars don’t acknowledge that they have an issue, although Victoria’s Secret model Adriana Lima openly admitted recently that she simply stopped eating solid food 12 whole days before the Angel runway show!

Remember, beauty is from the inside and shines when one is confident from their inner core. There is a great new web site promoting a new definition of beauty – check it out at www.BeautyRedefiend.net/.

 

Beauty Redefined Sticky-Notes

 

Is This Healthy?

How do you answer your child’s question “Is this healthy?” http://bit.ly/wRRBZe or read my answer at www.momdishesitout.com

If you make resolutions, vow to choose these:

Vow to:

Take One Step at a Time.

Are you thinking about your 2012 resolutions? Consider this: Rather than making brash diet resolutions, make small changes in your intake instead to prevent the feeling of deprivation or a potential binge. For example, if you are feeling guilty from over-consuming during the holidays, identify one thing you can change. Make it a small change and start today rather than waiting until January 1st. Perhaps you decide to decrease your dinner portion by 25%. Do this for 1 week and then add another modification on week 2, such as enjoying one cookie after lunch rather than 4 after dinner. Remember that moderation is key when it comes to your nutritional intake and setting health goals—and achieving them with ease.

 

Eat Like You Have Diabetes.

There are 70 million American children and adults at risk for diabetes. Don’t let it be you. Eating consistent meals and snacks that incorporate a blend of wholesome carbohydrates, lean proteins and healthy fats (MUFA’s and Omega 3 FA’s) will leave you feeling full longer, prevent a hormone rollercoaster and eventually aid in consuming less and depositing less body fat. Vow to eat mixed meals with an average of 45 to 60 grams of carbohydrates per meal.

Feed Yourself.

Don’t starve yourself with endless fad cleanses and one-meal-a-day dinner diets. Rather than skipping meals and slowing your resting metabolic rate, eat every 3 to 4 hours. If your stomach is grumbling at the start of a meal, you are more likely to overeat or even binge once your plate arrives. Worse yet, overeating and/or binging at the end of the day results in the consumption of more calories than had you eaten from breakfast until dinner. Vow to feed yourself regular meals and snacks to ultimately be a healthier you.

 

Center Before Meals.

Take a deep yoga breath and practice a simple mindful meditation before each meal. This will help you to relax and to separate your eating experience from your hectic day. You will be able to better recognize your fullness cues and, more importantly, to provide your brain with the opportunity to be psychologically satisfied with the food you have eaten and experienced. Vow to practice this form of “centering” daily to prevent over-consuming, decrease emotional snacking and develop a healthier relationship with food and eating.

 

Other Recommended Resolutions:

Vow to become a mindful eater.

Vow to put yourself & your health first.

Vow to love your body.

Follow my additional recommended resolutions 12/31/2011 on twitter @MomDishesItOut.