What are treatments for eating disorders?

Introduction

There are three major types of eating disorders: anorexia
nervosa, bulimia nervosa, and binge eating
disorder. Anorexia nervosa involves compulsive dieting and exercise to reduce
weight, leading to dangerous weight loss and, in women, the absence of menstrual
periods. Bulimia nervosa is characterized by binge eating followed by purging. The
recently identified binge eating disorder is marked by binge eating that is not
followed by purging.

Eating
disorders are most common in teenage girls and young adult
women from the middle and upper socioeconomic classes. The causes of the various
disorders are not known, but it seems indisputable that the Western emphasis on
slimness as a mark of feminine attractiveness contributes greatly.

Because severe anorexia can be life-threatening, treatment generally combines a
weight-gain program with psychotherapy and, sometimes,
antidepressant
drugs. Bulimia nervosa and binge eating disorder are both
treated with psychotherapy, antidepressants, or appetite suppressants to help
control binge eating.

Proposed Treatments

While there are no well-established natural treatments for eating disorders, there is some evidence that zinc supplements, when used in conjunction with conventional medical treatments, may help people with anorexia to gain weight. Preliminary attempts to treat bulimia by altering serotonin levels are also promising. In addition, the supplement dehydroepiandrosterone (DHEA) might be helpful for protecting bone mass.

Zinc. The relationship between anorexia nervosa and zinc deficiency is controversial. The relationship also is the subject of many studies.

Symptoms of zinc deficiency, including weight loss, appetite loss, and behavior changes, resemble those of anorexia nervosa to some extent. This has led some researchers to theorize that low zinc levels may be related to the onset of the eating disorder.

Preliminary evidence, including one small double-blind trial, suggests that zinc supplements might indeed be helpful in treating anorexia nervosa, possibly enhancing weight gain and helping to stabilize mood. One frequently quoted study that has often been used to discredit the use of zinc in anorexia appears to be relatively meaningless when inspected closely.

Tryptophan. Animal and human studies suggest that when levels of the brain chemical serotonin rise, hunger decreases. People who engage in binge eating may have a different response to changes in serotonin levels. In an attempt to change binge eating behavior, some researchers have tried to alter serotonin levels. Standard antidepressant drugs are most often used for this purpose. However, it might be possible to achieve similar results with tryptophan and related supplements.

The body uses the amino acid L-tryptophan to make serotonin. Preliminary evidence from a small, double-blind, placebo-controlled study suggests that a combination of L-tryptophan and vitamin B6
significantly reduced binge eating among people with bulimia. This evidence, however, is contradicted by results of another small study that found no significant difference between the effects of L-tryptophan and those of placebo on binge eating.

L-tryptophan is no longer sold as a supplement because of safety concerns. The
dietary supplement 5-hydroxytryptophan might be a safer
option; however, it has not been studied in eating disorders. The antidepressant
herb St. John’s
wort might also raise serotonin levels.

Dehydroepiandrosterone. Women with anorexia often experience bone
loss, partly because of decreases in estrogen levels. In a one-year double-blind
study, women with anorexia received either dehydroepiandrosterone (DHEA) at a dose
of 50 milligrams per day or standard hormone replacement therapy. The
results showed equivalent bone preservation in both groups. However, because there
is considerable doubt that hormone replacement therapy is truly helpful for
preventing bone loss caused by anorexia, these results mean little to
researchers.

Other proposed treatments. A small trial involving fifty-four
adolescents with eating disorders found that adding eight weeks of
yoga twice weekly to standard therapy was associated with
improved eating-disorder-related thoughts and behaviors compared with standard
therapy alone.

Bibliography

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