What are eating disorders? Treating with mainstream and complementary medicine

What are eating disorders?

Eating disorders are a complex and serious group of mental illnesses associated with significant problems with eating habits, weight management practices, and body image. People with eating disorders have extreme attitudes towards food intake, weight, and body shape. These factors become unhealthy preoccupations, interfere with daily activities, and negatively impact quality of life.

Eating disorders can affect men and women of any age from a range of cultures and backgrounds. The two main types of eating disorders are anorexia nervosa and bulimia nervosa.

The key feature of anorexia nervosa is that the individual is focused on achieving and maintaining a low body weight. The goal weight is often so low that the body cannot function normally. Extreme dieting, food avoidance, purging behaviours (i.e. self-induced vomiting or laxative abuse), and excessive exercise are often used to reduce weight.

Bulimia nervosa is characterized by recurrent, uncontrolled periods of binge eating, followed by behaviours designed to compensate for the binge, such as extreme dieting, fasting, excessive exercise, or purging.

What are the causes of eating disorders?

There is no single cause of eating disorders. It is thought that a number of interacting psychological, biological, and social factors may contribute to the development of an eating disorder. These include:

  • Unstable or difficult family and personal relationships
  • Other mental illnesses such as depression and anxiety
  • Feelings of loneliness and social isolation
  • Feelings of loss of control
  • Feelings of unworthiness and inadequacy
  • High personal expectations and unrealistic personal goals
  • Major life changes or crises such as relationship breakdown or loss of a loved one
  • Imbalances in brain chemicals
  • Cultural attitudes around beauty and weight

 

Signs and symptoms of eating disorders

There are a number of signs and symptoms of eating disorders, and no two cases are identical. If you suspect that you or a loved one may have an eating disorder or may be developing one, it is very important to seek help. Early intervention is vital in preventing the development of long-term patterns, and promoting recovery. Signs of eating disorders can be mental, physical, or behavioural.

Mental signs:

  • Preoccupation with body weight and appearance
  • Poor concentration
  • Sudden mood changes, and feelings of irritability, sadness, or anger
  • Intense fear of gaining weight
  • Distorted, negative body image
  • Constant preoccupation with food
  • Anxiety and depression
  • Low self-esteem
  • Feelings of loss of control

 

Physical signs:

  • Rapid weight loss or weight change
  • Irregular or absent menstrual periods in females
  • Sensitivity to cold
  • Faintness or dizziness
  • Fatigue and increased need for sleep

 

Behavioural signs:

  • Extreme and constant dieting
  • Disappearance of large amounts of food (may indicate binge eating)
  • Frequent trips to the bathroom around meal times (may suggest vomiting or laxative use)
  • Compulsive, excessive exercise
  • Changes in food preferences, fussy eating, or restrictive food choices
  • Obsessive rituals around food and eating
  • Withdrawal from social situations that involve food
  • Avoidance of eating meals, and frequent excuses not to eat
  • Social withdrawal or isolation
  • Wearing baggy clothes or changing clothing style
  • Lying about the amount or type of food eaten, eating in secret, or secretly throwing out uneaten food
  • Denial of hunger

 

Diagnostic considerations

At The Health Lodge, we run tests to gather more information relating to the health of patients with eating disorders.

  • Nutritional deficiencies are common in eating disorders, so we may screen for a number of nutrient deficiencies
  • Depression, anxiety and obsessive-compulsive disorder are common co-morbidities in eating disorders, and can have major impacts on health. It may be important to test for zinc deficiency and copper overload, metabolic abnormalities such as raised urinary pyrroles, and genetic factors including MTHFR gene polymorphisms. These factors can all play major roles in a person’s psychological well being.
  • We may test levels of stress hormones, as these can be raised in eating disorders
  • Digestion may be impaired and tests that give us important information on digestive function may be needed.

 

Treatment options for eating disorders

Treatment of eating disorders can be a long and difficult journey. Many people with eating disorders do not seek treatment due to an unwillingness to change, feelings of fear and shame, or because they do not believe that their behaviour is a problem. Treatment of eating disorders is very important, as eating disorders can severely impact health, and in some cases can be fatal.

Eating disorders are incredibly complex, and are best treated by a team of health carers. One or more psychologists are essential in every health care team for a person with an eating disorder. Psychological support aims to help the individual to learn about their eating patterns and beliefs associated with eating and weight, and provides strategies to help shift dysfunctional attitudes and develop healthier behaviours. Strategies may include:

  • Cognitive behavioral therapy
  • Family therapy for children and adolescents
  • Education regarding eating disorders and factors that influence or increase the risk of developing eating disorders
  • Building self-esteem and improving self-awareness
  • Supporting and enhancing social and family relationships
  • Learning and developing tools to prevent relapse

 

At The Health Lodge, the integrated healthcare team will include:

  • A GP to oversee medication if required, diagnostics and specialist referrals
  • A naturopath to assist with digestive health and nutrient imbalances
  • A dietitian to advise on diet and eating practices
  • An acupuncturist to help treat underlying causes i.e. anxiety/depression
  • A yoga/meditation teacher to bring body awareness back into balance
  • A carer who has a prior history of eating disorders and can share the journey

 

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of eating disorders. The multidisciplinary team may include general practitioners, psychologists, dietitians or nutritionists, naturopaths, osteopaths, and acupuncturists. This comprehensive and holistic approach is designed to support the patient’s physical, mental, and emotional well being.

 

For enquiries call The Health Lodge on 02 6685 6445

What is ulcerative colitis? An integrated treatment approach

Inflammatory bowel disease (IBD) is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss ulcerative colitis, and you can find out more about Crohn’s disease in last week’s blog.

What is ulcerative colitis?

Ulcerative colitis is a chronic autoimmune disease characterized by inflammation of the large bowel (colon and rectum). Unlike Crohn’s disease, it only affects the inner layer of the bowel wall.

Cause of ulcerative colitis

Like many of the conditions we see at The Health Lodge, the cause of ulcerative colitis remains unknown. Ulcerative colitis is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an abnormal immune response of the bowel mucosa to gut flora in genetically susceptible individuals.

While the exact cause of ulcerative colitis it not yet understood, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of ulcerative colitis in susceptible individuals.

Symptoms of ulcerative colitis

The most common symptoms of ulcerative colitis include abdominal cramping and pain, diarrhoea (which is often bloody), and rectal bleeding. Other common symptoms include loss of appetite, fatigue, and anaemia due to blood loss. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, liver disorders, and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms).

 Treatment for ulcerative colitis

Ulcerative colitis can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of ulcerative colitis is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Acupuncture: Several studies have found that acupuncture may be of benefit to people with ulcerative colitis.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms of ulcerative colitis. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques. Psychotherapy may also help you understand manage the emotional impact of your condition.

 

Naturopathic approach to ulcerative colitis

This section will discuss some of the naturopathic approaches to management of ulcerative colitis. We advise you to consult your health carers before considering commencing any of these therapies.

Diet

There is no single diet for ulcerative colitis. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with ulcerative colitis include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Identifying and avoiding problem foods- Certain foods may increase cramping and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with ulcerative colitis are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

Correcting nutritional deficiencies

People suffering from ulcerative colitis are at risk of a number of nutrient deficiencies as a result of chronic diarrhoea, blood loss, the use of certain medications, and chronic inflammation. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them.

Identifying food allergies

While there is much contention as whether food allergies play a role in ulcerative colitis, some researchers suggest that food allergies may trigger ulcerative colitis and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of ulcerative colitis. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.

What is Coeliac Disease?

Coeliac disease is a chronic disease of the small intestine (also called the small bowel) caused by intolerance to gluten. Gluten is a protein found in wheat, oats, rye, barley, spelt and kamut.

Cause of coeliac disease

 As we mentioned above, coeliac disease is caused by an abnormal immune reaction to the protein gluten. In people with coeliac disease, gluten causes inflammation and flattening of the villi of the small intestine. Villi are small finger-like projections that line the wall of the small intestine.  The role of villi is to absorb nutrients from your food. In coeliac disease, the villi are so inflamed and flattened that they are unable to fulfill their role. The surface area of the bowel that absorbs food is greatly reduced, leading to malabsorption of nutrients, and nutrient deficiencies.

Symptoms of coeliac disease

The most common symptoms of coeliac disease include diarrhoea, abdominal pain, bloating, flatulence, nausea and vomiting, weight loss, anaemia, and fatigue. Untreated coeliac disease can lead to infertility, loss of bone mineral density (osteoporosis), neurological disorders, and dental problems. Some of the symptoms of coeliac disease are related to the gluten-induced damage to the wall of the small intestine, while other symptoms, such as anaemia, are related to nutritional deficiencies caused by poor absorption of nutrients from food.  In children, untreated coeliac disease can affect growth and normal development, leading to short stature, weight loss or poor weight gain, and behavioural problems.

How is coeliac disease diagnosed?

Two blood tests are used to screen for coeliac disease. These are tissue transglutaminase antibodies (TTG), and deamidated gliadin peptide antibodies (DGP). Other tests that may be used are anti-endomysial antibodies and anti-gliadin antibody, but these tests are less commonly used these days.

If you suspect you may have coeliac disease, do not commence a gluten free diet before you have these tests. Cutting out gluten can make the tests unreliable, and you can get a false negative result. If you have already cut gluten out of your diet, but wish to have the tests done, you will have to re-introduce gluten into the diet for at least six weeks prior to getting the tests to make sure your results are reliable.

The most reliable diagnostic test for coeliac disease is a biopsy of the small intestine. In coeliac disease, the biopsy will find inflammation and flattening of the villi. If your blood tests come back positive for coeliac disease, your GP may recommend that you see a gastroenterologist and have a biopsy.

Treatment options for coeliac disease

The only recognised treatment for coeliac disease is to remove all gluten from the diet. This means cutting out all wheat, oats, rye, and barley, and all food products that contain them, such as bread, pasta, pizza, biscuits, cakes, and pastries. Ingredients within packaged foods can also come from a gluten source. Reading labels and becoming ingredient aware is essential to following a gluten free diet. At The Health Lodge, we work closely with your chef and dietitian or nutritionist to provide you with a gluten-free diet that is tailored to your individual needs.

At The Health Lodge, we recommend a multidisciplinary program that integrates the best of medical and complementary therapies in managing all aspects of coeliac disease, including gastrointestinal health, psychological wellbeing, and potential nutrient deficiencies.  There is a range of therapies available to you, including:

  • Medical care: People with coeliac disease are at a higher risk of nutrient deficiencies, especially iron, folate, calcium, and B12. Your GP may order blood tests to screen for nutrient deficiencies.
  • Nutrition: A dietician or nutritionist can offer nutritional advice and counseling to ensure you enjoy a healthy, nutritious diet that is sustainable in the long run.
  • Psychological support: Research has shown that psychological factors such as anxiety, depression and fatigue contribute to poor compliance to a gluten-free diet. A psychologist can support you in your mental wellbeing, and help you develop strong beliefs in personal control and self-management. These factors, along with a greater understanding of coeliac disease, have been shown to contribute to improved quality of life and improved dietary self-management in people with coeliac disease.
  • Naturopathy: Many of the symptoms and nutrient deficiencies seen in coeliac disease are due to chronic inflammation of the gut wall. Your naturopath may suggest the use of herbs with anti-inflammatory properties to help decrease inflammation and aid in repairing the gut wall.

 

Helpful tips for a gluten free diet

  • Read labels: Gluten can be found in many packages foods. Always read the label and check if any ingredients are made from gluten sources.
  • Look for gluten free products: The public is becoming increasingly aware of gluten-intolerance. You can find gluten free flour, bread and pasta and other products in supermarkets and many food stores.
  • Focus on what you can eat: For many at first, following a gluten-free diet can feel very restricted. Try to focus on the huge amount of food that is available to you, including fresh fruits and vegetables, fish, meats, eggs, legumes, nuts, seeds, and dairy. Many grains are also gluten free, including buckwheat, rice, corn, and quinoa.
  • Plan ahead when eating out: Many cafes and restaurants now offer gluten-free options. Find out which cafes and restaurants cater to your needs, or phone ahead to check menu options when going somewhere new.
  • Build a gluten free recipe repertoire: A simple internet search will find many sites that offer gluten free recipes. Get cooking, get creative!

 

In the long run

The gluten-sensitivity seen in coeliac disease is a life-long sensitivity. Symptoms will flare-up if gluten is reintroduced to the diet. A gluten free diet allows the wall of the small intestine to heal and resume normal function. If a life-long gluten free diet is strictly followed, the condition can be managed effectively, and symptoms and nutritional deficiencies can be prevented. At Byron integrated Medicine, we suggest that you seek out ongoing support and education, and see that any changes in nutritional needs are addressed, to ensure a high level of general wellbeing and quality of life.

Links

Coeliac Australia www.coeliac.org.au

For enquiries call The Health Lodge on 02 6685 6445

 

What is Crohn's Disease - An integrated treatment approach

In the next two blogs we will be discussing inflammatory bowel disease (IBD). IBD is a general term that covers a number of conditions that involve inflammation of the bowel. The two main types of IBD are Crohn’s disease and ulcerative colitis. In this week’s blog we will discuss Crohn’s disease, and you can find out more about ulcerative colitis in next week’s blog.

What is Crohn’s disease?

Crohn’s disease is a chronic (on going) condition characterised by inflammation of all the layers of the bowel wall.  While the most common parts of the digestive tract that are affected are the large intestine (colon) and the last section of small intestine (ileum), Crohn’s disease may affect any part of the digestive tract, from the mouth to the anus.  

Causes of Crohn’s disease

Like many of the conditions we see at The Health Lodge, the cause of Crohn’s disease remains unknown. Crohn’s disease is considered an autoimmune disease, where the body’s immune system attacks its own healthy tissues. However, some researchers suggest it arises from an immune deficiency state, where the immune system is unable to control bacterial growth in the bowel, leading to chronic infection and inflammation.

While the cause of Crohn’s disease remains a contentious issue, researchers do agree that a number of factors, including genetics, environmental factors, infectious agents (bacteria/virus), and immunological factors may all play a role in the development of the disease, and that the interaction of these factors may lead to the development of Crohn’s disease in susceptible individuals. 

Symptoms of Crohn’s disease

The main symptoms of Crohn’s disease are abdominal cramps and pain; frequent, watery diarrhoea; and weight loss. Other symptoms include fatigue, fever, and loss of appetite. Some people may also experience symptoms or manifestations outside the digestive tract, including swollen joints, inflamed eyes, skin lumps or rashes, jaundice (yellowing of skin), and osteoporosis.

Symptoms can range from mild to severe depending on the individual, and the disease process often follows a pattern of flare-ups (when the disease is in its active stage and the bowel is inflamed) and remissions (where there is minimal inflammation and mild or no symptoms). 

Crohn’s disease treatment

Crohn’s disease can be an incredibly debilitating disease to live with, and can have a high impact on your quality of life. It is essential that you receive adequate care so you can function happily in day-to-day life.  Treatment of Crohn’s disease is aimed at controlling symptoms, preventing flare-ups, improving quality of life, and minimising complications. There is a range of treatment options available to you, and we recommend an integrated “team approach” to your health management.

  • Medical care: Depending on your symptoms and the severity of condition, your GP may recommend anti-diarrhoeal medications, antibiotics, anti-inflammatory medication, or immunosuppressive agents.
  • Dietetics: A dietitian may be able to help identify problem foods, and to design a diet tailored to your needs to prevent nutritional deficiencies and weight loss.
  • Psychotherapy: Stress may trigger or worsen symptoms. A psychologist may assist you in identifying areas in your life that cause you stress, and help you develop stress management techniques.
  • Acupuncture: In a study of 51 patients with Crohn’s disease, acupuncture was found to improve disease activity markers, and to improve general wellbeing.

Naturopathic approach to management of Crohn’s disease

This section will discuss some of the naturopathic considerations in managing Crohn’s disease. We advise you to consult your health carer provider before considering commencing any of these therapies.

 

Diet

There is no single diet for Crohn’s disease. Each individual will react to foods differently, and your diet needs to be tailored to your individual needs. Some dietary changes commonly beneficial to people with Crohn’s disease include:

  • Low fibre diet - a low fibre diet may help to ease diarrhoea and reduce abdominal cramping during flare-ups.
  • Low fat diet – Many people with Crohn’s disease experience diarrhoea that contains undigested fats. These people may benefit from a low fat diet; however care should be taken to prevent weight loss and nutrient deficiencies.
  • Identifying and avoiding problem foods- Certain foods may increase cramping, bloating, and abdominal pain. It is important that you identify any foods that cause such problems and try to avoid them. Common problem foods include fruit and fruit juice, cabbage, beans, broccoli, spicy food, and chocolate.
  • Eating small frequent meals- Small meals are easier to digest and so you may feel better eating five or six small meals per day.
  • Drinking plenty of water- Try to drink plenty of water to prevent dehydration, especially during times of frequent diarrhoea. Try to avoid alcohol and caffeinated beverages as these stimulate your intestines and can make diarrhea worse. Soft drinks and other carbonated drinks frequently produce gas.
  • Avoiding dairy – Some people with Crohn’s disease are lactose intolerant, and avoiding diary products may be helpful in these individuals.

Lifestyle

Stress reduction: As we’ve already mentioned, stress can trigger or exacerbate symptoms. Techniques such as exercise, yoga, meditation, and massage may help to reduce stress levels.

A word on smoking: If you have Crohn’s disease, smoking can lead to a worsening of your condition. Smoking increases your likelihood of having flare-ups, needing medication and requiring repeat surgeries. Quitting smoking can improve the health of your digestive tract, as well as your general wellbeing.

Correcting nutritional deficiencies

People suffering from Crohn’s disease are at risk of a number of nutrient deficiencies. If the last part of the small intestine is inflamed, you will have difficulties absorbing B12 from your diet and B12 injections may be needed. If the entire small intestine is inflamed there will be difficulties absorbing all nutrients. Your naturopath, with your other health care providers, will identify those nutrients you may be deficient in, and may adjust your diet or suggest supplements to correct them. 

Identifying food allergies

While there is much contention as whether food allergies play a role in Crohn’s disease, some researchers suggest that food allergies may trigger Crohn’s disease and exacerbate symptoms. If food allergies are present, it is important to identify the problem food, remove it from the diet, and adjust the diet to prevent possible nutrient deficiencies caused by elimination of that food.

Your integrative team of health care specialists

We believe that a multidisciplinary team of health care professionals is essential in managing all the aspects of Crohn’s disease. Depending on your needs, your multidisciplinary team may include general practitioners, gastroenterologists, naturopaths, dieticians, osteopaths, massage therapists, acupuncturists, counsellors, and psychologists. This comprehensive and holistic approach is designed to support your physical, mental, and emotional wellbeing.