Reverse Anorexia? Are you kidding me? Luckily i have not seen this term much (if at all) in the news, but if i do i think im going to have to go off on someone...

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You’d be forgiven for mistaking “reverse anorexia” to mean either the act of recovering from Anorexia or in the simplest form, a person who has no 

fear of food or weight gain – quite a non-term in itself then. When I saw it popping up amongst the headlines I let off a sigh of despair, especially as it was referring to a new ‘trend’… I have moaned incessantly in my past about ‘trends’ with names which relate to Anorexia; manorexia, pregorexia, drunkorexia – all of which leave a bitter taste in my mouth because they are made up terms to make them sound sexier in magazines. Utter rubbish.

So what is this, the latest of ‘trending’ eating disorders? In real terms, what all the papers are actually referring to is ‘Muscular Dysmorphia’ – sufferers of which convince themselves that they are too small or scrawny and go to extremes to build muscular body mass. It sounds to me like a specific form of Body Dysmorphic Disorder (BDD) of which the affected person is excessively concerned about and preoccupied by a perceived defect in his or her physical features – in this case, their leanness (or not, as they build more and more muscle). This BDD is the only thing that really, it has in common with Anorexia Nervosa at all – and it should be known as what it IS, not what makes it sound ‘easy to understand’ or snazzy or sexy or whatever other reason people feel the need to dumb down such illnesses.

Lumping all body-related illnesses only causes more room for misunderstanding, misdiagnosis and from the point of view of the sufferer and their families, a great deal of confusion. Nobody likes to be labelled, but it is better to have a clear idea of what is wrong with someone in order to treat that problem in the most effective way.

Muscular Dysmorphia is becoming more recognised, and aside from the silly terms, I am glad that it is getting some attention at the moment. Perhaps if it is highlighted in the media world, more people will realise that what they think is a meticulously planned diet and excercise regime could be more than that. If exercise and diet are an obsession, if they cause the person to have moodswings or feel anxious if other things ‘get in the way’, or if they start taking steroids or other unnatural means of building muscle – these are all signs that it could be more serious than it seems on the surface. It is thought that the cause is a mixture of psychological issues such as low self esteem and inferiority, and external, environmental issues such as images of football stars on billboards in skimpy pants with their six, eight, ten packs on show for all – hello Photoshop! There are and always will be images of those whose job it is so keep in that shape, but this does put pressure on ‘normal’ people to look a certain way that is just not realistic. It is important to remember though, that no disorder is down to vanity alone, nor comparison, nor the fault of the media. It is a psychological problem and it can be treated with Cognitive Behavioural Therapy, which uses logical steps of thought to bring a person to understand and question their illogical thinking patterns.

Research into Muscular Dysmorphia is only just getting into full swing, focussing mainly on young Rugby players – so it is difficult now to know or even guess how widespread this problem may be. I will more than likely come back to the topic when the findings, or any other research arises (the study I know of is over 3 years though – so don’t hold your breath).

What I want people to take from this though, is that we hear of ‘new’ illnesses cropping up all the time. All I want to do is help raise awareness of such problems by smashing through the simplified, belittling little nicknames given to problems that would be much more easy to understand if we were just told it straight.

http://blogs.independent.co.uk/2010/10/27/reverse-anorexia-the-true-meaning/

Eating disorders experts are treating growing numbers of women who are developing anorexia or bulimia well into adulthood, far beyond the teenage years when the conditions usually emerge.

Psychiatrists are seeing more patients who have become seriously ill with either of the crippling conditions for the first time in their 30s, 40s, 50s and occasionally 60s. In many cases, the illness has been triggered by a relationship breaking down, unemployment, the menopause, losing a parent, or seeing children leave home.

Some working with patients say that the rise in what are called late-onset eating disorders is linked to some women in their 40s and 50s feeling under pressure to look young because of the prominence of age-defying older female celebrities, such as Madonna and Sharon Stone.

"Five or 10 years ago, I would've seen one case of an older person developing an eating disorder about once every year or two. But now I see them more often – about five new patients a year with late onset anorexia nervosa or bulimia," said Dr Sylvia Dahabra, a psychiatrist in Newcastle who works for the regional specialist eating disorders service.

Sian, who didn't want to be fully identified, tells the story of her mother, Fiona, who died of anorexia in 2008 aged 48. "The trauma of me moving out of the family home at 18 to live nearby, and then relocating further away to Bournemouth when I was 21, triggered her serious decline. I was pretty much mum's life, and me leaving meant she was alone. She ended up weighing just six stone when she passed away when I was 21," said Sian. Fiona died in her sleep after contracting bronchial pneumonia.

"Once she got the pneumonia, she couldn't fight it because her body was so weak from the anorexia," said Sian.

Major life events are usually the cause of these disorders. "The person can lose their job, suffer a bereavement, have a child or see their relationship break down. As a result, their mood deteriorates and they develop a depressive illness. They lose their appetite and then lose weight," said Dahabra. "They then notice that they feel better when they don't eat, that they look 'better' and might even get compliments, and this then distracts them from what really bothers them and gives them a new focus." Dahabra has helped several women who have developed dysfunctional eating behaviours after their husbands left them. "In one case the husband's parting words to her were a derogatory comment about her weight. She associated the breakup with being overweight, began dieting. She ended up being found unconscious at home and hospitalised because her blood sugar level had fallen very dangerously low."

Dr Adrienne Key, the lead clinician for eating disorders treatment at the Priory clinic in Roehampton, south-west London, said: "In the last 18 months I've seen 10 women in their mid to late-30s, mainly with bulimia, who have had a baby in the previous few years and have had increased body dissatisfaction. They start dieting but then try more drastic measures such as skipping meals or going on these strange protein, no-carbs diets, and then their starvation triggers the biology of an eating disorder."

Why only some women who do that then develop anorexia or bulimia is not fully understood, but it may be because their brains function slightly differently under the pressure of food deprivation, said Key. "Growing numbers of women in their 30s and 40s are dissatisfied with their bodies because they are presented with visual imagery of perfect bodies and unobtainable body ideals, especially in magazines, due to airbrushing, and they feel pressured to try to achieve that."

Mental health experts at the British Dietetic Association, which represents dieticians, have also noticed the same trend. Beat, the UK's main eating disorders charity, is getting more calls from adults, mainly women.

Men can succumb too. Dahabra has treated one man who developed depression and then anorexia in his 40s amid grief at losing his mother. Another patient who was the same age was under severe stress, first at work, and then after losing his job and supporting his partner through a serious illness.

Lee Powell, a 37-year-old civil servant in Gloucester, saw his weight drop from over 10st to just over seven when obsessive exercise led him to start trying even harder to lose weight. "I used to have a cereal bar for breakfast and another for lunch, and then some proper food for my tea, but that quickly became just a salad. My wife, Annette, once said I looked like something out of a prisoner of war camp and broke down crying."

Experts are unsure whether the growing number of older onset cases they are treating indicates a real change in people's behaviour or simply GPs becoming better at identifying eating disorders.

Struggle to survive

By the time Natasha Craig died of anorexia in July 2007 at the age of 35, she weighed barely four stone. Years of starving herself had taken their toll. She fell over while playing with children at the primary school where she was a volunteer classroom assistant, broke two ribs and never recovered.

"She loved working at the school because the children didn't notice her thinness or comment on it," recalls her father Stuart. "After breaking the ribs her breathing got bad, she developed pneumonia and died soon." Anorexia, he points out, has the highest mortality rate of any mental illness, including depression, schizophrenia and bipolar disorder.

Natasha's struggle with anorexia since childhood proved so disabling that she grew to only five foot one; doctors said it should have been four inches more. It also led to her becoming stooped and developing severe osteoporosis, which seriously restricted the quality of her life. "Her legs were frail and she didn't have the stamina to walk very far; it became too painful for her," said Stuart.

"I think that anorexia is a bit like being an alcoholic, except that with alcohol it's much easier because you can give up drinking; but you can't give up eating."

While treatment exists for eating disoders, not all patients respond. That, says Stuart, helps explain why a third of anorexics are estimated to lead fairly normal lives, another third become seriously emaciated and the other third die.

http://www.guardian.co.uk/society/2010/oct/08/new-anorexics-women-over-30

The first entry in schoolgirl Anna Wood’s diary is written in a meticulous, careful, neat hand. Dated January 5, 2009, it starts: ‘My diet begins properly today, as I was not very good on Friday or Sunday — ate way too much.’

Noting down her weight — a healthy 10st 5lb for her 5ft 7in height — she vows to keep a daily log of her food intake in the quest, along with her mother, to shed a few post-Christmas pounds. ‘Less is more if I’m going to lose weight,’ continues the grade A pupil.

Flicking through the pages, it makes pitiful reading. She records no more than coffee and water for breakfast. 

Tragic: A smiling Anna Wood before she became consumed by anorexia. She died from a heart attack brought on by the illness when she was just 16

Lunch consists of carrots, apple and celery, while dinner is the only real meal she allows herself.

As her weight drops, the log shows that her meagre vegetable lunch has been replaced with water. Soon, there is too little to record and, by June, there are no more entries. 

Anna’s diary now sits on the kitchen table between her mother Christine Gibson, 51, an accounts administrator, and her father Paul Wood, 62, a structural engineer. 

Christine cannot help but cry as she reads aloud from it and asks: ‘Why Anna? Why us? I still don’t understand it.’

Their bewilderment is palpable as they talk about the speed with which anorexia claimed their daughter.

In August, last year — eight months after starting the diet — Anna was admitted to the eating disorders unit at Capio Nightingale Hospital, in Marylebone, London, weighing 6½st. 

Devastating: Anna rapidly went from healthy teen to frail anorexic

Discharged last December, having reached 8st, she reverted to starvation — believing herself to be ‘disgusting’ and ‘fat’ — and, in February this year, collapsed in the street.

She died on March 26 from a heart attack, six weeks after an emergency operation on a perforated duodenal ulcer. Too weak to breathe unaided, she used her last ounce of strength to mouth ‘I love you so much’ to her devastated family. She was just 16.

‘I will never get over her loss. It is such a waste of a beautiful, talented person,’ says Christine, who found her daughter’s diary only after she was admitted to hospital.

‘We felt so helpless. It seemed to creep up on her. Even Anna’s doctors said they’d never had a case where anorexia had become so entrenched in a patient, so quickly.’

Mr Wood adds: ‘In the space of months, Anna went from a bright, healthy girl with a dry sense of humour into one from whom the spark had gone. She became secretive and didn’t accept she was ill.’

Today, Christine and Paul, know more about anorexia than they could ever wish to. 

They are speaking now because they want other parents — who these days tend to worry more about obesity — to be on their guard.

This week, it emerged that the number of girls aged nine or under being admitted to hospital for anorexia has doubled in the past year, as children become obsessed with their bodies in our ‘size zero’ culture.

Up to 90,000 Britons are being treated for eating disorders at any one time, with those between 14 and 24 believed to be at greatest risk.

Anna’s parents have come to realise, too late, that their daughter fitted almost exactly the template for those considered by experts to be most vulnerable to eating disorders.

A pupil at £12,000-a-year Wimbledon High School, Anna was a high-achieving, conscientious, perfectionist, capable of showing a lot of self-discipline. She was a member of the school swimming squad and played water polo.

She did a morning paper round and organised fund-raising events, saving £3,500 for the cost of a World Challenge Expedition she hoped to take part in this summer, which involved building a new school in Brazil. 

‘From an early age Anna was tidy, meticulous and ordered. At our first school meeting, Anna’s teacher said ‘she’s a perfectionist’. She was only four,’ says Christine, who also has a son Matthew, aged 20. 

‘We never argued. She wasn’t involved with boys or interested in wearing make-up, but she was fashion conscious.

‘We had a wonderful relationship. Anna used to say: “Mum, I’m so lucky, as I can talk to you about anything.” ’ 

Paul adds: ‘We did worry that she was working too hard. We told her not to do so much homework at weekends; that she should be out enjoying herself, but she was self-disciplined.’

Like many parents in such situations, Christine and Paul continually ask themselves if they were in some way to blame for Anna’s illness. They divorced when Anna was nine, after 18 years together, and accept their daughter was very upset by this.

But after a tricky period post- separation, when relations were far from amicable, the pair rebuilt their friendship and were closely involved in their children’s lives, often spending time together as a family. Neither has re-married and both feel confident Anna felt secure in their love.

They now believe Anna’s tendency towards perfectionism and self- discipline, combined with the well-documented biochemical changes to the brain caused by starvation, tipped her over the edge into anorexia. 

According to Professor Janet Treasure of King’s College Hospital, director of the Eating Disorders Unit at the Maudsley Hospital, London, the brain needs 500 calories a day; without that thinking becomes so rigid, anorexia is difficult to cure.

How Christine and Paul wish they’d know this sooner, along with the surveys which also suggest that mothers who diet are twice as likely to have daughters who suffer from an eating disorder. 

Christine, in her desolation, sometimes wonders if Anna would be alive if she hadn’t embarked on her own post Christmas diet in January 2009.

As she’d done in the past, Christine joined a reputable national slimming club and was following a healthy eating plan, but Anna took a sudden interest in it, even though her mother tried to discourage her.

But while Christine reverted to normal eating patterns after six weeks, Anna became obsessed with losing weight, r ecording in her diary: ‘I have lost 11lb so far, nearly a stone!’

Christine says: ‘Anna was never fat, but like many teenage girls she wanted to be slimmer. I told her not to worry, but even before she started the diet she’d given up chocolate and started cutting the fat off her meat.’

In the mornings, Christine would go to the kitchen and, seeing crumbs around the toaster, would assume Anna had eaten. Anna had always loved her food, so it never crossed Christine’s mind that she wouldn’t eat her school packed lunch.

With Anna still tucking into her evening meal at home, Christine had no reason to be suspicious. She s uspects now that Anna was purging what she ate by making herself sick.

It was Anna’s swimming coach who first raised concerns about Anna’s weight loss, three months after she started the diet. The school nurse contacted Christine, urging her to make an appointment with their GP.

Christine admits she initially thought they were being alarmist. Anna did look slimmer but, at 8st 11lb, not dangerously so. Anna insisted she was eating properly. Christine believed her, as she had always been honest.

But, by May, Anna’s weight had continued to drop. She was finding it harder to concentrate on her studies and becoming more moody. 

The Head of Wimbledon High called Christine to a meeting at which fears were expressed that Anna had anorexia. Christine took Anna to her GP and after a series of appointments she was referred to Merton Child and Adolescent Mental Health Services (CAMHS). 

Apart from physical monitoring, Anna had regular meetings with a child psychologist. Her parents attended family therapy sessions and were given a meal plan for her. 

Paul says: ‘We were given a meal plan, but no advice of how to get her to eat it. Why didn’t anyone try to teach us how to deal with anorexia? We were told we had to sit with her until she ate all her food, but no amount of reasoning worked. Anna was always one step ahead of us.’

Once Paul sat with Anna for two hours trying to persuade her to eat some risotto, without success.

Christine adds: ‘Mealtimes were very frustrating. We would all be finished, while she was still cutting up her food and re-arranging it.’

When Anna was told by her doctor on June 24, 2009, that she was too unwell to go on the Brazil expedition, she was devastated. This, say Anna’s parents, was the turning point in her illness, triggering her rapid decline.

Paul says: ‘Anna was distraught. She refused to eat and became so thin, frail and weak.’

In August last year, doctors had become so concerned about Anna’s low heart rate that she was admitted to St George’s paediatric A&E. From there she was referred to the eating disorders ward at Capio Nightingale Hospital.

To her parents’ distress, Anna refused to accept she was ill. She loathed the 24 hour supervision, the compulsory meals and weekly weigh-ins, begging her parents: ‘Why won’t you help me when you can see how much I hate it here?’ 

When Christine phoned Anna to tell her of her stunning GCSE results — ten starred As and an A — there was no reaction. ‘She was withdrawn and down,’ says Christine, ‘like her fire had gone out.’

Christine, weeping now, shows me a handmade card Anna sent her. In that neat handwriting, she insists she does not have anorexia and is ‘fat’ and ‘disgusting’. She says she feels ‘embarrassed’ to be sitting with other people who are genuinely ill.

‘I’m double the size of everyone else here,’ she writes. Ultimately I will become so fat and depressed I know I will kill myself. I would rather save Dad and you this pain.’

Christine also found another note after Anna’s death. She writes: ‘I hate myself and my life so much — what’s the point in continuing all this s*** and prolonging my pain. I’m never happy and hate how alone in this world I am. I’m s*** at everything and boring. I’m so disgusting and lonely I just want to DIE’.

Christine and Paul admit their relationship with Anna’s consultant was strained at times. Fearful for their daughter’s mental state, they questioned the regime. 

The consultant — they claim — became increasingly exasperated with them, saying they didn’t realise just how ill their daughter was. 

They were particularly upset when Anna was told — before her supper one night — that her target weight was 9st, sending her into despair.

Last November, when Anna’s weight had increased to 8st, they wrote to their daughter’s consultant asking if she could be treated as a day patient. They say it was made clear that should she lose weight again, they would like her to be re-admitted.

Today, Christine and Paul feel deeply upset over the subsequent management of Anna’s illness. Their daughter’s inquest is due to be heard next month, and they have written to the coroner claiming Anna was discharged as a day patient from Capio Nightingale back into the care of Merton CAMHS, against their wishes.

‘We have been told that in cases such as Anna’s there is a 15 to 20 per cent mortality rate,’ says Christine.’ Had we known that then, we would never have asked for her to become a day patient.’

A spokesman for Capio Nightingale said an internal review had been carried out and found ‘no material criticism’.

Christine and Paul say they were desperately looking into finding a private hospital for Anna, when she collapsed in the street and was rushed to A&E in February 2010. 

At this time, Anna was helping out in a nursery run by a family friend, but unknown to her parents was walking the six-mile round trip to work and not eating her lunch.

Diagnosed with a perforated duodenal ulcer, doctors warned Anna’s parents that she was so weak, she may not survive surgery. She pulled through, but the anorexia had left her body so weak that one-by-one all her major organs began to fail.

‘It’s so tragic, as Anna was so intelligent, yet anorexia crept up on her’ says Christine. ‘Anna used to say it was like having two people on her shoulder. One was saying “eat”, the other “don’t eat”. It was like a demon, tormenting her.’

For Anna’s parents, left with the diary of her self-destruction, their torment is that they were powerless to save her.

Read more: http://www.dailymail.co.uk/femail/article-1320292/Anorexia-killed-Anna-Wood-16-1-year-starting-diet-mother.html#ixzz12eetRy6S