Eating disorders have plagued women in Western societies. According to the National Association of Anorexia Nervosa and Associated Disorders, up to 30 million Americans have an eating disorder, with women affected at a much greater rate than men. Among the most common eating disorders are anorexia nervosa and bulimia nervosa. Anorexia involves compulsive dieting to the point where the woman eats so little that she becomes malnourished and may actually starve to death. It is marked by muscle wasting, loss of menstrual periods, body image problems, and an exaggerated fear of becoming fat. Bulimia is compulsive eating and forced vomiting or the use of laxatives or diuretics to eliminate the calories that are consumed during binge episodes.
Particularly among women, disordered body images and destructive eating behavior came “out of the closet” about thirty years ago, spurred in part by the revelation that popular singer Karen Carpenter had died of anorexia. Social critics and psychologists have looked to media pressure—and the more available surgeries for re-shaping the human body—as some causes of the dissatisfaction women often feel about “normal” bodies.
Most experts agree that a spectrum of factors contributes to these diseases—individual, family, interpersonal, biological and cultural. Treatment, often multidisciplinary, addresses both the physical and psychological components of the eating disorder. Among the interventions being used are individual and family therapy, support groups, medical treatment and medications to treat associated depression or anxiety. Nutrition has been recognized as part of the problem and part of the cure.
Carolyn Costin, author of The Dieting Daughter and other books, came to the study of eating disorders through her own experience: “I had anorexia myself when I was about sixteen years old. I had a pretty severe case, was seventy-nine pounds for a few years.” In Costin’s opinion, a number of seemingly benign factors, such as the emphasis on exercising and dieting in our culture, as well as interpersonal family pressures may cause a person to fall into any of these negative eating practices.
The problem with diets is that they often disappoint their users. Costin explains, “The main thing I say to people about any kind of diet program is, ‘Don’t do anything to lose weight that you’re not prepared to do for the rest of your life, because going on a diet certainly implies that you’ll ultimately go off it.’”
So what happens when you go off it? This will lead to disillusionment and weight disorders, such as constantly going on and off trendy diets, unless a person realizes that a healthy lifestyle, not a temporary eating change, is the only answer to maintaining proper weight.
Another problem is that a healthy desire to exercise can be developed in the wrong way. This, Costin says, is “a little bit like an activity disorder. They can’t not do it. There’s an addictive component that makes them have to do more and more. Things in their life get put on hold in order to do the activity. They will continue to do it even if they’ve been injured or are in pain or it’s snowing outside. And the way the eating disorders correlate with activity disorders, there are certainly a lot of anorexics and bulimics who also have activity disorder.”
In Costin’s view, eating disorders are also caused by the way people obsessively codify rules of eating, what she calls “the Thin Commandments.” She notes, “Over the years I started to come up with these rules that people with eating disorders have, such as ‘If I eat anything, then I have to exercise and burn it off,’ or ‘I have to wear clothes to make myself look thinner. I have to punish myself if I’ve eaten anything fattening.’”
Delving deeper, one finds that eating disorders in women are often rooted in relationships they had with their parents, particularly their mothers, though not the type of relationship that’s commonly assumed to be at fault. “In the beginning,” Costin explains, “anorexia nervosa was often blamed on overcontrolling mothers. But that’s way too simplistic.” Rather, the problem is the type of role models that mothers sometimes provide for their daughters. Costin asks, “What are little girls learning from these role models about their bodies and about weight and about food?”
Not only those who actually end up with eating disorders but almost all young women and girls are influenced by these role models. Costin says, “When you have statistics that 80 percent of fourth-grade girls report that they’re dieting and 10 or 11 percent of those girls report that they’re vomiting on these diets, you’ve got to look at what’s happening with their role models.”
Costin describes a six-year-old girl in her waiting room who said she was really excited at having chicken pox. Asked why, she said it meant going to bed without any dinner. “I said, ‘Well, what’s so good about that?’ And she said, ‘Because it means I didn’t have any calories.’ The thing is, she’s six. Her mother was a binge eater seeing me for treatment. But kids are little sponges. And she hears her mother saying that calories are bad, so she just learns that part of being female is trying not to have too many calories.”
Fathers can also have a negative influence. “I talk to fathers a lot,” Costin comments, “about being conscious about what they say about female bodies when they’re reading magazines or watching television or things like that. I talk to them about not just praising their daughters for the way they look, which is a very common thing that fathers do with their little girls. A lot of praise and attention focus on appearance as opposed to internal validation. I also encourage them to pay attention to who their daughter is, and to do things with their daughter.”
There is mounting evidence that eating disorders have some basis in genetics. Costin states, “It’s pretty clear from twin studies that we’re going to learn more and more in the next few years about genes that predispose people to inherit this. It’s probably going to turn out that there’s a biological predisposition. And then maybe a cultural trigger sets it off. Thus, there’s a swing back to a more biological basis of these illnesses and not as much of a focus on the big, bad culture. But I think there’s no doubt that the culture plays a big role in it, which is why we see over the years an increasing incidence of anorexia and bulimia. But I think it’s a combination of someone who has a predisposition and dieting, which is certainly a risk factor. So if more of the population is dieting, more people who have the biological predisposition are exposed to this trigger.”
Some research has shown that anorexia nervosa, bulimia, and obesity may be the result of a zinc deficiency. Dr. Alexander Schauss, a clinical psychologist and eating-disorders specialist from Tacoma, Washington, reports that science has long been aware of this connection: “We’ve known since at least the 1930s that when animals were experimentally placed on diets deficient in zinc, those animals would develop anorexia. Our interest in eating disorders in relationship to zinc has to do with the observation that when humans are placed on zinc-deficient diets, they, too, develop eating disorders.”
“By characterizing three of the most common eating disorders,” Dr. Schauss continues, “you can see how vital zinc is. In morbid obesity, when people are significantly overweight in such a way that it could shorten their life span or increase their risk of disease, we know that there is an inverse relationship between the level of obesity and the level of zinc, meaning that the more obese they are, the less zinc they have in the body. We don’t know yet whether this is cause or effect, but it is a very important observation because at the other end of the continuum, with anorexia nervosa, self-induced starvation, we also have individuals who are generally always zinc-deficient. We believe there is strong evidence today . . . that the lower the zinc status is, the more likely it is that the patient will not recover from any treatment plan to resolve the anorexia.”
Stress is commonly associated with the onset and continuation of eating disorders and can also be understood in terms of zinc loss, since constant mental stress results in the depletion of this mineral. Women are more prone to stress-related zinc loss than men and therefore more likely to have eating disorders. Dr. Schauss explains: “The answer may lie in the fact that males have prostate glands and women do not. Zinc is highly concentrated in the prostate in males; it provides a mineral that is essential for the development, motility, viability, and quantity of sperm. If a male is under psychological stress, he can catabolize or seek out stores of zinc in the prostate. Since women don’t have a prostate, they will catabolize the zinc from other tissue.
“In women, the richest source of zinc is found in muscle tissue and bone. A common feature of anorexia is muscle wasting and an increased risk of osteoporosis. Anorexics actually catabolize or eat their own tissue as a way of releasing nutrients they are not getting in the diet. The last muscle, and one that contains only about 1 percent zinc, is the heart muscle. When the body starts to scavenge zinc out of heart muscle tissue, it can interfere with the heart’s function, which contributes to bradycardia, tachycardia, arrhythmia, and eventual heart failure. It is particularly dangerous when patients with damaged hearts are in recovery. As they put on weight, they add extra pressure to the heart. That is what killed the singer Karen Carpenter, for example.”
Carolyn Costin outlines some of the basic approaches to nutritional therapy. “There are many ways to do nutritional therapy with eating-disorder patients,” she notes. “One is educational. A dietitian will do some educational sessions. The patients have a lot of myths about food, such as ‘If I eat anything with sugar, it’s going to turn into fat,’ or ‘If I eat anything at night, it’s going to turn into fat.’ So you send them just to be educated.”
Costin may also combine education with therapy. This is needed because “patients’ food fears are related to some very deeply rooted psychological stuff. So you combine nutrition therapy and nutrition education.”
There are various ways to do this. “For example,” Costin explains, “I can send someone to a dietitian, and they get a food plan set up. They get some help, and they go for a few weeks, and then they continue with their therapy, but they don’t go back for more nutritional sessions until they’re ready to take the next step.”
The first step in counseling is to help the person analyze why she has this problem. Costin starts off by asking, “Why do you have this disorder? What’s good about it? How has it helped you? Let’s talk about the advantages of it.” The person needs to understand how the eating disorder has come to serve a purpose. And that’s the whole psychological aspect of it.
“Getting to the emotional aspect is really, really important, and if you don’t deal with that, I think you don’t really deal with the illness.”
Costin finds supplements helpful in treating eating disorders: “We’re using amino acids in some cases with patients instead of medication, and it’s working. It’s pretty interesting. We use tyrosine and tryptophan and glutamine.”
More specifically she recommends “the use of tryptophan, particularly with bulimia nervosa. We use it for people who have trouble sleeping as well. Phenylalanine also, for depression. Tyrosine for depression. For people who are often given medications such as Ritalin, we use a combination of tyrosine, glutamine, and phenylalanine together.”
Dr. Schauss adds that liquid zinc may have a positive effect in the treatment of eating disorders, as it is directly absorbed into the blood. Powders, tablets, and capsules, which must first be broken down by the stomach and absorbed by the small intestine, do not work as well because many eating-disorder patients are unable to digest nutrients properly. Once the patient shows marked improvement, a good zinc supplement will do unless deterioration occurs, in which case the more expensive Zinc Status is needed.
While results are not usually immediate, taking from several days to weeks, once liquid zinc takes effect, its benefits are long-lasting. According to Dr. Schauss, “In fifteen years I worked with hundreds of eating-disorder patients. Until I saw this treatment, my colleagues and I felt that the best we could expect in long-term outcome in treating patients with either bulimia or anorexia was maybe a 20 to 30 percent recovery. In our five-year study, we found that bulimics had a 64.1 percent success rate after recovery on the liquid zinc treatment. In anorexic patients, our five-year follow-up study found an 85 percent recovery rate. These are extraordinarily high recovery rates for a condition that is considered difficult to treat and insidious.”
Another favorable finding is that liquid zinc can lift the depression that is usually associated with eating disorders. Dr. Schauss reports, “In our eating-disorder studies, we used a multidimensional design and evaluated the mood state of our patients. One of the first things to improve was the degree of depression they were experiencing based on psychometric instruments such as the Beck Depression Scale and the Profile of Mood Scales, among other depressive indexes. The fact that we have discovered this antidepressive effect and could document it in patients under blind conditions is of great value.”
People recovering from bulimia and anorexia need to return to normal eating patterns gradually. Carolyn Costin explains: “In fact, a lot of the deaths that happened early on with anorexia occurred during the refeeding process, because the heart just can’t take the volume that you start giving it if you do the refeeding too fast.”
In her practice, “We slowly raise the patients’ calories. We get lab tests two to three times a week. We take their pulse in the morning and sometimes even during the day and after meals just to make sure their bodies are handling the stress that comes from refeeding. You can’t just take someone who’s emaciated and say okay, start eating.”
Dr. José Yaryura-Tobias, an orthomolecular psychiatrist, also finds that because of the life-threatening severity of a condition such as anorexia nervosa, any nutritional approach must be preceded by a program of cognitive therapy. “Anorexia nervosa, from our perspective, is an obsessive-compulsive disorder that is related to self-image, the way that we perceive ourselves. Basically, anorexia nervosa is the process by which a human being self-starves. Thirty percent of the population who self-starve eventually die.
“In the vast majority of cases, when patients come for a consultation, they are already very emaciated. The chemistry we can measure is very altered. From the biochemical viewpoint, we know that there is a groove related to an area of the brain called the limbic system. This is the hypothalamic area, which regulates sugar, thirst, appetite, and so forth. This information can help us classify some of these patients but does not tell us how to manage and eventually cure the problem. The rest of the problem, we feel, has to do with body-image perception, the way these patients see their own bodies. They feel too fat. They have different perspectives than the rest of us do.
“How do we treat this condition? Basically, we use a nutritional approach after the patient has undertaken a behavioral program with cognitive therapy. Cognitive therapy is important because the idea is to educate the person about her problems and to discuss with her the many false beliefs she has about who she is, why she thinks this way, why her body looks the way it does for her, and so forth. So false-belief modification is an important part of treatment.”
Dr. Hyla Cass, a holistic psychiatrist who integrates psychotherapy and nutritional medicine, describes her experience as follows: “Some time ago, a psychologist who specializes in eating disorders began to send her clients to me because she had heard that antidepressant medications work for these patients. I had shifted to a more holistic way of looking at things, so I told the psychologist that before I did anything with antidepressants I would try some other things. With certain eating disorders, such as food cravings, the underlying problem is a food allergy. We often crave the very foods to which we are allergic. Typically, it’s the very things we want to eat that are the most damaging, that create the symptoms. In fact, it’s like an addiction to alcohol: as you abstain from the foods you’re addicted to, you begin to have withdrawal symptoms and crave those foods even more.
“In order to break the cycle in cases of food addiction, just as in breaking the cycle with drinking (alcoholics are actually allergic to alcohol), you need to supply the body with the appropriate nutrients. When we correct the deficiencies and restore body balance, the food cravings and allergy symptoms will often be relieved. Rather than having to rely strictly on ‘willpower,’ it is possible for individuals to break addictive cycles by achieving metabolic balance through avoiding the offending foods and supporting the body with a balanced nutritional program of vitamins, minerals, and amino acids. Often the cravings will then simply go away. It’s quite remarkable: with a good vitamin and mineral product, you can often put a stop to the food allergy and its accompanying symptoms.”
Amino acids may a play a role. “I may order a plasma amino acid analysis, a blood test to determine which amino acids—especially among the essential ones the body cannot synthesize by itself—are low,” Dr. Cass says. “The amino acid glutamine, in a dose of 500 to 1,000 milligrams, is particularly useful for reducing cravings, including alcohol cravings. Dr. Cass also recommends magnesium supplements, acupuncture and acupressure.
“As we can see,” Dr. Cass concludes, “there are many ways, other than psychotherapy and medication, to approach what at first seems like a psychological problem.”
Carolyn Costin, however, disagrees with those who say that eating disorders such as bulimia are an addiction like alcoholism. “It’s really, really important that you can be recovered from conditions such as anorexia and bulimia. With alco-holism, you have it and your body responds to alcohol differently. For your whole life you can’t have a drink because you are then going to be off the wagon and compulsively drink.” This is distinct from eating disorders: “For example, the approach to bulimia shouldn’t be, well, okay, if you eat chocolate you binge on it, and therefore you can’t eat chocolate. I think that instead we have to learn how to teach you that you can absolutely be in control of this. You have to learn how to have it without bingeing and purging it.
“The bottom line is that the new studies show that people become fully recovered from these illnesses. It takes a long time. The new research shows approximately five to eight years, but the recovery rates are high, much higher than originally thought. It’s like 76 percent full recovery with anorexia nervosa. There’s fewer studies on bulimia, but it’s pretty good.”
Dr. Doreen Virtue, former director of a clinic and inpatient psychiatric unit specializing in eating disorders, has a Ph.D. in counseling psychiatry and is the author of several books on dieting and health, including Constant Craving from A to Z.
“Most nutritionists would have you believe that nutritional deficiencies are at the heart of all food cravings,” Dr. Virtue says. “The problem with that approach is that it still leaves many food cravings unexplained. Food cravings tend to be so specific. For example, a person may crave a hard-boiled egg but not a soft-boiled egg. Or a person may want a chocolate candy bar but not chocolate pudding. It sounds bizarre and a little childish, but anyone who has experienced food cravings will understand how intense and specific they can be.
“Another reason why nutrient deficiencies may not be the only possible cause of these cravings is that not everyone satisfies his or her craving for food before the craving passes. Just as mysteriously as the food craving appears, it may vanish. A food craving can change as easily as a person’s state of mind.” Dr. Virtue has been researching food cravings for some twenty years and has found patterns that correlate with people’s personalities and emotional issues. Again and again, for instance, she found that someone who craved, say, bread was very different from someone who craved ice cream. It’s similar to drug-taking behavior. Someone addicted to marijuana, say, has a very different personality and style from someone addicted to another drug.
Noting this, she says, “I investigated further to look at the correlation between personality, emotional and spiritual issues, and how they are connected to food cravings. I did a great deal of research in university libraries, looking at the psychoactive, that is, mood-altering, chemicals found in different foods. I’m not talking about chemicals such as pesticides. I mean the inherent properties, such as vitamins, minerals, amino acids, and so on, that can actually increase or decrease our blood pressure and trigger the pleasure centers of the brain and other areas, chemicals that really affect our moods and energy.
“What I found is that we all tend to act as intuitive pharmacists. We tend to crave foods that will bring us to a state of homeostasis, which means balance or peace of mind. Whenever we are upset, it is normal for us to do something to fix that. If we don’t want to take direct action, for instance, by making changes overtly in our lives, a more covert way of dealing with the upset is food cravings, which are cravings for a chemical that will make the body feel at peace.”
From this point of view, Dr. Virtue believes that food cravings should be dealt with by trying to understand their underlying emotional sources. Instead of getting angry at yourself for having food cravings, thinking, “Oh, I’m so weak. I should have more willpower,” it’s better and healthier to listen to those cravings, which are a form of intuition. As Dr. Virtue puts it, “Deciphering them is almost like dream interpretation. They can give us guidance in our lives and help us in many ways.”
Just as a food craving is not due to a nutritional deficiency, neither is it due to physical hunger. Dr. Virtue explains, “Let’s think about the difference between emotional hunger and physical hunger. They can feel identical, and actually, this is one of the most important points in managing the appetite: to know the difference between emotional cravings and physical cravings.”
She notes several underlying differences. For one thing, emotional hunger comes all of a sudden, out of the blue. As she puts it, “You feel like you are starving. Whereas physical hunger is gradual, at one moment you might just feel a little pang in your stomach, then over the course of the next hour or so it grows into a voracious hunger.”
The second difference is that emotional hunger is usually for a very specific food. It has to be Rocky Road ice cream or it must be a pepperoni pizza. Physical hunger, while it may have preferences, is open to different types of food. It doesn’t require an exact type of food to be satisfied.
Third, Dr. Virtue says, “Emotional hunger is always above the neck, whereas physical hunger is based in the stomach. Emotional hunger is a kind of ‘mouth hunger’ where you get a taste for a certain thing. It’s a very cerebral type of hunger. It is also very urgent. It has to be satisfied now, whereas physical hunger says, ‘I am hungry but I could wait fifteen minutes or a half hour if I needed to.’”
The demanding nature of emotional food cravings is due to the urge’s misguided attempt to fill an emotional hole: “One of the reasons emotional hunger is urgent is that it really is uncomfortable with the feeling and wants to make that feeling go away. Emotional hunger is also usually paired with some upsetting emotion. And if we stop for a moment when we are experiencing this emotion and ask, ‘Could there possibly be something that upset me that I wasn’t acknowledging?’ as we go into introspection, we usually see that a clerk was rude or a driver cut us off on the road. We are upset, not really hungry.”
Usually, if you really look at it, Dr. Virtue notes, there are a few trigger foods that cause a voracious appetite. If you want to find out what your triggers are, you can ask a friend or someone who eats with you, “What kind of food do I seem to binge on?” If you are aware of your own food cravings, you can ask yourself, “What’s going on and how do I feel?”—the same way you would about stress.
Dr. Virtue says, “What I’ve found is that several factors are involved that correlate the particular trigger food to the emotions. One is the texture. Is the food crunchy or soft or chewy? The next is the actual physical components and the underlying chemical properties that either increase or decrease blood pressure, elevate or lower mood, and create neurochemicals that alter mood. The last thing is the flavor or the taste, whether it’s spicy, salty, sugary. All these things have to do with who we are as a personality.”
Again, identifying your trigger foods is a way to understand what your underlying fears and other emotions are expressing. “Instead of getting mad at ourselves for craving these things,” she counsels, “we need to see our cravings as a blessing in disguise. It’s the body’s way of talking to us. It’s just like when a person puts his or her hand on a hot plate. Then the body talks back and says, ‘Get that hand off that heat.’ Our appetite is trying to do the same sort of thing and give us a message.”
Colette Heimowitz has a master’s degree in nutrition from Hunter College, is certified in health and nutrition by Pratt University, and has twenty-five years of clinical experience in weight management. The number-one biological cause of obesity in our sedentary population, she maintains, must be understood in terms of insulin resistance. “In a normal homeostasis, an individual ingests a carbohydrate and it raises the glucose levels in the blood. When someone eats protein or fat, by contrast, this doesn’t happen. Once the glucose level rises in the blood, it sparks an insulin response from the pancreas. What the insulin does is take the glucose to the peripheral tissues, either to the fat cells, the liver, or to muscle as storage. As a result of years of eating refined carbohydrates, maintaining high-sugar diets, and living a sedentary life, when we age, the insulin is no longer efficient at taking the glucose to the peripheral tissue.
“One of two things happens. Either the glucose levels remain high or the insulin is constantly being produced—overproduced in a prediabetic state—and fat is constantly being stored. When we are sedentary, the process of burning glucose for energy is not happening. It will even provoke the reaction more.”
Among the factors that contribute to insulin resistance, “one, of the utmost importance, is lifestyle, a sedentary lifestyle. Some research was done with retired master athletes. Glucose tolerance tests with insulin levels were studied before putting them on bed rest for only one day. The glucose tolerance factors were normal, and the glucose in the blood was normal, because they were still leading an active life, not an elite athlete life, but still one that was active. After one day of bed rest, the glucose tolerance test was repeated and the glucose levels were much higher.”
Equally important, Heimowitz says, was a history of eating refined foods, which “the American public is known for—taking the bran out of food, taking the fiber out of food, and replacing the essential fatty acids with hydrogenated fats. This causes a complete stress on the insulin level. The glycemic index of foods [a measurement of the amount of glucose found in the blood as a result of eating a specific food] is much higher, provoking more of an insulin response. The pancreas eventually gets trigger-happy.”
There is also a genetic component. It has been shown that people whose parents have a history of diabetes or cardiovascular disease have a weak gene that makes them susceptible to this particular condition. She says, “They have to be especially careful and have an active lifestyle and a low-saturated-fat, higher-protein, lower-carbohydrate diet.”
To alter this continuous fat-and-flabby syndrome, a lower-carbohydrate diet is needed to give the pancreas a rest. Heimowitz recommends eating “lowglycemic-index-type foods, that is, complex whole foods such as fruits and vegetables.” She also recommends specific supplements for the insulin-resistant individual.
Alpha-lipoic acid (ALA) is the biological spark plug in converting glucose to energy. She states, “It can lower and stabilize glucose levels and stimulate insulin activity. Some research was done with diabetics being given 600 milligrams daily, and it stabilized their glucose levels without any medication. A nondiabetic or hypoglycemic person could probably use 200 to 300 milligrams a day.”
The mineral vanadium, found in vanadyl sulfate, also reduces insulin resistance; 15 to 30 milligrams a day is appropriate.
Chromium is a component of the glucose tolerance factor, a molecule essential for normal insulin function in glucose metabolism. Usually 200 to 1,000 micrograms daily is the range for a beneficial effect.
Heimowitz also emphasizes “essential fatty acids, which are grossly lacking in the American diet and also improve insulin sensitivity and reduce insulin resistance. So supplementing the diet with 3,000 to 6,000 milligrams of the omega3 fatty acids is appropriate.”
Vitamin E is also important. It relieves some of the oxidative stress caused by excessive glucose, which results in free radicals. It will also reduce the risk of cardiovascular disease. Heimowitz adds, “Excessive insulin also causes a lipidation of the triglycerides, and that causes free radical pathology. The excessive insulin also thickens the aortic valve. You are at a higher risk of cardiovascular disease. The vitamin E should be anywhere between 400 and 800 international units [IU] daily.”
Zinc also influences carbohydrate metabolism, increases the insulin response, improves glucose tolerance, influences the basal metabolism rate, and supports thyroid function; 50 to 100 milligrams of zinc a day is important.
Magnesium helps maintain tissue sensitivity so that insulin is more effective at taking that glucose to the peripheral tissues. Magnesium helps control glucose metabolism and also decreases sugar cravings; 500 to 1,000 milligrams a day is recommended. “Sometimes,” she cautions, “when you go as high as 1,000 mil-ligrams, it may cause diarrhea, so the dose should be determined individually. People should start at 500 and work up slowly.”
Heimowitz notes that manganese has been shown in studies to be important for insulin activity: “Manganese-deficient rats showed reduced insulin activity and impaired glucose tolerance. This lack also lowered glucose oxidation and the conversion of triglycerides in the rats’ adipose tissues. However, the manganese should be dosed in relation to zinc and copper because they will compete at the cell site. So as little as 35 milligrams of manganese is all you need. The proportionate amount of zinc would be 100 milligrams.”
She notes further, “If someone has hypotension because of the insulin resistance, the amino acid tyrosine could also help control the hypotension; 1,500 to 3,000 milligrams daily is appropriate. Hawthorn berry, an herb, can also help control hypotension; 240 to 480 milligrams is a good range.
“When there is cardiovascular involvement, with a high risk, especially with low HDL [high-density lipoprotein] and elevated triglycerides in individuals with insulin resistance, coenzyme Q10 is also appropriate. I suggest 100 to 200 milligrams a day.”
Lack of exercise also causes blood sugar problems. Thus, exercise is key. Heimowitz recommends that “for exercise, we look at the fitness level of the individual. I wouldn’t tell someone who has been a couch potato to go out and exercise an hour a day. The fitness level needs to be increased slowly so that the body can adjust to the different mechanisms that are going on.
The multifaceted approach to combating eating disorders presented so far combines assessing your emotional state, exercising, eating right, and taking supplements. This is in contrast to the faddish, highly touted wonder diets that appear in the media every season. These diets are more often feel-good panders to eaters’ worst cravings than scientifically sound practices.
Dr. Joel Fuhrman is a board-certified physician in private practice in New Jersey who specializes in preventing and reversing diseases through nutritional methods. He is the author of Fasting and Eating for Health.
“High-protein, low-carbohydrate diets have become increasingly popular over the past few years,” he notes, “and doctors who promote these diets list a number of reasons why people with weight problems need to get onto this type of diet. One reason they give is that these people’s bodies do not metabolize carbohydrates properly, a condition popularly referred to as insulin resistance.”
“In fact,” Dr. Fuhrman cautions, “such diets, promoted in some of the most heavily promoted, best-selling diet books, are among the most dangerous. Among these books are Enter the Zone by Barry Sears, the [Dr. Robert] Atkins books, and Protein Power by Michael Eades.”
The problem is how these books recommend breaking the habits. “All these people who read these books, wanting to lose weight by eating a high-protein, lowcarbohydrate diet, remind me of people who want to lose weight by snorting cocaine and smoking cigarettes. In other words, there are lots of ways that may work to help you lose weight, but we are interested in more than just having a person temporarily lose weight. We want a diet that is going to enable us to lose weight and protect our health simultaneously, not something that will end up making us look thin in a coffin or increase our cancer risk.”
These diets recommend replacing one bad food, refined carbohydrates, with another, animal fats. “You know,” Dr. Fuhrman says, “some of these high-proteindiet gurus claim that they have the truth [about the value of eating meat and animal products] and that there’s a conspiracy among the 1,500 scientific studies that continue to point to the association between the consumption of meat, eggs, and dairy products and cancer, heart disease, kidney failure, constipation, gallstones, and hemorrhoids, just to name a few. They are overlooking the fact that you must pay a price with your health for eating increased animal proteins as a way to lose weight.”
“Of course, there is one good point in what these people say,” he adds. “It’s true that refined carbohydrates such as pasta, bread, sugar, sweets, candies, bagels, croissants, potato chips, and all the junk food that Americans eat are not doing us any good. This junk now constitutes about 50 percent of the American diet. We know that this food is linked to heart attacks, cancer, obesity, and diabetes. That is absolutely true.”
However, the gurus “are taking the fact that these highly refined, low-fiber carbohydrates can cause increased insulin levels, obesity, and insulin resistance, showing that those are dangerous foods and then saying that therefore the diet should be low in carbohydrates and high in animal protein.
“But that’s a jump that the nutritional and scientific literature doesn’t make. As a matter of fact, there are no data showing that a person on a high-carbohy-drate diet rich in unrefined carbohydrates, such as mangoes, cabbage, beans, legumes, and squash, is in any danger. In fact, many studies show that a diet centered on unrefined carbohydrates—vegetables, whole grains, legumes—will not raise blood sugar or insulin levels.”
What people don’t realize, Dr. Fuhrman continues, is the value of plant protein. “Compare a steak to broccoli, for example. Let’s look at the protein comparison for 100 calories of steak and 100 calories of broccoli. Sirloin steak has 5.4 grams of protein for 100 calories, and broccoli has 11.2 grams. In other words, green vegetables are very rich in protein. Beans are very rich in protein. We can devise a diet that is very low in animal fat or totally vegetarian, but with a good, satisfactory amount of healthy protein.
“People have to realize that there is a big biochemical difference between animal and plant protein. Plant protein lowers cholesterol; animal protein raises cholesterol. Plant protein is a protector against cancer; animal protein is a cancer promoter. Plant protein promotes bone strength; animal protein promotes bone loss. Plant protein has no effect on aging or kidney disease, and animal protein accelerates both of them. In other words, plant protein is packaged along with fiber, phytochemicals, vitamin E, and omega-3 fatty acids. Animal protein is packaged with saturated fat, cholesterol, and arachidonic acid.”
Therefore, “if you are on a diet such as the Atkins diet or another high-protein diet in order to lose weight, you are paying a price with, for example, the risk of increased cancer.”
In Dr. Fuhrman’s opinion, after studying the food recommendations of these diets, “I suspect that a person really following one of these high-protein diets that restrict fruit and carotenoid-rich starches—found in foods such as sweet potatoes, corn, and squash—could be more than doubling her risk of colon cancer.
“There are studies that show a clear and dose-responsive relationship between increased cancers of the digestive tract and low fruit consumption. High fruit consumption has a powerful dose-response relationship to reduction of mortality from all causes of death. The only other food that even approaches this powerful effect of reducing cancer is raw vegetable consumption. So I suggest that if you are going to average 60 to 70 percent of your calories from fat and animal products with no fruit, you have to consider that diet exceedingly dangerous.”
Other popular diets advocate eating according to a person’s blood type. These diets have sold many books, and the authors have appeared on all the shows. The authors say, “It’s your blood type. You have to eat this for your blood type.” I’ve seen a ton of scientific evidence that could disprove that and show its lack of validity. So why is that approach not being challenged by the American public or the media?
According to Dr. Fuhrman, these diets are popular because they give free rein to people’s ingrained bad habits: “I think it reinforces what people want to believe. People are addicted to their rich diets. They are looking to hang on to any reason, however irrational it may be, not to have to change.
“If you talk to smokers, you’ll see the same thing. You’ll hear how irrational are the reasons they give for why they must still smoke and how they have diminished in their own minds the strong reasons against smoking. The same is true with eating. People want to rationalize why it is okay to do whatever they are addicted to.
“The American addiction to such things as junk foods is such that when you stop doing it, you get uncomfortable. The problem is that the American diet is so toxic and so unhealthy that when people try to go off it, when they skip a meal and start eating fruits and vegetables, they feel sick. They get headaches and abdominal cramps. They get shakes and confusion. Then they think that it must be this new diet. It must be that eating healthily is making them sick. They must need this rich animal-fat protein and the junk food. In other words, they don’t see that this is a temporary phase that lasts a week or two, when they are withdrawing from caffeine and the rich nitrogenous waste. You might feel a little ill when you change your diet. That slight resistance to change is one basis of people’s addiction to harmful foods, and it makes them turn to these quack diets.”
An increasing body of evidence is showing the benefits of natural modalities to overall health and well-being. Following is a sample of recent peer-reviewed scientific studies related to eating disorders.
Publishing in Disability and Rehabilitation in 2014, researchers found that aerobic exercise, yoga, massage, and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in patients with anorexia and bulimia nervosa. A 2010 study published in the Journal of Adolescent Health determined that an eight week trial of individualized yoga treatment in conjunction with biweekly physician and/or dietician appointments decreased eating disorder symptoms in adolescents. Researchers concluded in Nutrition and Clinical Practice, also in 2010, that assessment by a nutrition professional via food intake history may be more practical than laboratory tests and more accurate than current food intake for determining potential micronutrient deficiencies in people with anorexia and bulimia.