By Kevin Wang
Before I start my column, I’d like to remind everyone of a survey I’m conducting to increase awareness of the LGBT community in the medical community. These surveys ask you what you wish or would like your primary care physician to know about our community. For a more detailed explanation, please see https://www.pridesource.com/article.shtml?article=17789 . Please e-mail me at the address below and I’ll send out the materials. I’d like to thank those of you who have responded. Your help is much appreciated.
In my last two columns, we’ve been talking about anorexia and bulimia. These are two very real and very dangerous conditions… especially since we’re bombarded by messages, advertisements, television shows, Hollywood glitz and glamour to tell us what they consider beautiful and attractive. With these influences, some people have turned towards anorexia and bulimia. Please visit https://www.pridesource.com to reread those columns regarding these two diseases.
What I would like to discuss today are what sort of resources the medical community has and some of the medications used to treat anorexia and bulimia. Just as a bit of context, I am, by no means, an expert in these conditions but what I can offer are the resources available as well as some medications doctors use to treat bulimia and anorexia. In cases of extreme disease, hospitalizations may be required to bring a person back to physical and mental safety.
We use what we call an interdisciplinary approach to treat these two eating disorders. What this means is we ensure there are a set number of specialists to help our patients. These specialists include the medical provider, dietitian and a mental health professional.
The role of the medical provider is to manage medical concerns as vital sign stability, blood abnormalities and to ensure proper hydration. Medical providers are vital to act as the coordinator of care. For the dietitians, they provide nutritional education and reasons to make changes in eating behaviors. They also give the medical providers the weight and nutritional goals. The mental health provider plays the most critical role to provide individual and cognitive behavioral therapy while including the families involved. The psychiatrist works to treat the underlying issues that may have started the patient on this path. Treatment of anorexia or bulimia primarily focuses on this aspect, as the eating disorder is often a side effect of mental health issues.
Once treatment begins, some patients require medications. In terms of bulimia, antidepressant drugs have been used and studies show that these work quite well. A recent study showed that there was a significant reduction in binge eating and vomiting as well as stabilization in weight in patients taking antidepressants. Other medications may be used but antidepressants like Prozac have the least number of side effects with the best outcomes. As for anorexia, the medications can help with the depression, anxiety and obsessive-compulsive disorder that often accompany anorexia, but studies haven’t been too optimistic. There have been some antidepressants that can aid with weight gain but the mainstay of treatment is therapy from psychiatrists.
Now in severe cases where patients are severely malnourished (less than 75 percent of expected weight for age, sex and height), dehydration, blood abnormalities, cardiac rhythm problems, failure of outpatient treatment and other medical problems that arise, they may require hospitalization. Patients stay until they regain their necessary weight with intensive therapy from the interdisciplinary team.
Recognizing these symptoms in our family members or friends is often difficult and denial is a huge issue involved in anorexia, bulimia and other eating disorders. Some resources available involve some websites – www.gurze.com, www.nationaleatingdisorders.org and www.anad.org. These are great sites to get some additional information regarding these eating disorders as well as some community resources. We do have two treatment centers in Michigan. The first is Forest View Psychiatric Hospital in Grand Rapids and they can be contacted at 800-949-8439 and the second is Four Seasons Treatment Center in Plymouth and they can be contacted at 734-416-3341.
As always with my columns, in any medical emergency, please call 911 and before you start any sort of treatment, please consult your primary care physician. And remember, I’m available for any questions you might have and just e-mail me at the address listed below. I hope this column finds all of you in good health and spirits. See you next month!