No Thinspiration

Doctors have been issued with controversial new guidelines which spell out for the first time when they are legally allowed to force-feed anorexic patients close to death.

The rules state that if two doctors believe an anorexic patient is mentally ill and in danger of dying, the patient can be sedated and tube-fed against their will.

The new Scottish guidelines, issued by the Mental Welfare Commission, also allow dangerously underweight children to be force-fed against the wishes of their parents.

Anorexia affects a growing number of Scots and there has been severe criticism of the lack of specialist services. Scotland on Sunday can reveal that each year around 30 patients are already tube-fed without consent north of the Border.

The practice is allowed under existing mental health laws, but until now there has been no specific guidance on when and how anorexic patients should be force-fed, leaving medics vulnerable to compensation claims.

Patients’ groups last night expressed concern about the guidelines because they fear doctors will be more likely to resort to force-feeding rather than trying to persuade patients to consent to treatment.

But Dr Flora Sinclair, medical officer for the Mental Welfare Commission, said they wanted to ensure the practice was only carried out as a last resort and under strict criteria.

Patients who become extremely ill as a result of their eating disorder need to be kept alive by artificial means, such as a tube inserted into the nose or stomach which gives the body vital nutrients.
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Without their parents’ knowledge, many adolescents with diagnosed eating disorders are visiting Web sites that encourage anorexia and bulimia, according to a study in the journal Pediatrics last month.

“Parents of pro-eating-disorder Web site users were more likely to know about these sites” – which provide “thinspiration” (images of extremely thin women) and reinforce disordered eating habits – than other parents, said Rebecka Peebles, one of the study’s authors and an instructor in adolescent medicine at the Stanford University School of Medicine. “Still, over half the parents of these pro-eating-disorder Web site users didn’t know their own kids were on these sites.”

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Their views on food and body image could not be more different: Susannah Jowitt is the author of Fat, So?, which celebrates larger women. Candida Crewe wrote Eating Myself about her battle with anorexia and bulimia.

So what happened when they met?

Susannah Jowitt, 38, is 5ft 7in, weighs 14 stone and is a size 16 to 18.

She lives in West London with her husband Anthony and children Adelaide, five, and Winston, three. Susannah says: When I was 14, I nicked two pieces of bread from the middle of a new loaf of Hovis, then carefully re-sealed the bag with that fiddly piece of sticky yellow tape to escape detection.

Such extraordinary attention to detail was all in vain. My mother had counted the number of slices in the loaf and confronted me with my crime.

It was at that moment that I should have realised all was not well in our family’s Garden of Eating. How many parents count the slices in a loaf?

Such elaborate surveillance was necessary because I was, apparently, a Fat Child and needed to diet. My brother, on the other hand, was a Thin Child, so he was allowed sweets after tea (that’s how I remember it, anyway).

My parents yo-yoed between being people who loved their food (my mother was a truly great cook) and people who paid for their love of food by eating grapefruit. I inherited their greediness but, to my mother’s frustration, I missed out on the guilt gene.

Looking back at photos of myself as an adolescent, I wasn’t even particularly big - sturdy, yes, and with the same frame as my mum, who, by that time, was fat - but certainly nothing to worry about. But worry she did.
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LONDON (Reuters) - Marg Oaten’s daughter was a happy, healthy girl who loved table tennis and drama until at the age of 10 she developed anorexia. Twelve years on she is still fighting the illness, which almost killed her.
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“I was absolutely distraught,” said Oaten, 54. “It is the worst thing in the world to know your daughter might die.”

At her darkest point, Oaten said her daughter existed on five flakes of cereal a day, washed down with a mouthful of water.

Children as young as seven can suffer from eating disorders. The illness also afflicts older women as well as men and boys, though it is most common in young women, health experts say.

In Britain, about five to ten percent of women aged 14 to 24 suffer from some form of eating disorder. The ratio falls to 1 percent for the whole female population, said Professor Janet Treasure, head of the eating disorders service and research unit at King’s College London.

Bulimia nervosa, when a person binges and vomits, is two to five times more common than anorexia nervosa, when someone restricts their intake of food and drink, she said.

Both psychiatric disorders, can be fatal — two models from Latin America died this year after becoming anorexic — or cause permanent health defects such as brittle bones and infertility.
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More than half the people diagnosed with eating disorder anorexia never fully recover, 20 percent remain chronically ill and five percent die, the British Medical Journal estimates.

Here are some key facts on the disease:

WHO IS MOST AT RISK?
- Anorexia has the highest fatality rate of any psychiatric illness, with 13 to 18 percent of sufferers dying, most commonly due to heart disease or suicide, health experts in Britain say.

- Eating disorders are generally more prevalent in industrialized countries, among young women or adolescent girls.

- An estimated three percent of young women experience eating disorders. In Britain, about five to ten percent of women aged 14 to 24 suffer from some form of eating disorder.

- Eating disorders are more common among competitive athletes than the general population. Female gymnasts, ballerinas, figure skaters, and distance runners are at high risk, as are male bodybuilders and wrestlers.
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Young sufferers of anorexia and bulimia who try to hide their eating problems from their parents and doctors are turning to a growing number of internet chat rooms dedicated to perpetuating their illness.

A pilot study released this week of US eating disorder patients aged between 10 and 22 showed that up to a third learn new weight loss or purging methods from websites that promote eating disorders by enabling users to share tips, such as what drugs induce vomiting and what internet sites sell them.

But the study - published in the American Academy of Pediatrics’ journal Pediatrics - found that eating disorder sufferers were also learning new high-risk ways to lose weight from each other on websites aimed at helping them recover.

The survey by researchers from Stanford University School of Medicine and Lucile Packard Children’s Hospital at Stanford showed a third of patients also visited pro-recovery sites and half of them learnt new weight loss and purging methods.

“Parents and physicians need to realise that the internet is essentially an unmonitored media forum,” said Rebecka Peebles, Packard Children’s adolescent medicine and eating disorder specialist and an author of the study.
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Anorexia nervosa is a psychiatric diagnosis that describes an eating disorder characterized by low body weight and body image distortion. Individuals with anorexia often control body weight by voluntary starvation, purging, vomiting, excessive exercise, or other weight control measures, such as diet pills or diuretic drugs. It primarily affects young adolescent girls in the Western world and has one of the highest mortality rates of any psychiatric condition, with approximately 10% of people diagnosed with the condition eventually dying due to related factors.[1] Anorexia nervosa is a complex condition, involving psychological, neurobiological, and sociological components.[2]

Anorexia is a life threatening condition that can put a serious strain on many of the body’s organs and physiological resources. A recent review of the scientific literature outlined a number of reliable findings in this area.[3] Anorexia puts a particular strain on the structure and function of the heart and cardiovascular system, with slow heart rate (bradycardia) and elongation of the QT interval seen early on. People with anorexia typically have a disturbed electrolyte imbalance, particularly low levels of phosphate which has been linked to heart failure, muscle weakness, immune dysfunction, and ultimately, death. Those who develop anorexia before adulthood may suffer stunted growth and subsequent low levels of essential hormones (including sex hormones) and chronically increased cortisol levels. Osteoporosis can also develop as a result of anorexia in 38-50% of cases,[4] as poor nutrition lead to the retarded growth of essential bone structure and low bone mineral density.

Furthermore, changes in brain structure and function are early signs of the condition. Enlargement of the ventricles of the brain is thought to be associated with starvation, and is partially reversed when normal weight is maintained.[5] Anorexia is also linked to reduced blood flow in the temporal lobes, although as this finding does not correlate with current weight, it is possible that it is a risk trait, rather than an effect of starvation.[6]

Via: Wikipedia