Effectiveness of Drugs in Treating
Eating Disorders

New Insights Into Eating Disorders

• Dana is 17, five feet tall, and weighs 84 pounds. She is thin, but always seems to be on a diet. Dana obsessively reads food labels and carefully calculates fat grams.
• In Patti’s home, food disappears rapidly from cabinets. Often at dinner, Patti will eat quickly, then excuse herself to use the bathroom.
• Jennifer was never much interested in physical activity until she entered high school. A sudden change in behavior led her friends to call Jennifer an exercise freak.

These are some of the outward signs of eating disorders, which may affect as many as one in 20 adolescent girls and young women. But eating disorders are rarely the real problem. Rather, they can be triggered by a stressful life event and are the expression of a deeper emotional issue. Such troubles usually include a lack of self-esteem and may revolve around troubled relationships or family problems. As many as two-thirds of eating disorders patients have been sexually abused.

The most common eating disorders are anorexia nervosa, whose sufferers are underweight but often think they are fat, and bulimia nervosa, which is characterized by binge-purge cycles. Both disorders are predominantly found in females between 12 and 25 years old.

According to Susan M. Ice, MD, medical director of the Eating Disorders Unit at Belmont Center for Comprehensive Treatment, part of Albert Einstein Healthcare Network, new research has shed light on the treatment of eating disorders, and the behavior of those who suffer from them. "Studies have shown that Prozac is very effective in treating bulimia," says Ice. The FDA is about to sanction the use of Prozac for bulimia.

Prozac (and its pharmaceutical cousins, Zoloft and Paxil) increases levels of serotonin, a chemical in the brain. Until recently, its use had been limited to the treatment of depressive and obsessive/compulsive disorders. But like many people with clinical depression, bulimics tend to have low serotonin levels. Not surprisingly, many bulimics also suffer from some form of clinical depression.

Other research is defining what may be an even more common disorder than either anorexia or bulimia -- binge eating disorder. "This is distinct from bulimia, in that it doesn’t involve purging," says Ice. "It can also be called compulsive overeating." It is marked by uncontrolled eating episodes and weight gain. It may or may not include the body image distortion many bulimics experience.

The American Psychiatric Association is considering whether to classify "binge eating disorder" as an official diagnosis. If it does, it could spur the development of weight-control therapies which are more effective than dieting.

Ice says recent sociological research has changed popular thinking about the nature of eating disorders. Ice sees eating disorders "not so much as an illness, but rather, an aberration in female development." Effective treatment, she says, is achieved through "an understanding of female behavior and of women and relationships."

Fortunately, there is more hope for eating disorders patients today than ever before. Like many illnesses, however, early intervention is important. Because many people with eating disorders are secretive about their rituals, family members should pay attention to outward signs. "If caught early enough" says Ice, "eating disorders are highly treatable."

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