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Eating issues

Eating disorders
in female athletes

College female athletes participating in judged sports
are at a higher risk for eating disorders than women in refereed sports,
according to a Louisiana State University study of 131 female students.
The researchers looked at three groups: women in judged sports such as
diving, cheerleading, and gymnastics; women in refereed sports such as
tennis, basketball, volleyball, and track; and nonathletic women. They
administered nine tests related to body image and eating disorders, including
interviews and body measurements. Although the number diagnosed with eating
disorders was too small for significant differences, the researchers found
13.5 percent of women in the judged sports had clinical eating disorders,
compared with 3 percent in the refereed sports, and 3 percent of the nonathletic
women. (Mean body mass index was about 22, and did not differ among the
three groups.) The researchers conclude that being in a refereed sport
may be protective against the female athlete triad. (Healthy
Weight Journal 2000:14:2:19 / Zucker NL, Womble LG, Williamson DA, et al.
Protective factors for eating disorder in female college athletes. Eat
Disorders 1999;7:207-218)

Does dieting
trigger bulimia?

A drop in serotonin levels in the brain may trigger the
symptoms of bulimia nervosa in vulnerable individuals, according to a study
published in the February issue of the Arhives of General Psychiatry
(pages 171-176). Even healthy but vulnerable women who diet may experience
this drop in brain serotonin levels, which may set up the cycle of bingeing
and purging, says the report.

   In the study, 10 recovered female
bulimics and 12 healthy women were given a mixture of amino acids that
lacked tryptophan, an important precursor molecule for producing serotonin.
A week later, the women were given a balanced mixture of amino acids. The
women who had recovered from bulimia were more likely to feel fat and fear
losing control of eating in the 7 hours after ingesting the tryptophan-free
mixture, but not with the balanced mixture. Six of them reported such feelings
compared with none of the healthy women. Dieting is known to lower blood
levels of tryptophan, which may alter serotonin levels. Therefore, the
researchers say, this may be one way that dieting may trigger bulimia.
Weight Journal 2000:14:1:3 / Serotonin drop may trigger gulimia. New York:
Reuters Health, February 15, 1999)

Sexual abuse
and eating disorders

A study that compared sexual abuse for three subtypes
of eating disorders found clear differences. Exual abuse was most frequent
and most severe when bulimia nervosa was combined with comorbid substance
dependance (65 percent), whereas 37 percent of bulimia nervosa patients
who were not substance dependent, 23 percent of anorexia nervosa patients,
and 7 percent of a control group suffered abuse. The research compared
20, 27, and 26 eating disordered patients in these three groups, respectively,
with 44 control women without a history of eating disorders. All subjects
had reasonably intact congnitive functioning and were interviewed face-to-face
by psychologists with extensive experience. Relatives also were interviewed.

   About half of all bulimia nervosa
patients had been sexually abused, and one fourth of anorexia nervosa patients,
rates that are similar to other studies. Subjects were asked if they had
ever been sexually traumatized, (e.g., rape, incest, or unwanted sexual
touching) and were encouraged to elaborate on the nature of events. Half
of the patients with bulimia nervosa and substance abuse had been raped,
15 percent were victims of incest (intercourse or fondling by a family
member), and 10 percent reported fondling by a nonfamily member. Incest
was the most common form of sexual abuse among the bulimia nervosa without
substance abuse patients, with 19 opercent reporting incest, 11 percent
reporting rape, and 7 percent fondling. Fondling by a nonfamily member
was the most common form of abuse among anorexia nervosa patients (12 percent
fondling, 8 percent incest). Fondling and incest were the types of abuse
reported by control subjects.

   There were no differences for the
age of eating disorder onset compared to ages of first sexual abuse, but
for the majority of patients in all three groups sexual abuse preceded
eating disorder onset.
Weight Journal 1999:13:4;51 / Deep AL, Lilenfeld LR, Plotnicov KH, etal.
Sexual abuse in eating disorder subtypes. Int J Eat Disord 1999;25:1-10)

Meatless diets
put athletes at risk

Menstrual abnormalities and the female athlete triad are
linked to the meatless diets that are common among female athletes, warns
an article in The Physician and Sportsmedicine. One study cited
reported menstrual irregularities in 26.5 percent of vegetarian women,
compared with 4.9 percent in nonvegetarian women. Another compared 9 regularly
menstruating runners with 8 amenorrheic runners and found 44 percent of
the menstruating runners ate red meat, while none of the amenorrheic runners
did. Still another study showed that, of 13 amenorrheic runners, 12 were
vegetarians, and 8 had eating disorders. Only 3 of the 19 menstruating
runners were vegetraians, and none had eating disorders.

The review shoed that even though intake of iron and calories
was the same, female runners who ate a modified vegetarian diet (less than
100 grams of red meat per week) had significantly lower iron levels than
those who regularly ate red meat. One study showed that female runners
who did not eat meant, chicken, or fish had protein levels below the recommended
minimum for encurance athletes.

Although it is theoretically possible to compete athletically
on a meatless diet, the researchers emphasize thtere is risk. They recommend
that female athletes who call themselves vegetarians be screened for disordered
eating and amenorrhea, and if either is found, for osteoporosis. The American
College of Sports Medicine recently published a position statement on the
female athlete triad. (Healthy Weight
Journal 1999:13:4;50 / Loosli AR, Ruud JS. Meatless diets in female athletes:
A red flag. The Physician and Sportsmedicine. 1998;26:45-48,55)

Anorexia trends
In 40 years, anorexia nervosa seems to have increased
greatly among women in their 20s and 30s, but not much for teenagers, according
to a Canadian review. In a comprehensive data search, the researchers found
12 relevant, population-based studies using 45 independent samples from
several countries between 1950 and 1992, about half from the United States.
The incidence of anorexia was approximately 51 per 100,000 for teenage
girls (54.3 from 1980-1992), compared with 10 for women age 20 and older.
The increase for teenagers during the last 20 years was only 10 percent,
not statistically significant in these small samples, but there was a three-fold
increase for women of 20 and over.

   However, the Candian researchers
report that eating disorder statistics are based on small, incomplete studies.
The largest they found included only 166  cases. As yet, no single
large population-based study has been reported in the scientific literature,
they said.
(Healthy Weight
Journal 1999:13:3;34 / Pawluck D, Gorey K. Secular trends in the incidence
of anorexia nervosa. Int J Eat Disord 1998:23;347-352)

Dieting behaviors
in college students

Of 84 college females tested with the Eating Attitudes Test (EAT-40),
18 percent indicated high eating concerns and were consuming 415 fewer
calories than subjects with normal eating concerns and 629 fewer calories
than subjects with very low eating concerns. They were also eating less
fat. Of the total, 80 percent had dieted to lose weight and 32 percent
had dieted 6 or more times. Currently dieting were 46 percent of these
women students even though 82 percent of the dieters were within the recommended
body mass index range of 19 to 25. On average they wanted to lose 11.5
pounds. (Healthy Weight Journal
1999:13:1;3 / Pereyra L, et al. Eating attitudes, dietary intake, and dieting
behaviors in college females. J Am Diet Assoc 1997;97(S):9:A-48)

Disordered eating
on campus

In a sample of 1,226 university students, faculty, and
staff in North Carolina, 23 percent of women and 8 percent of men tested
above 20 points on the Eating Attitude Test (modified, approved version),
indicating disordered eating patterns. When asked if terrified about being
overweight, 80 percent of women and 20 percent of men reported being terrified. 

One third (85 percent women, 15 percent men) reported
being preocuupied with the desire to be thinner. Half thought about burning
calories when exercising (65 percent women; 35 percent men). Over one third
were preoccupied with the thought of having fat on their bodies (73 percent
women; 27 percent men). Over one-third ate diet foods (83 percent women;
17 percent men). Nearly one third dieted (84 percent women; 16 percent
men). Eleven percent had the impulse to vomit after meals, and 7 percent
said they vomited after meals (98 percent women, 2 percent men). Hartung
concludes that this study shows that males are more conscious of their
appearance, body fat content, and self-control around food than previously
believed. It supports the need for continued nutrition education and psychological
support on college campuses for both sexes. (Healthy
Weight Journal 1998:12:5;66 / Hartung L. Disordered eating patterns in
relation to gender in the college environment. J Am Diet Assoc 1997; 97:9

Thin models
upset women

College women who viewed pictures of thin female models
experienced higher levels of private self-consciousness, body competence,
and state anxiety, than those who looked at control pictures, in a West
Virginia University study. College men viewing pictures of attractive male
models were unaffected by such self-doubts or anxieties. 

Subjects were 103 psychology students, predominantly white,
who veiwed the pictures briefly alone in a small room. Three sets of pictures
were used: one, thin female models from magazines marketed to women; two,
attractive men from male magazines; and three, a control set of mixed photos
of older men and women, babies, and children playing. Women students were
randomly assigned to view set 1 or 3; men were assigned set 2 or 3. 

Results showed that even for this brief time the women’s
sense of internal self-awareness was disturbed as they compared themselves
to thin models. They felt upset, nervous, tense, and ill at ease. 

The researchers concluded that it is quite easy to influence
college women to feel more negatively about their bodies, while no such
impact exists for male college students. They cited studies that show women
exposed to media images of thin women are affected in negative ways, rate
themelves lower, have increased depression, stress, guilt, shame, insecurity
and body dissatisfaction, and that advertisers target women far mor 
than men with ads that create body dissatisfaction. One study found that
after viewing nude pictures of Playboy and Penthouse models,
subjects rated women of average attractiveness more negatively. Conversely,
the researchers said their own research showed the women’s increased sense
of body competency suggests they felt stronger than the models.

. (Healthy Weight Journal 1998:12:4;50
/ Kalodner C. Media influences on male and female non-eating-disordered
college students. Eating Disorders 1997; 5:47-57.)

Eating disorders
increase in Asia

Eating disorders are fast going global. Anorexia, first documented
in Japan in the 1960s, now afflicts an estimated one in 100 young Japanese
women, about the same as in the United States. In the past 5 years, the
self-starvation syndrome has spread to women of all socio-economic and
ethnic backgrounds in Seoul, Hong Kong, and Singapore. Cases are reported
in Taipei, Beijing, and Shanghai, and even in countries where hunger remains
a problem, including the Philippines, India, and Pakistan. 

“Appearance and figure has become very important in the
minds of young people,” said Dr. Ken Ung of the National University Hospital
in Singapore. “Thin is in, fat is out. This is interesting, because Asians
are usually thinner and smaller-framed than Caucasians, but their aim now
is to become even thinner.” 

Liposuction surgeons are popular, as are diet powders
and pills, cellulite creams, weight loss teas, and other herbal treatments.
In Singapore, headlines were made last year when a 21-year-old, 70-pound
college student at the prestigious National University died of complications
related to anorexia. 

Thinner faces are now also desired by Asian women. The
Takano Yuri Beauty Clinic chain offers a 70-minute facial slimming program
for $157 at 160 salons across Japan and reports business is booming. Drugstores
and beauty salons offer face-reducing seaweed creams, massage, steam, and
vibration treatments and even Darth Vader-like facial masks designed to
promote sweating. (Healthy Weight
Journal 1998:12:3;35 / Efron S. Eating disorders in Asia. Los Angeles Times
October 21, 1997)