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Obesity Related to Dopamine Although obesity is not a diagnosable mental illness, it shares a biochemical irregularity with some mental disorders. An article in the February 3, 2001 issue of The Lancet, reports that obese people have fewer dopamine receptors than normal-weight people; also, the more obese they are, the more prominent the deficit. Whether obesity causes the deficit in receptors or vice versa isn't known. Most drugs that affect dopamine levels are addictive; thus, the safest way to increase dopamine and the number of dopamine receptors is to exercise. It isn't big news that exercise and diet are the best treatment for obesity, and, unfortunately, no magic pills are in the offing. However, appropriate exercise is a near-magic cure for many problems, both mental and physical. Anorexia Dr.
Walter Kaye and colleagues at the University of Pittsburgh studied
relapses among anorexia nervosa patients who had achieved a healthy
weight. Only 3 of 19 patients given a placebo did not relapse over
the study period, but 10 of 16 who received fluoxetine hydrochloride
(Prozac) were successful in maintaining a healthy weight. The
researchers emphasize that the medication is not likely to work
unless a healthy weight has been achieved, because only then is
their serotonin system likely to be intact enough to respond to
medication. This study is the first to indicate that an
antidepressant may be effective for the post-hospitalization
treatment of anorexia. Another study also points toward a connection between depression and eating disorders. A March, 2001 article by Dr. Raymond Lam and colleagues in the Journal of Clinical Psychiatry reports that light therapy, usually prescribed for a form of depression called seasonal affective disorder (SAD) reduces binging and purging among bulimic patients who also suffer from SAD. Those treated with bright light therapy for 4 weeks decreased their number of binges by an average of 46%, and their number of purges by 36%. However, only 2 of the 22 patients treated stopped binging and purging altogether. The light therapy completely stopped the symptoms of SAD in 10 of the 22 patients. A study at Massachusetts General
Hospital reported on the psychwatch web site on November 24, 2000,
showed that 92% of the 130 young women studied had significant bone
loss. The lead author, Steven Grinspoon, M.D., said that the study
confirmed how significant the problem was. Estrogen replacement did
not affect the bone loss. None of the participants were
hospitalized. Even calcium and Vitamin D supplements failed to
prevent bone loss. Thus this study adds to the list of severe health
effects that are a consequence of anorexia. A second study led by Dr.
Katherine Halmi at New York Presbyterian Hospital confirmed the
impression that anorexics are extreme perfectionists. The study,
reported in the November issue of the American Journal of
Psychiatry, enrolled 322 women and many of their relatives.
Whether anorexia has a genetic, as well as environmental, basis
remains an open question, but DNA studies are under way in a search
for a possible genetic basis for perfectionism and anorexia.
Perfectionism
and Depression Related to Anorexia Dr. Julia Graber
and her colleagues at the University of Florida report in the
November, 2002 issue of the International Journal of Eating
Disorders that adolescent girls who progress from eating problems to
full-blown anorexia tend to be those who are perfectionistic and
have emotional problems. The study enlisted
girls as young as 12 who attended a private school, and followed
some of them into their early twenties to see which ones became
anorexic. The perfectionism
shows up in other areas besides body image, and the researchers
suggest that when unrealistic goals cannot be reached in these other
areas, anorexia may follow because the girls have better control
over their eating than over other aspects of their lives and can
satisfy their urge for what they see as perfection in their body
images. If families can encourage healthy eating habits and provide
emotional stability, it may help to decrease the risks of later
anorexia.
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