While the problems of various eating disorders has been the focus of both media and scientific attention for some time now, the exploding epidemic of obesity in this country as well as increased pressure for the perfect body type has led to many unique challenges for physicians and psychologists. While we are counseling some of our patient’s to lose weight for health purposes we must be careful to recognize that many of our patient’s have body image issues that require equal amounts of attention.
Thankfully significant research in the areas of eating disorders and eating behaviors has helped strengthen both our understanding and treatment of patients. New understanding of the brain chemical which control both eating centers and body self-imaging are moving forward. Additionally new and innovative techniques which use the latest technologies allow patients to have further resources to combat this dangerous problem.
Scientists are beginning to understand that eating disorders encompass psychological and genetic causes and that any treatment strategy which does not address all aspects of the problem will likely fail. More and more it is recognized that sometimes eating disorders may in fact be a component of a more serious systemic disease such as thyroid or hormonal disorders and will respond to individualized treatment. Patient with eating disorders are no longer being ignored and instead undergoing thorough medical examinations and treatment along with the psychotherapy that is needed to treat these disorders.
With more advanced imaging technologies researchers are beginning to map out specific areas of the brain, such as the hypothalamus, which control our desire to either eat or restrict food intake. Greater understanding of these mechanisms will lead to targeted therapies for each patient. New brain signals, including a protein called leptin, are being investigated as it appears the amount in our systems helps regulated our food intake. A better understanding of this molecule and other will hopefully clear the path for new drugs to treat various eating disorders.
Several drugs which have already been on the market for the treatment of eating disorders such as orlistat (Xenical) and newer developments like rimonabant (Accomplia) are continually being studied for both short and long term effects and are showing great promise. Interestingly, older drugs such as metformin which are used for other diseases demonstrate properties which may effect that brain’s signaling in food centers and are being investigated for use.
Finally, unique and effective cognitive and behavioral therapies are being rigorously tested to combat various eating disorders. A recent study showed the effectiveness of a completely Internet-based program which involved online discussions, body image journals, and up to date information in reducing weight and shape concerns. This type of approach opens up treatment options for individuals who may have been reluctant to seek traditional medical help. In addition, a movement to educate and alter meal programs in schools and offices, as well as, a better understanding of the influence of different cultural attitudes on eating disorders has made for more successful treatment.
Thus, despite the daunting problem of both obesity and other eating disorders in this country both patients and their doctors stand ready to move forward in combating this important and complex medical problem.