Assignment 15

NEWSWEEK COVER: Fighting Anorexia - New Research Into Its Origins - and Its Youngest Victims

In the December 5 issue of Newsweek (on newsstands Monday, November 28): "Fighting Anorexia." Newsweek looks at the new research into the origins of the disease and how to treat its youngest victims. Also: the exit plans for Iraq; Dems recruit vets for midterm elections; what's next for Ariel Sharon; drought wiping out wildlife on the African plains; Chrysler's new CEO; an exclusive review of the King Kong remake and the best plug-and-play games. (PRNewsFoto/NEWSWEEK) NEW YORK, NY UNITED STATES

Age of Youngest Anorexia Patients Declining to Nine From Thirteen; Seven Years Ago, a 9- or 10-Year-Old Anorexic Would Have Been Shocking, Says Specialist; 'Now We're Seeing Kids This Age All The Time' Science Offering Clues About Brain Chemistry That Causes the Disease Treatment: Treat Food Like Medicine, With Amounts That Must be Eaten Each Day NEW YORK, Nov. 27 /PRNewswire/ -- Researchers, clinicians and mental-health specialists say they're seeing the age of their youngest anorexia nervosa patients decline to 9 from 13 years old, Newsweek reports in the current issue's cover story. Administrators at Arizona's Remuda Ranch, a residential treatment program for anorexics, received so many calls from parents of young children last year, they launched a program for kids 13 years old and under; so far, they've treated 69 of them. Six months ago, the eating-disorder program at Penn State began to treat the youngest ones, too -- 20 of them so far, some as young as 8. In the December 5 Newsweek cover "Fighting Anorexia" (on newsstands Monday, November 28), General Editor Peg Tyre examines the factors that may be causing the declining age of anorexia patients and new treatments for the illness. (Photo: http://www.newscom.com/cgi-bin/prnh/20051127/NYSU005 ) Anorexia nervosa, a mental illness defined by an obsession with food and acute anxiety over gaining weight, has long been thought to strike teens and young women on the verge of growing up. Seven years ago "the idea of seeing a 9- or 10-year-old anorexic would have been shocking and prompted frantic calls to my colleagues. Now we're seeing kids this age all the time," says David S.

Rosen, a clinical faculty member at the University of Michigan and an eating- disorder specialist. Tyre reports that there's not single explanation for the declining age of onset, although greater awareness on the part of parents certainly plays a role. In the past decade, psychiatrists have begun to see surprising diversity among their anorexic patients, Tyre reports. Not only are anorexia's victims younger, they're also more likely to be black, Hispanic or Asian, more likely to be boys, more likely to be middle-aged -- all which go against the conventional wisdom that victims are mostly white, type-A girls from privileged backgrounds succumbing to pressures. New science is offering tantalizing clues about these changes. Doctors now compare anorexia to alcoholism and depression, potentially fatal diseases that may be set off by environmental factors, such as stress or trauma, but have their roots in a complex combination of genes and brain chemistry. As Tyre reports, scientists are tracking important differences in the brain chemistry of anorexics. Using brain scans, researchers at the University of Pittsburgh led by professor of psychiatry Dr. Walter Kaye, discovered that the level of serotonin activity in the brains of anorexics is abnormally high. These pumped-up levels of hormone may be linked to feelings of anxiety and obsessional thinking, classic traits of anorexia. Kaye hypothesizes that anorexics use starvation as a mode of self-medication. How? Starvation prevents tryptophane, an essential amino acid that produces serotonin, from getting into the brain. By eating less, anorexics reduce the serotonin activity in their brains, says Kaye, "creating a sense of calm," even as they are about to die from malnutrition. In the past three years, some prominent hospitals and clinics around the country have begun adopting a new treatment model, in which the entire family helps anorexics get better. The most popular of the home-based models, the Maudsley approach, was developed in the 1980s at the Maudsley Hospital in London. Two doctors there noticed that when severely malnourished, treatment- resistant anorexics were put in the hospital and fed by nurses, they gradually gained weight and began to participate in their own recovery. They decided that given the right support, family members could get anorexics to eat in the same way the nurses did. Tyre explains the therapy: a team of doctors, therapists and nutritionists

meets with parents and the child. They explain that while the causes of anorexia are unclear, it is a severe, life-threatening disease like cancer or diabetes. Food, they tell the family, is the medicine that will help the child get better. Like oncologists prescribing chemotherapy, the team provides parents with a schedule of calories, lipids, carbohydrates and fiber that the patient must eat every day and instructs them on how to monitor the child's intake. They coach siblings and other family members on how to become a sympathetic support team. After a few practice meals in the hospital or doctor's office, the whole family is sent home for a meal. While there are critics to the Maudsley approach, mental health specialists says the success of the family-centered approach is finally putting the old stigmas to rest. "An 8-year-old with anorexia isn't in a flight from maturity," says Dr. Julie O'Toole, medical director of the Kartini Clinic in Portland, Ore., a family-friendly eating-disorder clinic. "These young patients are fully in childhood." Most young anorexics, O'Toole says, have wonderful, thoughtful, terribly worried parents. These days, when a desperately sick child enters the Kartini Clinic, O'Toole tries to set parents straight. "I tell them it's a brain disorder. Children don't choose to have it and parents don't cause it." Also in the cover package is an essay by James S. Berrien, a father of a 16-year-old anorexia patient. He describes the journey from the time he learned of his daughter's illness through her recovery and how the entire family changed. (Read cover story at http://www.Newsweek.com) http://www.msnbc.msn.com/id/10219756/site/newsweek/

SOURCE Newsweek