Go Nuts

Information for Eating Disorder for the Family

Often the family of a person suffering from anorexia or bulimia is left confused and afraid, and information on eating disorders is imperative for family healing. The following information on eating disorders is provided so that the entire family can begin the long yet rewarding healing process. First of all, in spite of how desperately you want the other person to get well, here are a few 'cannots,' or things you should avoid doing:

• You cannot force or shame an anorexic to eat
• You cannot keep a bulimic from purging
• You cannot make a compulsive overeater or binge eater stop overeating
• You cannot scare, threaten or shame someone with an eating disorder into right thinking or behaviors

It's helpful to fully comprehend pertinent information on eating disorders and to understand that food is not the problem and neither is refusal to eat, purging, or overeating. Research and current information on eating disorders confirms that all eating disorders are emotionally based and the behaviors are only a symptom of deeper emotional and stress related problems. Information on eating disorders has shown that an eating disorder is an attempt to control, hide, stuff, avoid and forget emotional pain, stress and/or self-hate.

If you are the parent of a child under 18 you will have difficult decisions to make regarding their care and should educate yourself on all information on eating disorders. Regardless of pleas to "not make me," and promises that the behavior will stop, you will have to stay very attuned to what is happening with your child and may have to force them to go to doctors and/or the hospital. Keep in mind how serious eating disorders are and that they can kill.

One of the most important things you can do is support and encourage your friend or loved one, and express concern, and the best thing you can do is to learn to attentively listen.

It is up to the individual suffering to decide they are ready to deal with the emotional issues in their life that have lead them to their Eating Disorder. The latest information on eating disorders confirms that they need to make a personal choice for recovery and to want to do the work to get there.   

 

Signs and Symptoms of Eating Disorders

For the anorexic or bulimic who exhibits any of the following signs it's essential to encourage them to seek medical help or inpatient treatment immediately.

1. Dizziness and fatigue
2. Black-outs
3. Extreme temperature sensitivity, significant hair growth especially on face
4. Chest pains, stomach pains, tingling in hands or feet
5. Blood in stools or vomit
6. Incontinence or uncontrollable vomitting or diarrhea
7. Significant weight loss of total average body weight in a short period of time
8. Dramatic weight loss in a relatively short period of time
9. Wearing big or baggy clothes or dressing in layers to hide body shape and/or weight loss
10. Obsession with weight and complaining of weight problems (even if "average" weight or thin)
11. Obsession with calories and fat content of foods
12. Obsession with continuous exercise
13. Frequent trips to the bathroom immediately following meals (sometimes accompanied with water running in the bathroom for a long period of time to hide the sound of vomiting)
14. Visible food restriction and self-starvation
15. Visible bingeing and/or purging
16. Use or hiding use of diet pills, laxatives, ipecac syrup (can cause immediate death!) or enemas
17. Isolation. Fear of eating around and with others
18. Unusual Food rituals such as shifting the food around on the plate to look eaten; cutting food into tiny pieces; making sure the fork avoids contact with the lips (using teeth to scrap food off the fork or spoon); chewing food and spitting it out, but not swallowing; dropping food into napkin on lap to later throw away
19. Hiding food in strange places (closets, cabinets, suitcases, under the bed) to avoid eating (Anorexia) or to eat at a later time (Bulimia)
20. Flushing uneaten food down the toilet (can cause sewage problems)
21. Vague or secretive eating patterns
22. Keeping a "food diary" or lists that consists of food and/or behaviors (ie., purging, restricting, calories consumed, exercise, etc.)
23. Pre-occupied thoughts of food, weight and cooking
24. Visiting websites that promote unhealthy ways to lose weight
25. Reading books about weight loss and eating disorders
26. Self-defeating statements after food consumption
27. Hair loss. Pale or "grey" appearance to the skin
28. Dizziness and headaches
29. Frequent soar throats and/or swollen glands
30. Low self-esteem. Feeling worthless. Often putting themself down and complaining of being "too stupid" or "too fat" and saying they don't matter. Need for acceptance and approval from others
31. Complaints of often feeling cold
32. Low blood pressure
33. Loss of menstrual cycle
34. Constipation or incontinence
35. Bruised or calluses knuckles; bloodshot or bleeding in the eyes; light bruising under the eyes and on the cheeks
36. Perfectionistic personality
37. Loss of sexual desire or promiscuous relations
38. Mood swings. Depression. Fatigue
39. Insomnia. Poor sleeping habits

Signs and Symptoms of Compulsive Overeating / Binge Eating

1. Fear of not being able to control eating, and while eating, not being able to stop
2. Isolation. Fear of eating around and with others
3. Chronic dieting on a variety of popular diet plans
4. Holding the belief that life will be better if they can lose weight
5. Hiding food in strange places (closets, cabinets, suitcases, under the bed) to eat at a later time
6. Vague or secretive eating patterns
7. Self-defeating statements after food consumption
8. Blames failure in social and professional community on weight
9. Holding the belief that food is their only friend
10. Frequently out of breath after relatively light activities
11. Excessive sweating and shortness of breath
12. High blood pressure and/or cholesterol
13. Leg and joint pain
14. Weight gain
15. Decreased mobility due to weight gain
16. Loss of sexual desire or promiscuous relations
17. Mood swings. Depression. Fatigue
18. Insomnia. Poor Sleeping Habits

Compulsive Overeating or Binge Eating Disorder

Compulsive eating disorders and other conditions like anorexia and bulimia can wreck havoc on a person’s body and can cause emotional turmoil as well. Usually victims of compulsive eating disorders are suffering from psychological unrest that manifests itself in destructive and compulsive ways and frequently victims of depression and/or anxiety suffer from compulsive eating disorders or addictions as well. This is why it is essential to treat both the mind and the body and to cultivate inner peace and serenity when managing compulsive eating disorders.

 

If you think that you or someone you love may be suffering from a compulsive eating disorder, look for the following signs:

• frequent episodes of compulsive, out-of-control eating and bingeing 
• frequently eating an abnormally large amount of food in a short period of time
• Indeating much more rapidly than normal
• eating until feeling uncomfortably full
• eating excessive amounts of food when not feeling physically hungry
• eating alone because of being embarrassed by how much one is eating
• lack of control over eating during the binge episodes
• feeling disgusted with oneself, depressed, or very guilty after overeating
• bingeing on food without using purging methods

While bulimia and compulsive overeating both involve binging and are dangerous conditions, the primary difference is that people with compulsive overeating or binge-eating disorder do not purge their bodies of excess calories by means of vomiting, fasting, excessive exercise, or misusing laxatives as is seen with bulimia patients. Therefore, many people with the disorder have a history of weight fluctuations or are overweight for their age and height. Feelings of self-disgust and shame with can lead to bingeing again, creating a vicious cycle of binge-eating and self-loathing.

Bulimia Treatment

At Casa Palmera anorexia and bulimia treatment center, we understand that a comprehensive approach to recovery is imperative for long-term relief from destructive conditions like eating disorders. Successful anorexia and bulimia treatment must heal the spirit as well as treat the body, and our anorexia and bulimia treatment center is founded on that philosophy of wholeness.

Bulimia

Bulimia nervosa is known as the diet-binge-purge disorder, and an effective bulimia treatment plan must provide information and education about the disorder to those who are suffering and the loved ones who are concerned Bulimia nervosa:
the diet-binge-purge disorder.

The bulimia cycle generally follows the following:

• Person binge eats.
• Feels out of control while eating.
• Vomits, misuses laxatives, exercises, or fasts to get rid of the calories.
• Diets when not bingeing. Becomes hungry and binges again.
• Believes self-worth requires being thin. (It does not.)
• May shoplift, be promiscuous, and abuse alcohol, drugs, and credit cards.
• Weight may be normal or near normal unless anorexia is also present.

Like anorexia, bulimia can kill and bulimia treatment can be a matter of life of death. Even though bulimics put up a brave front, they are often depressed, lonely, ashamed, and empty inside. Friends may describe them as competent and fun to be with, but underneath, where they hide their guilty secrets, they are in the midst of profound emotional pain. Feeling unworthy, they generally have great difficulty talking about their feelings, which almost always include anxiety, depression, self-doubt, as well as deeply buried anger. Impulse control may be a problem and can manifest in pathological ways such as shoplifting, sexual adventurousness, alcohol and drug abuse, and other kinds of risk-taking behavior.

If you or a loved one is suffering from a devastating eating disorder, comprehensive anorexia or bulimia treatment is essential for permanent healing. 

 

Anorexia Nervosa and Anorexia Treatment

Anorexia nervosa is a dangerous disorder characterized by the relentless pursuit of thinness. Immediate anorexia treatment is essential for recovery due to the grave consequences of the disease. At Casa Palmera, we understand the complexities of anorexia treatment and our facility is renowned for eating disorder therapy.

Anorexia treatment addresses the person who refuses to maintain normal body weight for age and height and often weighs 85% or less than what is expected for age and height. In women without successful anorexia treatment, menstrual periods stop. In men levels of sex hormones fall. Young girls kept from adequate anorexia treatment and long-term recovery do not begin to menstruate at the appropriate age.

Anorexia treatment is notoriously difficult, because the victim often denies the dangers of low weight, and is terrified of becoming fat. A person needing anorexia treatment is typically afraid of gaining weight even though s/he is markedly underweight and reports feeling fat even when dangerously thin.

In addition, anorexia nervosa often includes depression, irritability, withdrawal, and peculiar behaviors such as compulsive rituals, strange eating habits, and division of foods into "good/safe" and "bad/dangerous" categories. A successful anorexia treatment strategy addresses the underlying psychological issues, as a person may have low tolerance for change and new situations and may fear growing up and assuming adult responsibilities and an adult lifestyle.

 

Eating Disorder Support through Equine Therapy

Addiction, pain, and eating disorder support therapies are important for long-term healing. At Casa Palmera, we are the only facility of our type that has an in-house equine therapy program for addiction recovery and eating disorder support.

Equine therapy focuses on dynamic group and individual interaction between humans and animals and allows a person to cultivate trust and optimism – an integral part of any successful eating disorder support system. It can be highly therapeutic for men and women who are caught up in the cycles of addiction, need eating disorder support, or are seeking relief from other illnesses.

Interacting with horses can help humans to remember that we are a part of and connected to all things in nature. Horses are powerful yet graceful, and they are extremely forgiving. Equine therapy is a powerful therapeutic tool for addiction, pain and eating disorder support that acts as a metaphor for our relationship with ourselves. It reminds us of the essential importance of respecting and taking care of our bodies and ourselves as we learn to channel the compassion that we apply to the animals and direct it towards ourselves.

A horse's sensitivity to our own body language and other non-verbal cues allows us to discover and examine unconscious signals that we communicate to other people and the world around us. In such therapies such as addiction healing or eating disorder support, understanding this non-verbal communication is imperative. For guests, the horse becomes a "co-therapist" and serves as a listener and also a mirror that reflects feelings, thoughts and emotions. Horses also rely upon their instincts instead of judgments and preconceived thoughts or behaviors when interacting with humans, which makes Equine Therapy so unique and valuable to the healing process and for alleviating psychological disturbances and providing eating disorder support. 

 

HEALING THERAPIES

Specific conditions are alleviated by a variety of unique programs for recovery, such as addiction or anorexia nervosa treatment. Specialty therapies help to strengthen the mind and the spirit and are powerful additions to particular programs such as pain management or anorexia nervosa treatment.

Specialty Therapies 

Specialty Therapies are not required components of a client's treatment but are options available to wellness programs such as trauma recovery or anorexia nervosa treatment. Participation in one or more of these programs is mutually agreed upon by the client, their therapist, and the treatment team.

Part of Casa Palmera's individualized and personalized approach to treating the wide range of conditions of our clients includes a variety of the treatment components listed below. They are applied interchangeably in our treatment of eating disorders, trauma, behavior healthcare, and conditions related to chronic pain. For instance, a client seeking anorexia nervosa treatment can also benefit from yoga or Person-Centered Therapy.

Our therapeutic staff draws from the following modalities:

Animal Therapies

• Equine Therapy
• Pet Encounter Therapy

Bodywork Therapies

• Breath Therapy
• Craniosacral Therapy
• Massage Therapy
• Meridian Flexibility System™
• Reflexology
• Shiatsu / Acupressure

Energetic Therapies

• Acupuncture
• Healing Touch
• Reiki

Exposure Therapies

• Hypnotherapy
• Thought Field Therapy (TFT)
• Guided Imagery
• Emotional Freedom Technique (EFT)
• Eye Movement Desensitization & Reprocessing (EMDR)
• Virtual Reality

Expressive Therapies

• Art Therapy
• Body Image Therapy
• Dance Movement Therapy
• Drum Therapy
• Music Therapy

Lifestyle Practices

• Healthy Lifestyle Counseling
• Spiritual Wellbeing

Meditative Practices

• Biofeedback
• Chi Kung (Qi Gung)
• Meditation
• T'ai Chi
• Yoga

Movement/Exercise Therapies

• Feldenkrais
• Personal Training / Functional Fitness
• Pilates
• T'ai Chi
• Yoga

Natural Medicine

• Acupuncture
• Herbal Medicine
• Homeopathic Medicine
• Naturopathic Medicine

Nature Therapies

• Organic Gardening
• Nature walks
• Recreational Activities
• Surf Therapy

Nutritional Therapies

• Nutritional Counseling
• Nutritional Supplementation

Psychotherapies

• Cognitive Behavioral
• Dialectical Behavioral Therapy (DBT)
• Gestalt Therapy
• Guided Imagery
• Hypnotherapy
• Journaling
• Neuro Linguistic Programming
• Person-Centered Therapy
• Psychodynamic Therapy
• Psychosynthesis
• Rational Emotive Therapy
• Transpersonal

Other Therapeutic Modalities

• Hyperbaric Oxygen Therapy
• Challenge Course & Climbing Wall
• Sauna Therapy

 

Alcohol Abuse Treatment

A person suffering from alcoholism needs help. Alcoholism can destroy a family and can result in death for the alcoholic. Therefore, alcohol abuse treatment is of the utmost importance for a person suffering from alcoholism. An effective alcohol abuse treatment plan offers both individualized residential and outpatient treatment, as well as extended care. An alcohol abuse treatment plan consisting of residential treatment involves remaining in a confidential, secluded environment throughout a portion of the treatment. Intensive outpatient alcohol abuse treatment is another treatment option. Through this plan, individuals are still able to work and to remain at home with their families while receiving alcohol abuse treatment.

Extended care, also referred to as aftercare, is an extremely important component of an alcohol abuse treatment plan. Through aftercare, the alcohol abuse treatment center can monitor and ensure that the knowledge and lifestyle changes gained through the alcohol abuse treatment center are being used in daily life. A strong aftercare system helps prevent relapsing into alcoholism.

An alcohol abuse treatment center must also involve a medical evaluation and a psychological assessment. Through a thorough medical evaluation, the alcohol abuse treatment plan can address specific physical problems that may have resulted from the alcoholism. It also helps the alcohol abuse treatment center develop a holistic approach to improve the patient’s overall health. Likewise, a psychological assessment helps the alcohol abuse treatment team develop a plan to address psychological difficulties, such as depression, while helping the patient recover from alcoholism.

A successful alcohol abuse treatment center will also include a 24-hour medically supervised detoxification and withdrawal system. Individuals undergoing alcohol abuse treatment can experience extreme withdrawals, both mentally/emotionally and physically. Therefore, it is important to provide monitoring and assistance with withdrawal to someone involved in an alcohol abuse treatment plan.

An alcohol abuse treatment plan should also include both individual and group therapy. Often, those participating in an alcohol abuse treatment plan need the strength and support they gain by discussing their alcoholism with others who have shared their same struggles. On the other hand, one-on-one counseling and attention is important in working toward individual goals.

Since alcoholism rarely affects only the alcoholic, family therapy is another important component of an alcohol abuse treatment. In this way, the whole family can heal and become educated in ways to help the alcoholic recover.

Do Surgeon General’s Recommendations on Physical Activity & Health Apply to Cardiovascular and Pulmonary Patients?

Hélène Perrault, Mc Gill University, Montréal, Canada

Ten years ago, the US Department of Health and Human Services published the first Surgeon General’s report on physical activity and health. This report entitled: “Physical Activity and Health: A Report of the Surgeon General” was the most comprehensive review of the research on physical activity and health involving the contribution of more than one hundred exercise scientists and is a landmark in bringing attention to  “physical activity” or “lack of ” as a major public health issue. Despite nearly fifty years  of national efforts to encourage young Americans to partake in sports and exercise, results showed that more than half of the population was not regularly active. This observation raises many questions as to the reasons for such statistics, the interactions and/or overlap between these observations and the current prevalence of chronic cardiovascular and pulmonary disease, the application of findings from the Surgeon General Report to patients with chronic cardiopulmonary disease, the reversibility of this lifestyle statistic.

In an interactive forum, this workshop will examine the bases and evolution of  exercise prescription in health and disease and review the current knowledge on physical activity and health interactions. More specifically, the workshop will address  a series of issues related to the assessment, prescription and supervision of physical activity and exercise such as 1) the assessment and interpretation of cardiorespiratory fitness 2) the evidence base for health-related benefits of physical activity 3) the nature of the relationship between physical activity and health 4) the adverse effects of physical activity 5) the current recommendations in terms of physical activity and exercise 6) the patterns of physical activity participation 7) recommending physical activity. Participants will be quizzed as to their awareness and understanding of  the current knowledge base status on these issues followed by a presentation and discussion of the standing evidence and the potential for translation to the cardiovascular and pulmonary patients.

 

Measuring Skeletal Muscle Strength and Endurance, from Bench to Bedside

Thierry Troosters, Katholieke Universiteit Leuven, Leuven, Belgium
Didier Saey, Institut Universitaire de Cardiologie et de Pneumologie,
Hôpital Laval, Québec, Canada

Skeletal muscle dysfunction is an important feature determining morbidity in many chronic diseases, including chronic obstructive pulmonary disease and congestive heart failure. Skeletal muscle weakness is a determinant of exercise intolerance,
excess utilization of healthcare recourses and mortality. Exercise training does
enhance skeletal muscle function and exercise performance. In addition, patients
who start a training program with impaired skeletal muscle function may be more
likely to respond adequately to an exercise training program. Hence assessment of peripheral muscle function is of interest to clinicians to identify more fragile patients
and to select patients for exercise training interventions. Researchers may get
insight in the mechanisms through which the disease (be it COPD or CHF) exerts
its systemic action, or may get further insight in the mechanisms of clinically
relevant improvements in physical activity levels, exercise capacity or health
related quality of life.

Measurement of skeletal muscle function range from a simple 5-point Medical
research scale or hand held dynamometry to utilization of magnetic stimulation
of peripheral nerves to elicit non-volitional contractions of the skeletal muscles.
The first techniques are ideally used bed-side. In the context of rehabilitation more standardized, machine based tests are more feasible and advisable. For research purposes, techniques which are independent of the voluntary muscle activation are
the golden standard. To gain complete insight in the skeletal muscle properties clinicians and scientists may be interested in muscle strength, endurance and fatigability. Recently it has become clear that skeletal muscle endurance may be
even more impaired than skeletal muscle strength. Several tests are used to measure skeletal muscle endurance. Most of these consist of repeated lifting of submaximal weights, or sustained isometric contractions. Skeletal muscle contractile fatigue
proved to be an important factor directly contributing to exercise intolerance. This skeletal muscle property, however, can only be addressed using rather complex research tools, involving magnetic stimulation. Symptoms of muscle fatigue, however, seem to be somewhat associated to contractile fatigue, and therefore may guide clinicians. Unfortunately there is no uniform guideline as to how to perform strength tests, endurance tests and tests to assess skeletal muscle fatigue. The present workshop, therefore will blend evidence base with expert opinion.

Recent insights in the importance of skeletal muscle function in chronic disease make this workshop timely. The aim is to review the different features of skeletal muscle function as well as a practical insight in the different techniques to assess skeletal muscle function. Clinical as well as research experience in dealing with these topics
will be exchanged, and recent literature giving insight in the usefulness of different
tests will be reviewed.