Anorexia nervosa and other eating disorders pose new diagnostic and treatment challenges as they affect younger and older patients.

Kathleen Phalen Tomaselli

It was a daily menu of gum and tea sprinkled with 20 or so over-the-counter diet and water pills, 10 laxatives and six hours running on the treadmill. A few times a week, she would cut on her body with knives she kept taped under chairs; a release of pain, anger and starved emotions. At night she would lie awake, agonizing about how she could stay committed to this regimen.

"I'd eat one meal a week if I had to," says Sherri Crowl, now 40, of Edinboro, Pa. "My eating disorder started when I was 8." After 30 years, Crowl was diagnosed with anorexia nervosa. "I kept thinking, if I could be thinner, people would be in awe of me and want to be that size, too."

...Bodies of all ages fade into wisps of what once was, and anorexics are dying at a rate of 10 percent to 20 percent from complications of starvation or from suicide. Still, skeletal frames continue to sashay down runways; extreme-makeover programs highlight body perfection; and reality shows reward weight loss and excessive exercise. In the war on obesity, thinness has become the hallmark of success. "There's this continued glorifying of unhealthy and unnatural images," says Harry A. Brandt, MD, a psychiatrist and medical director of the Center for Eating Disorders at the Sheppard Pratt Health System in Baltimore.

To further complicate diagnosis, anorexia is no longer only a disorder of white teenage girls. It affects all ages, races and cultures. It even can cross gender boundaries. About 15 percent of anorexics are men. "Men are underdiagnosed and undertreated," Dr. Brandt says. "If a man loses weight, the physician does a mega medical work-up. It couldn't possibly be an eating disorder."

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Sudbrook Middle Magnet School's Ariana Vaeth, of Windsor Mill, drew a poster for Sheppard Pratt's Center for Eating Disorders' Love Your Tree campaign that was selected to be reproduced for school and community outreach programs to use to promote a healthy body image.

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The Center for Eating Disorders at Sheppard Pratt received more than 80 posters created by students from five public and private schools in Baltimore County, in response to the center's second annual Love Your Tree campaign. The challenge invited students to create posters that confront narrow ideals about beauty and embrace body diversity and acceptance. The campaign is based on the work of Eve Ensler, author of "The Good Body" and "The Vagina Monologues." Ariana Vaeth, a seventh-grade student at Sudbrook Magnet Middle School, had her poster selected for reproduction.

For more information on the Love Your Tree poster challenge, visit Events

Author and self-esteem expert, Jess Weiner, appeared on the morning show of WBAL-TV, and spoke about the importance of positive body image and the presentation she gave later that day as part of National Eating Disorders Awareness Week.

Matthew Cedrone

Jess Weiner kept her shameful secret until she was 18.

She and her friends would nearly starve themselves through bingeing and vomiting. Classmates at a performing-arts school, they strived incessantly for an ideal body weight.

Only it kept getting more elusive.

Eating disorders warp the way sufferer's view the world, others and themselves, says Weiner, the author of "A Very Hungry Girl" and "Life Doesn't Begin 5 Pounds From Now."

As a teen, she said: "I suffered in silence with my eating disorder. I felt ashamed. I felt like it was all in my mind. I was consumed every second of the day with what I was eating."

At 12, Weiner began trying to lose weight by alternating between eating and getting sick.

Therapy helped, and in 1995, Weiner created ACT Out, a national theater company performing pieces that dealt with body image and violence against women.

"Eating disorders are a legitimate mental health issue," Weiner said.
Weiner is to speak Sunday at Sheppard Pratt Health System.

"We want to light a fire and inspire hope in people with eating disorders," said Sarah Blake, social worker and outreach coordinator for the Pratt's Center for Eating Disorders.

More than 11 million Americans suffer from an eating disorder, experts say, and as many as 1 million of those are men. Eating disorders can lead to kidney failure, abnormally low heart rate, anemia and other illnesses.

Many cases of eating disorders are never reported because of the stigma and the common misconception that the disorders aren't mental illnesses, Weiner said.

If you go:

What: Jess Weiner at Sheppard Pratt Health System

When: 2 to 4 p.m. Sunday

Where: The Conference Center at Sheppard Pratt, 6501 N. Charles St.

Registration: Pre-registration requested. Call 410-938-3157

To view the article, visit here.

Maayan Jaffe and Rochelle Eisenberg

Eating disorders are an American epidemic. According to the National Eating Disorders Association, the disease plagues between 5 million and 10 million people. Anorexia has the highest premature mortality rate of any psychiatric disorder.

In conjunction with National Eating Disorder Awareness Week, Feb. 24 to March 1, two authors plan to help Baltimore women fight back, with separate lectures.

Jess Weiner will speak at the Center for Eating Disorders at Sheppard Pratt Hospital. Ms. Weiner, who has appeared on "Oprah," is author of "A Very Hungry Girl" (Hay House), which chronicles her own battle with eating disorders, and her latest book "Life Doesn't Begin 5 Pounds From Now" (Simon Spotlight Entertainment). She will discuss links between self-esteem and body image, and the media's role in contributing to these issues.

BJT: What are the best ways for parents to promote their daughters' self-esteem?

Jess Weiner: They need to have consistent conversations with their kids about their bodies and identities. The one-shot homework conversation just doesn't do it anymore. Also, mothers can't say, 'You're beautiful no matter what you look like,' then look in the mirror and sa, 'Mommy's so fat.' Walk your talk.

To read more of this Q&A with Jess, click here.

Dr. Harry Brandt was interviewed on the Ron Smith Show about whether there is an obesity epidemic in the U.S.

Dr. Harry Brandt, director of the Center for Eating Disorders, spoke about key signs and symptoms that may indicate you or a loved one has an eating disorder. He also spoke about the Center's new online eating disorder assessments.

The assessments can be found here.

Holly Selby

As the holiday season hits full swing, stress mounts, too. Let's face it, anyone who watches his weight, worries about how he looks or has issues with his family, can be susceptible to holiday-induced anxieties.

But for some people - including those with bulimia nervosa - this time of year may be particularly challenging, says Dr. Harry A. Brandt, director of the Center for Eating Disorders at Sheppard Pratt Health System and head of the department of psychiatry at St. Joseph Medical Center. About 1.5 million to 2 million people in the United States have this eating disorder that in its most severe cases can be fatal.

To read the entire article visit the Baltimore Sun

Dr. Brandt is interviewed live by WTOP's Veronica Robinson about a recent study published in the Journal of the American Medical Association that states that being overweight boosts the risk of dying from diabetes and kidney disease but not cancer or heart disease, and carrying some extra pounds appears to protect against some other causes of death.

To listen to the interview click here

Tanika White

Last year, some Johns Hopkins University fraternity members raised the ire of other classmates by staging a "Halloween in the Hood" party, complete with "bling bling," "hoochie hoops" and a pirate hanging from a noose. Also last year, at the University of Pennsylvania, a student who was dressed as an "Arab suicide bomber" caused a major online discussion about matters of taste.

This year, a sexy "Anna Rexia" costume has caused a firestorm of criticism among eating disorder experts, feminists, bloggers and others.

What is it about Halloween that - in addition to ghosts, goblins and witches - brings out demons of another kind: rudeness, insensitivity, bias and prejudice?

...But few in the eating-disorder community think that "Anna Rexia," a black minidress emblazoned with a glittering skeleton graphic that includes a tape-measure belt to accentuate the waistline, is funny or sexy. The outfit is being sold for $42.95 on the Web site 3Wishes.com.

"I personally am offended by it," says Harry Brandt, director of the Center for Eating Disorders at Sheppard and Enoch Pratt Hospital, who became aware of the costume this month when a co-worker pointed it out to him online. "We don't make costumes about people who have cancer or people who have developmental disabilities. Why would we make a costume about the most serious of psychiatric disorders with one of the highest death rates? It's pretty pathetic."

To read the entire article visit the Baltimore Sun

Aimee Liu, author of "Gaining: The Truth About Life After Eating Disorders," who conducted a presentation at the Center for Eating Disorders at Sheppard Pratt, was interviewed about her personal struggle with anorexia, how people can get help and her book "Gaining."

Aimee Liu, author of "Gaining: The Truth About Life After Eating Disorders," who conducted a presentation at the Center for Eating Disorders at Sheppard Pratt on Sunday Oct. 21, shared her personal account of living with and recovering from anorexia, discussed her book "Gaining," and how people with eating disorders can get help.

Valerie Bauman, Associated Press

Shortly after helping a popular high school student in her recovery from anorexia, Dr. Richard Kreipe had a strange request from another student at the same school.

She wanted to know how much weight she would have to lose to be anorexic, just like the wealthy, thin, popular -and very sick - girl who had entered into treatment.

...Most commonly found among teenage girls, wannarexia is a label describing those who claim to have anorexia, or wish they did. While wannarexia hasn't been studied, experts say a growing number of girls have a misguided desire to be anorexic to gain popularity or to lose weight.

...Some girls labeled as wannarexic may fit a diagnosis of EDNOS, or Eating Disorders Not Otherwise Specified, said Dr. Harry Brandt, director of the Center for Eating disorders at Sheppard Pratt in Towson, Md.

Not as dangerous as other eating disorders, EDNOS is characterized by a constant focus on weight, occasional bingeing and purging, and chronic dieting. It's not uncommon for those suffering from EDNOS to be 'normal,' or even overweight.

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Elizabeth Bernstein

For years, Brad Huffaker obsessively exercised, up to five hours a day. Then he stopped eating for up to 12 hours a day. Eventually, he began gorging each evening on any food he could find in the house and making himself vomit it all back up -- a cycle he repeated up to eight times throughout the night.

Finally, last summer, Mr. Huffaker realized he had an eating disorder and needed help. But after scouring the Internet and researching 20 in-patient facilities, he found only one that specialized in treating men. Mr. Huffaker, a 24-year-old in Knoxville, Tenn., says finding a male-focused center was important because he felt ashamed dealing openly with his problem in front of women. "It's much easier for me to eat in front of guys," he says.

Even amid a growing understanding of the incidence of eating disorders in men and boys, experts say there is a dearth of treatment options for male patients. Only a handful of residential treatment centers have programs that focus on men and boys. Many centers are reluctant to treat men at all. And there has been virtually no research done on males with anorexia or bulimia.

...At the Center for Eating Disorders at Sheppard Pratt, in Baltimore, which has four to six male patients in residence at a time, double the number from five years ago, doctors hold male-only group sessions when they have enough patients. "We focus on what it's like for males to live in a society that focuses on these disorders as women's issues," says Harry Brandt, director of the center.

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