Eating Disorders Blog

In a March 29 article on shreveporttimes.com, author Doreen Nagle provided the following details on the prevalence of eating disorders among teenagers:

• About 10 of every 100 teen girls suffer from two body image disorders, bulimia and anorexia. These two diseases are classified as psychiatric disorders and may run in families.
• Over 12 percent of high school students admit that they have gone without eating for 24 hours so they may lose weight or prevent weight gain.
• More than six percent of students nationwide admitted having taken diet supplements without a doctor's advice to lose weight or to keep from gaining weight.
• Forcing oneself to vomit as an aid in losing weight or keeping weight off is a practice used by about 5 percent of teens; the number of girls using this method is more than twice that of boys.

"Is your child unrealistically concerned with being 'fat' when she or he is too thin in your estimation? Does your child's weight fluctuate with no reasonable explanation?," Nagle wrote. "Watch for the signs of anorexia or bulimia."

Labels: bulimia, teen eating disorders, anorexia

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According to new research, individuals suffering from anorexia exhibit especially high levels of fat in their bone marrow, which may explain why these individuals often suffer from osteoporosis. The findings appear in the February issue of the Journal of Bone and Mineral Research.

For the study, researchers conducted and analyzed MRI scans of 40 girls aged 16 to 20. Half of the girls suffered from anorexia and half did not. The researchers found that the anorexic girls had significantly higher levels of fat in the marrow of their knees, thighs and upper shin bones, as well as significantly less red marrow.

Earlier studies have also confirmed that malnourished individuals experience hormonal changes that cause the bone marrow's mesenchymal stem cells to turn into fat cells rather than bone-forming cells. This change may help to explain why some anorexic individuals develop osteoporosis.

Dr. Catherine Gordon, an endocrinologist and director of the Bone Health Program at Children's Hospital Boston, explained the phenomenon in a hospital news release: "It's counterintuitive that an emaciated young woman with almost no subcutaneous [below the skin] fat would be storing fat in her marrow. Bone formation is very low in girls with anorexia, and that's a particular problem because they are growing adolescents who should be maximally forming bones.

"But because of the hormonal alterations induced by malnutrition, the bone marrow stops yielding the needed cells to form bone. Instead, the stem cells are pushed toward fat formation."

Experts hypothesize that the body makes this change in a "last ditch" effort to preserve body fat and increase body temperature. With little or no body fat, anorexics often suffer from dangerously low body temperatures (hypothermia) and must be hospitalized because of it.

(Source: www.businessweek.com)

Labels: anorexia, osteoporosis

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Former runway model Inga Radziejewski is speaking out about the deadly standards of high fashion. At her thinnest, 5'11" tall Inga weighed just 98 pounds and was still rejected from a fashion audition for being too fat.

At the time, Inga was so skinny that she was just weeks away from complete organ failure due to anorexia. She was subsisting on half an apple a day and peppermint tea with brown sugar. Her body mass index was only 14 (anything under 18.5 is considered underweight, according to the World Health Organization). Inga also heard other models regularly discuss their extreme methods for staying rail thin.

She explained, "I heard one girl say that she started throwing up her food three days before a casting and another said she was taking epilepsy medication to help her concentrate because she was so ­delirious from hunger. When I looked shocked all the other girls said they did it too."

Inga says that although models were often friends with each other, there was definitely a sense of rivalry, and ever-present pressure from designers and photographers to measure up to an impossible standard. Even at size 00, Inga feared she would be passed over at auditions for being too big.

She said, "It was very competitive and I ­dreaded being bigger than the girl next to me. We were all friends but there was ­definitely a rivalry between agencies. If you didn't fit in your clothes they would be taken from you and given to another girl. I was so scared of losing out at castings, I would starve myself."

Inga finally received eating disorder treatment after she agreed to go home and see her parents. Her parents, who saw a photograph of their daughter and became alarmed, begged her to come home for a visit. While home, she agreed to receive outpatient eating disorder treatment at a local clinic. However, when the doctors at the clinic examined her they informed her that she was probably days away from total organ failure and said that they would not let her leave until she began to recover.

Inga says even at that time she didn't see anything wrong with her habits. She looked at other patients at the clinic who were recovering and thought of them as "fat cows," while she was envious of those patients who were even skinnier than she was.

After going through eating disorder treatment, Inga now has a healthy BMI of 20 and weighs about 149 pounds. She is working as a model in mainstream fashion, and has come to terms with leaving the world of high fashion.

"I know that my career in high fashion is now over and part of me is sad about that, but if I hadn't gone into rehab, the cost would have been a lot higher. I could have died," she said.

(Source: www.mirror.co.uk)

Labels: eating disorder, anorexia, media, fashion

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The National Eating Disorders Association (NEDA) will be sponsoring the 23rd annual Eating Disorders Awareness Week from February 21-27, 2010. The national event is designed to raise awareness about eating disorders, to combat unrealistic "body-perfect" ideals, and to counter the shame-filled and secretive attitudes that many people have regarding these life-threatening illnesses.

Lynn Grefe, CEO of NEDA, commented on the event and this year's theme, "It's Time to Talk About It." She said, "It really is time to talk about eating disorders, because people die, with anorexia having the highest death rate of any mental illness. You wouldn't be ashamed of developing asthma, diabetes, cancer or hundreds of other medical conditions.

"The sooner we get people to talk about it, the sooner we can get people to the help they need. It is necessary to educate upcoming generations about the issues that surround and lead to eating disorders. And to do that, we also need to address the societal pressures and the unrealistic images we are bombarded with in the media that have been irrefutably and scientifically proven a contributing factor among people who develop eating disorders, depression and other esteem issues."

To highlight the week, volunteers are coordinating events nationwide, including seminars and workshops on college campuses and in other venues, film festivals, health fairs and screenings, awareness walks, candlelight vigils, fundraisers, and artistic performances.

(Source: www.theopenpress.com)

Labels: eating disorder, awareness, anorexia

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According to data from the Touch Research Institutes (TRI) at the University of Miami, School of Medicine, bulimic patients who received massage therapy experienced immediate decreases in anxiety and depression, according to certain psychological and behavioral measures.

According to the TRI's report, "Bulimic adolescent girls received massage therapy 2 times a week for 5 weeks. Effects included an improved body image, decreased depression and anxiety symptoms, decreased cortisol levels and increased dopamine and serotonin levels."

A similar study, also conducted by TRI, showed that anorexic patients also experienced an alleviation of symptoms as a result of massage therapy. According to study authors, "Massage therapy reduced anxiety, depressed mood, salivary cortisol (stress hormone) levels and body dissatisfaction and increased dopamine levels in women with anorexia."

(Sources: www6.miami.edu, www.massagemag.com)

Labels: bulimia, anorexia, anxiety disorders, massage therapy

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Popular movie actress Brittany Murphy died suddenly on December 20th amidst rumors of drug use and an eating disorder. She was reportedly discovered unconscious in the shower Sunday morning by her mother. The 32-year-old actress died as a result of cardiac arrest, though contributing factors have not yet been determined.

While autopsy findings are pending, many experts believe that it is highly likely that the young actress suffered from an eating disorder, most likely anorexia. This opinion is shared by Dr. Daniel Kirschenbaum, a clinical psychologist and eating disorder treatment specialist who was consulted by US Weekly magazine.

Dr. Kirschenbaum commented on recent photographs of Murphy: "With the sunken cheeks and skeletal appearance, it suggests the possibility of anorexia. People who are anorexic die ... Starve the body long enough, the body will eventually consume itself.

"Anorexia is perhaps the deadliest of the psychological disorders, and if that applies to Brittany Murphy, it wouldn't be a complete shock. Karen Carpenter was an example of an anorexic, and she died many years ago from a heart attack."

Labels: eating disorder, anorexia

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At a time when obesity is a skyrocketing problem in the United States, some experts are seeing a backlash of eating disorders. Orthorexia, which is considered a type of anorexia, involves an obsessive fixation with eating only healthy foods. Orthorexia is a term coined by Dr. Steven Bratman to describe this condition; however, orthorexia is not an officially recognized clinical eating disorder.

Orthorexics gradually eliminate more and more types of foods from their diets and generally begin to fixate on a very limited diet. In some extreme cases, orthorexics become full-blown anorexics because they can't find food "clean" enough or "healthy" enough to satisfy their compulsion, and so their caloric intake becomes severely limited.

According to some experts, the connection between anorexia and orthorexia is a deep-seated fear of food. Anorexics fear food because they think it will make them fat, while orthorexics fear food because they think it will make them sick.

Ellen Astrachan-Fletcher, a clinical psychologist and director of the eating disorders clinic at the University of Illinois at Chicago, commented: "While orthorexia begins with a desire to achieve better health, it's very connected to an underlying fear of food. If I believe the food will make me sick, I become afraid of it, and I avoid it and, bit by bit, continue to avoid more and more food types."

Orthorexics typically become so obsessed with consuming the "right" foods that other activities in their lives begin to suffer, such as their studies, careers and family life. This is the point where a lifestyle choice may cross the line into a mental health issue.

Linda Van Horn, a clinical nutrition epidemiologist at the Feinberg School of Medicine at Northwestern University, stated: "The fundamental issue [with orthorexia] is the obsessive-compulsive nature of food intake. Anything too extreme can be unhealthy."

(Source: news.medill.northwestern.edu)

Labels: anorexia, diet, orthorexia

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According to a new study, practicing yoga can help individuals who suffer from eating disorders such as anorexia nervosa and bulimia nervosa. The study, titled "Randomized Controlled Clinical Trial of Yoga in the Treatment of Eating Disorders," appeared on Nov. 3, 2009, in the Journal of Adolescent Health.

Researchers tracked the progress of 50 adolescents, ages 11 to 16, who were receiving treatment for eating disorders. The adolescents were divided into two groups: one group received traditional treatment and the other group received traditional treatment plus two hours of yoga classes per week with a certified yoga instructor.

Researchers found that individuals who participated in yoga classes made greater improvement and were less likely to relapse than those who did not practice yoga.

(Source: www.lsureveille.com)

Labels: bulimia, anorexia, yoga

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At age 36, Alanis Morissette has reached a place of peace when it comes to eating, after spending many of her teen years battling unhealthy behaviors including the eating disorders anorexia and bulimia.

By the age of 14, Alanis was already living in the public eye as the star of a popular Canadian television show, the founder of a record label and the recipient of a contract with MCA Canada. But with her stardom came unbelievable stress, which the young star found difficult to handle.

In an interview with Health magazine for its December issue, Morissette recalls: "As a teen, I was both anorexic and bulimic. I was a young woman in the public eye, on the receiving end of a lot of attention, and I was trying to protect myself from men who were using their power in ways I was too young to know how to handle.

"Disappointment, sadness and pain hit me hard, and I tried to numb those feelings through my relationship with food. For four to six months at a time, I would barely eat. I lived on a diet of Melba toast, carrots and black coffee. I began recovering at age 18 when a sweet friend confronted me."

(Source: www.cnn.com)

Labels: bulimia, anorexia

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The state of London Fashion Week reignited a national controversy over soaring numbers of pro-anorexia websites. Psychiatrists are calling on the British government to take action to counter the influence of these destructive websites.

Approximately 1.6 million people in Great Britain suffer from eating disorders and approximately 90 percent of this group is comprised of teenage girls. The Royal College of Psychiatrists believes that increasing numbers of Britons are accessing pro-anorexia websites to get tips on how to starve themselves and camouflage drastic weight loss. Experts estimate that one in 10 girls is regularly accessing these sites to learn how to become anorexic.

Professor Ulrike Schmidt, chair of the college's eating disorders section, commented, "(These) websites normalize illness. In much the same way, the catwalks of international fashion events such as London Fashion Week can act as a showcase for underweight women."

Mary George, a spokesperson for a British organization that provides assistance to people with eating disorders, doesnt believe that outlawing the pro-anorexia websites is the answer: "Directing people away from these sites, toward pro recovery sites is what we would wish to see."

(Source: www.montrealgazette.com)

Labels: anorexia, pro-anorexia

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Ermina Errico pleaded guilty to one count of neglect in the death of her 25 year-old daughter, Emily. Errico obsessively and bizarrely controlled every aspect of her daughter's life from birth.

In January 2007, Emily Errico, age 25, was found dead from malnutrition and anorexia nervosa in her family's home. Among other strange behaviors, Emily's mother severely limited her food intake and forced her to wear plastic bags instead of clothes. At the time of her death, Emily was 5 feet, 7 inches tall and weighed only 97 pounds.

The family home is located in Garwood, N.J., a town of about 4,000 residents located outside of New York City. Ermina pleaded guilty at a hearing last week, during which she acknowledged that she was aware of her daughter's weakened state. Ermina was sentenced to probation and psychological treatment. Her husband, Edward, received a similar sentence earlier this year.

(Source: Associated Press)

Labels: anorexia, malnutrition

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According to a new study, cortisol levels are higher in women with anorexia and hypothalamic amenorrhea (a condition in which the brain fails to produce the hormone necessary to trigger menstruation). These increased levels of cortisol are strongly associated with depression, anxiety and bone loss.

The study, conducted by researchers at Harvard Medical School in Boston, was published online on Oct. 16, 2009, in the Journal of Clinical Endocrinology and Metabolism.

The Harvard researchers, led by Elizabeth A. Lawson, M.D., examined whether cortisol levels could be linked to bone loss and mood disturbance in 31 amenorrheic women (women who do not have menstrual periods). Of the study participants, 18 women were amenorrheic due to being anorexic and 13 women were normal-weight with hypothalamic amenorrhea.

The research team found that both groups had lower bone mineral density than healthy women. The two groups also exhibited higher than average cortisol levels, and more incidences of depression and anxiety. In general, the anorexic women had the lowest bone density and the highest cortisol, depression and anxiety levels.

Lawson commented on the study results: "Hypercortisolemia is a potential mediator of bone loss and mood disturbance in these disorders. It is unclear whether hypercortisolemia is secondary or underlies the psychiatric pathology in these disorders."

(Source: www.modernmedicine.com)

Labels: anorexia, anxiety disorders, depression

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Bobbie Jo Fatheree was finally hospitalized when her weight plummeted to 90 pounds. The Virginia native played sports avidly in high school and was always very physically fit. During her freshman year of college, however, she broke her foot.

Due to inactivity while her foot healed, she saw her weight spike up to 200 pounds. Her always-fit body was, she felt, out of control.

Once her foot healed, Fatheree began working out like a maniac. She was so driven to lose weight that she also developed bulimia and then anorexia. Her weight dropped down to 130 pounds. By the next year, while training for the women's hockey team, she pushed her weight down to a dangerous 90 pounds.

At this point, her parents stepped in, hospitalized her and helped to regain her perspective. Following college, she continued to struggle with eating issues and finding a diet that worked for her. It wasn't until she tried competitive body building that something clicked. A friend helped her with nutrition, workouts, and learning pose and dress in competitions.

Fatheree recovered from her eating disorders, and found that a key to preventing destructive eating patterns was to stop weighing herself on a scale. She commented, "The scale was one of my triggers. It would make or break my whole day, if I didn't see that magic number."

(Source: www.newrichmon-news.com)

Labels: eating disorder, bulimia, anorexia, body building

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Connecticut resident Sue Daigle began her struggle with anorexia at the age of 12. At one point in her adult life, she weighed only 80 pounds.

Like others who suffer from the clinical eating disorder known as anorexia nervosa, Daigle got hooked on the success of her initial weight loss and found she couldn't stop. She recalls, "I just started dieting and I saw myself losing. When I started losing, I liked it and I kept going, kept going ... I never thought I was skinny enough ... It got to a point that I was afraid to even let food touch my mouth."

Fortunately for Daigle, in the midst of her battle with disordered eating, she became interested in the sport of bodybuilding. Bodybuilding demands good nutrition, and her passion for the sport helped her to overcome her aversion to food.

Nearly 40 years after her disordered eating began, Daigle is an award-winning bodybuilder and is finally coming to terms with food and her body.

About bodybuilding, the sport that may have saved her life, she says, "It's just healthy and I just believe in it ... It's an achievement. And it's not with drugs, it's just with hard training and eating. Eating right."

(Source: www2.counton2.com)

Labels: eating disorder, anorexia, body building

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A study recently conducted in Sweden found that girls from well-educated families who do well at school may be at higher risk of developing an eating disorder.

The study, conducted by Stockholm's Karolinska Institute, followed more than 13,000 women born in Sweden between 1952 and 1989. Researchers found that as parents' or grandmothers' education increased, so did girls' risk of being hospitalized for anorexia or another eating disorder. The risk for eating disorders also increased in relation to the girls' own grades in high school.

The researchers commented on the findings: "It's possible that these girls feel more pressure from family to succeed -- which for some could translate into an obsession with controlling their eating and body weight."

Researcher Jennie Ahren-Moonga commented that pressure to succeed may be combined with other problems, such as lack of self-esteem. "This is even more relevant when combined with low self-esteem, as the feeling of not being able to live up to expectations plays a crucial role in both anorexia nervosa and bulimia nervosa," she said.

(Source: www.reuters.com)

Labels: eating disorder, bulimia, teen eating disorders, anorexia

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A group of 50 French lawmakers are demanding a law that would require published images to have bold printed notices stating whether they have been digitally enhanced. The lawmakers are hoping to protect women from false images of female beauty.

Valerie Boyer, one of the campaigning lawmakers who has written a government report on anorexia and obesity, commented on the importance of passing the law:

"We want to combat the stereotypical image that all women are young and slim ... These photos can lead people to believe in a reality that does not actually exist, and have a detrimental effect on adolescents ... Many young people, particularly girls, do not know the difference between the virtual and reality, and can develop complexes from a very young age ... In some cases this leads to anorexia or bulimia and very serious health problems ... It's not just a question of public health, but also a way of protecting the consumer."

(Source: dailymail.co.uk)

Labels: anorexia, media, obesity

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Psychiatrists in Britain are urging the British government to take steps against pro-anorexia ("pro-ana") and pro-bulimia ("pro-mia") websites.

In September 2008, the British government established the UK Council for Child Internet Safety to deliver recommendations regarding such websites made by Professor Tanya Byron in her report "Safer Children in a Digital World." Now, members of the Royal College of Psychiatrists' Eating Disorders Section claim the council's plans for action do not go far enough because they fail to specifically address pro-eating disorder websites.

This week, the Royal College published a position paper on the issue, requesting that the council increase its efforts by:

"Expanding its definition of harmful web content to include pro-eating disorder websites,
"Extending its plans to moderate Internet sites that promote harmful behavior to include pro-eating disorder websites, and
"Specifically addressing pro-eating disorder websites in its plans to raise awareness of e-safety among parents and teachers.

Professor Ulrike Schmidt, chair of the Royal College of Psychiatrists' Eating Disorders Section, commented:

The broader societal context in which pro-ana and pro-mia sites thrive is one where young women are constantly bombarded with toxic images of supposed female perfection that are impossible to achieve, make women feel bad about themselves and significantly increase their risk of eating disorders & Pro-ana websites normalise illness.

In much the same way, the catwalks of international fashion events such as London Fashion Week can act as a showcase for underweight women. We are very concerned that the lack of medical checks for models at London Fashion Week, coupled with working in an environment where being underweight is considered the norm, prevents models with eating disorders from gaining insight into their condition.

(Source: media-newswire.com)

Labels: anorexia, pro-anorexia, britian

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Approximately 50 percent of patients with a new cancer diagnosis and up to 70 percent of patients with advanced cancers may experience anorexia. A new study by Rudolph M. Navari, director of the University of Notre Dame's Walther Cancer Research Center, and Marie C. Brenner, a Notre Dame graduate who is a student at Loyola University Medical School in Chicago, indicates that a combination of two drugs shows promise in treating cancer-related anorexia (CRA). The researchers found that combining Olanzapine (Zyprexa) with megestrol acetate (MA) has resulted in weight gain for some patients suffering from CRA.

(Source: google.com/hostednews)

Labels: anorexia, cancer

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Researchers at Heidelberg University Hospital have used MRI technology to uncover the first glimpses of brain processes that may explain the eating disorder anorexia nervosa. Researchers examined 30 young women with and without anorexia using MRI technology. MRI-magnetic resonance imaging-was used to record the level of blood flow in different areas of the brain and evaluate key brain network pathways.

Researchers measured the capacity of each participant for flexible behavior modification of recently learned behavior. The young women were shown a sequence of geometric shapes in rapid succession and asked to match them. After one test run, the matching principle was changed. Dr. Hans-Christoph Friederich, head of the working group for eating disorders, commented on the findings:

"In this study, we confirmed that anorexic patients cling to familiar behavioral responses more frequently than healthy subjects, thus suppressing alternative behavior." Related to this finding, the MRI images also showed that "in patients with anorexia compared with healthy subjects, a certain network pathway between the cortex and the diencephalon is less activated. This network pathway plays a decisive role in initiating and controlling actions under rapidly changing environmental demands."

(Source: sciencedaily.com)

Labels: eating disorder, anorexia, mri

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Abnormalities in the brain circuitry of anorexics may help to explain the baffling symptoms of the eating disorder, according to a review paper published online this week in Nature Reviews Neuroscience. In the paper, Walter Kaye, MD, professor of psychiatry and director of the Eating Disorders Program at the University of California, San Diego, and colleagues discuss dysfunction in certain neural circuits of the brain which may help explain the origins of anorexia, and behaviors such as relentless dieting.

Study co-author Martin Paulus, UC San Diego Professor of Psychiatry and head of UC San Diego's Laboratory of Biological Dynamics and Theoretical Medicine, discusses the technology behind the findings: "Brain-imaging studies also show that individuals with anorexia have alterations in those parts of the brain involved with bodily sensations, such as sensing the rewarding aspects of pleasurable foods ... Anorexics may literally not recognize when they are hungry."

Dr. Kaye commented on the importance of the findings: "Currently, we don't have very effective means of treating people with anorexia. ... Consequently, many patients with the disorder remain ill for years or eventually die from the disease, which has the highest death rate of any psychiatric disorder. ... Anorexia is very complicated, and there needs to be a paradigm shift in understanding its underlying cause. ... We're just beginning to understand how the brain is working in people with this disorder."

(Source: www.sciencedaily.com)

Labels: anorexia, science

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Researchers at the Maudsley Hospital in London are exploring a theory that anorexia may not be a social or psychological phenomenon, but a genetic one. The London scientists have been studying autism and anorexia for several years, examining what the two disorders have in common. Although autism and anorexia appear very different on the surface - patients with autism struggle to connect with people in the outside world while anorexics are obsessed with other people's perceptions of them - the minds at Maudsley Hospital have identified some compelling similarities between the two conditions. For instance, both anorexics and autistic individuals exhibit obsessive behaviors and rigid thinking; tic disorders are fairly common among individuals in both populations; and both have trouble dealing with change. Researchers at Maudsley also found that 15 to 20 percent of anorexic patients may also have Asperger's syndrome, an autism spectrum disorder.

(Source: www.time.com)

Labels: eating disorder, anorexia, autism

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Some experts are promoting high-calorie, high-fat comfort foods as a way to help anorexic girls battle the eating disorder. Dr. Angela Celio Doyle, a University of Chicago clinical associate, comments on the new theory: "It is difficult to eat large amounts of low-calorie foods and get the calories needed to restore health, so turning to milkshakes and macaroni and cheese can be quite helpful. ... Many individuals attempting to gain weight after a period of malnourishment will need anywhere between 3,000 and 5,000 calories a day."

Recovering anorexics usually have very little stomach capacity, as their stomachs have shrunk over time as a result of never being full. Therefore calorie-dense foods, which provide maximum nutrition with minimum volume, may offer a way to deliver more nourishment more quickly.

A well-known eating disorder clinic in Evanston, Illinois, is putting this idea into practice. Registered dietician Oehme Soule encourages her patients to nourish themselves to help them recover and to help them learn new behaviors. She comments: "I say to them, 'First we'll get you nourished so you can think because I can't teach you to eat on a starving brain.' ... Fats have twice as many calories as protein or carbohydrates so it's a much faster route to nourishing. And if they can't eat, I can't teach them how to eat."

(Source: news.medill.northwester.edu)

Labels: eating disorder, anorexia, food

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Anorexia nervosa is a deadly eating disorder. It has the highest mortality rate of any psychiatric illness.

Historically, anorexia was believed to be induced by environmental factors such as home environment and social pressures. In the past few years, however, research has discovered that genetics play a significant role in the development of eating disorders. Experts currently estimate that 50 percent of the risk of developing an eating disorder is inherited.

In a recent story by a Denver-area news station, Dr. Ken Weiner said, "We know that there are multiple genes and they are closely related to anxiety, depression, and obsessive-compulsive disorders. ... If your mother or your sister has anorexia and you are a young woman, you are 12 times more likely to have anorexia nervosa in your lifetime and four times more likely to have bulimia nervosa."

Dr. Weiner was careful to say, however, that genes alone are not enough to trigger an eating disorder. "Genes load the gun, life pulls the trigger. With anorexia nervosa, if you never go on a diet or precipitously lose weight due to a medical condition, you never develop anorexia nervosa."

(Source: www.thedenverchannel.com)

Labels: eating disorder, anorexia, genetics

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March 11, 2009 marks the 105th anniversary of the birth of Hilde Bruch, one of the 20th century's groundbreaking experts on childhood obesity and anorexia. Dr. Bruch was born in a small town in Germany. As a young woman she wanted to become a mathematician, but an uncle convinced her that medicine was a more practical profession for a Jewish woman. In 1929, she earned her medical degree from the University of Freiburg. In 1933, she fled from Germany due to growing anti-Semitic sentiment and spent a year in England before immigrating to the United States.

In New York, she began working at Babies Hospital; here, she started groundbreaking research into obesity in children in 1937. In 1941, she left this area of research to study psychiatry at Johns Hopkins University in Baltimore, Maryland. Upon returning to New York in 1943, Dr. Bruch started a private psychoanalytic practice and joined the faculty of Columbia University's College of Physicians and Surgeons.

At Columbia, and later at Baylor College of Medicine in Houston, Texas (she joined the faculty in 1964), Dr. Bruch focused her research on the underlying causes of anorexia nervosa. Throughout her career, Dr. Bruch published academic and lay articles on eating disorders and saw patients in her private practice until she was 80. Dr. Bruch died in Houston in December of 1984. Her collected work was published in 1973 under the title Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within; it is still considered a definitive work. (Source: http://thisdayinjewishhistory.blogspot.com)

Labels: anorexia, childhood-obesity, research

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Halse Andersen, a National Book Award finalist and New York Times bestselling author, has written a young adult novel that may be an important read for anyone who is interested in the welfare of a teenage girl. The novel, Wintergirls, is narrated by Lia, an anorexic high school senior who has lost her best friend to a bulimia-related death. Lia, who is in the advanced stages of anorexia herself, believes that weighing 99 pounds at 5 feet 5 inches tall is "hideously fat." The novel reveals, among other important things, that young girls in America have access to surprising support to get and stay thin, including pro-anorexia chat rooms and websites that give tips on how to cut calories down to 500 per day (less than half of a young woman's required nutritional intake), as well as friends and classmates (Lia and her best friend vow to always be thin and support each other's eating habits). (Source: www.tampabay.com)

Labels: anorexia, girls

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Many people have trouble understanding anorexia. The solution can seem so simple - just eat! But, as many health experts know, anorexia is more complex than a simple choice or even a behavior. In the words of Marilyn Clark, a registered nurse and counselor with a small Canadian eating disorders treatment provider, "an eating disorder is not a behavior; it's an illness, an emotional illness." In other words, expecting an individual who suffers from anorexia to simply eat is like asking an individual with clinical depression to simply be happy. What people need to understand, Clark believes, is that "underneath all eating disorders is emotional turmoil." (Source: www.brantfordexpositor.ca)

Labels: anorexia, emotions, mental-illness

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A globally significant study, which began in 1985, concerning the behavior of teenagers suffering from anorexia nervosa has been published in both the British Journal of Psychiatry and the International Journal of Eating Disorders. This is the only study of its kind and has provided valuable information to compare against widely accepted statistics about anorexia nervosa.

Elizabeth Wentz, Associate Professor in Child and Adolescent Psychiatry at the Sahlgrenska Academy, comments, "This study is unique in an international perspective. It is the only study in the world that reflects the natural course of anorexia nervosa in the population."

The results show that 39 percent of the study group "have at least one other psychiatric disorder, in addition to the eating disorder. The most common of these is obsessive compulsive disorder." This study contrasts with the accepted fatality rate of 1 in 5 for anorexics, as not a single test subject in this study has died.

One encouraging finding that emerged from the study related to pregnancy of the test subjects. Because infertility is a commonly accepted side effect of anorexia nervosa, it is surprising that there was no difference in the number of births between the test group and the control group. Childbirth also appeared to have a routinely positive influence on anorexics.

(Source: www.eurekalert.org)

Labels: anorexia, mental-illness

Posted By: Contributor 0 Comments

Females with the eating disorder anorexia nervosa become dangerously underweight, and they actually lose gray matter in their brains. However, once they recover and regain weight, their brains recover too, according to a new study from Yale University.

• Dr. Christine Roberto and her colleagues used brain imaging technology to compare the brains of 32 adult female patients with anorexia to the brains of 21 healthy women.
• The women with eating disorders showed reductions in their brain volume at the beginning of the study.
• As they gained weight, they recover their loss of gray matter.
• Anorexia does not appear to affect the white matter in the brain. Dr. Roberto said she was unsure if such brain loss during anorexia nervosa had an effect on cognitive ability.

This study appeared in the International Journal of Eating Disorders.

 

Labels: anorexia, recovery

Posted By: Eating Disorders Blog 1 Comment

The beginning of Krista Phelps’s story is a familiar one: a great high school athlete with a promising academic and athletic future, preparing for her second state track meet. But before the story could get really good, it took a very bad turn.

Phelps, a Kingsely-Pierson (IA) sophomore who was just 16, died on Sunday … Phelps died from complications of anorexia …

The sudden death of a high school student sends a shock wave through a community. Grief counselors were brought in to help students and faculty cope. Our thoughts and prayers are with the family.

A longtime coach once told me about athletes with eating disorders: "John, anyone who’s coached girls' sports long enough knows of at least one." [Source: Des Moines (IA) Register]

As the final quote in the excerpt above indicates, several experts have noted an association between womens' athletics and eating disorders. Male athletes in some sports are also at increased risk.

 

Labels: anorexia, health, athletes, art, death

Posted By: Stefanie Hamilton 0 Comments

Anorexia’s devastating effects on the body are well-known and documented. Now, scientists have discovered that it affects the brain as well.

“A study published online this month in the International Journal of Eating Disorders compared changes in brain volume among 32 adult women with anorexia nervosa and a control group made up of 21 healthy women… At the beginning of the study, the women with anorexia had less gray matter volume than the healthy controls.” Source: LA Times]

The study used MRI scans to measure gray matter as the women with anorexia were treated and began gaining weight. Most saw an increase in gray matter volume as they gained weight, though the volume never reached levels considered normal for healthy adults.

 

Labels: anorexia, brain chemistry

Posted By: Stefanie Hamilton 0 Comments

Thirteen years ago, the crown princess of Sweden was trying to hide her eating disorder from the paparazzi. Suffering from anorexia nervosa, Princess Victoria grew thinner and thinner, even as the Swedish press printed pictures and articles of concern. She enrolled in the Yale University in United States, and sought treatment anonymously for her problems.

"I felt like an accelerating train, going right down during the whole period. I had eating disorders and was aware of it, my anguish was enormous. I really hated how I looked, how I was ... I, Victoria, did not exist. It felt like everything in my life and around me was controlled by others. The one thing I could control was the food I put in me."

This summer Victoria married her personal trainer, Daniel Wrestling, owner of the Balance Training gymnasiums. The press reported that the Princess looked "beautiful and fit "at their wedding in Stockholm's Storkyrkan Cathedral June 19.

Labels: anorexia

Posted By: Eating Disorders Blog 0 Comments

Anorexia nervosa is primarily a disease of the mind. Doctors have known this for years. Now, improvements in MRI technology are helping doctors focus in on the biological – and possibly genetic – links to the disease.

“In one study, participants were given a taste of sugar. In healthy people, the insula and frontal cortex areas of the brain lit up, signaling ‘Wow, that tastes good.’ That pleasure light didn’t turn on in the anorexic’s brain. Dr. [Walter] Kaye says they may literally not recognize when they’re hungry or when something tastes good.” [Source: KABC-TV (L.A.)]

Not only is the MRI enabling doctors to study brain activity and genetic traits that may make a person pre-disposed to anorexia, it also allows them to develop new biological treatments, and not just psychological ones.

 

Labels: anorexia, genetics

Posted By: Stefanie Hamilton 1 Comment

The bones of young girls suffering from anorexia nervosa have fat in the marrow, according to a new study from Children's Hospital Boston.

• Dr. Kirsten Ecklund and her colleagues performed MRIs on the knees of 20 girls with anorexia and 20 healthy girls whose average age was 16 years old.
• Radiologists reading their charts did not know which girls were in which group, and found that the anorexic girls had increased fat content or "yellow marrow" in their bones.

One theory is that the malnutrition caused by anorexia changes hormone levels, which in turn causes the bone marrow to stop producing bone-producing cells but to form fat instead. This may explain why people with anorexia lose bone mass. It is also known that many people with anorexia develop osteoporosis and are prone to fractures.

Anorexia nervosa is an eating disorder characterized by low food intake. An anorexic's weight can drop to a starvation level, but he yet perceives himself as overweight.

This study appears in the Journal of Bone and Mineral Research.

Labels: anorexia, health, research

Posted By: Jane St. Clair 1 Comment

People suffering from anorexia nervosa show decreased amounts of gray matter in their brains, according to a new study from Germany.

• Dr. Joos Kloppel and his colleagues used brain imaging technology to study the brains of 12 people with anorexia and 17 who are bulimic.
• The ones with bulimia did not show changes in the gray or white matter in their brains but the anorexics showed less volume in gray matter.
• One interesting finding of the study was that the subjects' scores on "drive for thinness" correlated with right inferior degree matter volumes in both the anorexic and bulimic subjects.

The study appears in the journal Neuropsychologist.

Labels: anorexia, brain chemistry

Posted By: Jane St. Clair 1 Comment

At first, Kitty Brown's parents thought she was just failing to gain enough weight to keep up with her growth in height.

Eventually, though, they learned that their teenage daughter had anorexia nervosa, a deadly eating disorder that kills people at a higher rate than any other psychiatric disorder, including schizophrenia and depression. Kitty's mother, Harriet, says her mantra became, "I love you and I'm not going to let you starve."

Kitty slowly recovered, although she had a relapse four years later.

The Browns' struggle with anorexia is recorded in the book, "Brave Girl Eating," published by William Morrow. The book has been the source of some controversy, as it promotes the Maudsley Approach, which encourages family members to take control of the eating habits of the eating disorder sufferer.

Research has shown that the human body does not tolerate being starved and then re-fed, and that process causes people to feel anxious, depressed and angry. This is often why anorexia is so difficult to treat. Many patients have to be put on feeding tubes if their weights and blood pressure levels drop to dangerous, life-threatening levels.
 

Labels: awareness, anorexia, maudsley approach

Posted By: Eating Disorders Blog 0 Comments

In a powerful post on the website of the Mona Shores (Michigan) High School newspaper, student journalist Kelley Wheeler recounts the story of anonymous eighth-grader's struggle with anorexia:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Eighth grade, for most students, makes them feel on top of the world. For one beautiful and talented girl, who agreed to tell her story on the condition of anonymity, eighth grade was a war of gossip and rude remarks that pushed her pain over the edge, causing her to start a dangerous habit of refusing to eat and of throwing up what she ate. This is her story. ...

I turned to an eating disorder and self-medicating for the control. This routine continued from eighth grade to the end of ninth grade. I would walk through the hallways at school, and no one knew what was going on inside of my mind and body, but at home, things were different.

My parents found out after awhile because I would drink green tea all the time and say that I wasn’t hungry. My parents were hurt, but they supported me in getting help. As for my friends, I kept it hidden pretty well, but it came to the time when I had to tell them. I only told two of my friends because I was going away for a while, and they needed to know why.

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Labels: awareness, anorexia

Posted By: Aspen Education Group 1 Comment