Excerpted from The Diet Cure
By Julia Ross
Our grateful acknowledgement to Julia Ross for permission to reprint here
Has deliberately skipping meals evolved into occasional all-day fasting and eventually become compulsive fasting – or anorexia? You may have found how easily you can get rid of the food consumed during a “pig-out” by vomiting or taking diet pills or laxatives. The use of these purging methods can become more frequent as bulimia and addiction to diet pills and laxatives take over.
The high school and college girls that come to my lectures report that 60 to 80 percent of all the girls at their schools binge, purge, and starve on a regular basis. It is discussed openly; there is no real stigma left. In fact, many girls want to be anorectic. They are disappointed if they can’t throw up and become bulimic. In a 1995 University of Michigan study, 86 percent of the 557 incoming freshmen women were dieters. Three percent were bulimic. Within six months, an additional 19 percent of the dieters had become bulimic. In total, 22 percent of freshmen girls were bulimic within six months of entering college. Although this study ended at six months, we can assume a continued increase in bulimia and the emergency of anorexia among these dieting students over time.
Puberty and adolescence are especially dangerous times for under-eating because the body is still growing. During this critical period, rapidly developing bodies already require at least 2,500 high-quality calories per day, yet many girls, if not most, at this age try to limit themselves to fewer than 1,000 calories a day, and often those are junk-food calories. This starvation dieting can quickly develop into compulsive eating, bulimia, and anorexia. In fact, two 14-year-old anorectic girls came to the Recovery Systems clinic recently. Their eating disorders had started after their very first diets.
As with anorexia, bulimia is rooted in the dieting mentality. Miranda’s story is a sadly typical one. A 24-year-old beauty with a well-proportioned and muscular body, Miranda found herself close to the upper weight limit for her height. (Muscle is heavier than fat.) She had never dieted in her life, but when she went to flight attendant training school, she noticed that most of the other trainees were regular dieters. At the school, which served fast food, she did not get her usual nutritious food or her usual exercise. She found herself gaining a little weight. Concerned that she might go over the weight limit, she began skipping meals. Soon her starving had turned to binging and vomiting. By the time she left the training, only two months later, she had developed unbearable sweet cravings and was binging and purging three to five times per day. I’m happy to say that, through using the supplements outlined in chapter 10 and following the Diet Cure plan, many bulimic women like Miranda have been able to return to their original weight and health.
Why is it so easy to become a bulimic? One reason is that both binging and vomiting can trigger waves of the potent brain chemicals – the endorphins. The release of these natural heroin-like brain chemicals helps establish the powerful compulsions that bulimics are helpless to fight. When we develop false ideas about what we “should” weigh and begin dieting, we open ourselves up to the possibility of developing an eating disorder, just as Miranda did.
A growing number of woman – and men – are forced by the dieting mentality into the danger zone of anorexia. They have literally lost their appetites as well as weight. No longer protected by healthy rebound food cravings, they never get to the point where they “just have to have a cheeseburger.” When very low-calorie dieting becomes a way of life, so does the descent through the levels of starvation.
A few months into her first-ever diet, 14-year-old Courtney developed most of the symptoms of full-blown anorexia. She was chronically sick with colds and flu, lost her period, and was too weak to exercise. She quit going out with her friends and just stayed at home. She developed radical mood swings that included irritability, hysteria, and insomnia. Soon it became easy for her to starve: an apple could last her all day.
Courtney’s symptoms are classic signs of malnutrition. In the concentration camps, the starving prisoners made tiny amounts of food last all day, too. How do the starving survive? How do anorectics endure working out for hours each day in the gym, like the Nazi’s slave laborers?
Most of the anorectics that I have worked with actually get high on starvation. Anorexia triggers the same kind of powerful high that opiates like heroin give to drug users. How do we know? When anorectics are given drugs that prevent opiates from affecting them, they go into a sudden withdrawal, just as heroin users do. Their highs are cut off. It turns out that anorectic starvation, like bulimic vomiting and binging, is a traumatic experience that can stimulate a deep survival mechanism; the release of endorphins, the powerful, natural druglike chemicals that allow us to experience pleasure. They also kill pain and ease stress. If your body has become addicted to these natural opiates and you resume normal healthy eating, you will miss the endorphin highs. Like laboratory monkeys who pull the level that gives them heroin in preference to food and drink until they die, an anorectic will ferociously defend her refusal to eat for powerful biochemical reasons. Bulimics binge and refuse to keep food down with a similar ferocity for the same reasons. This obsessive behavior is actually caused by nutritional deficiencies – which, thankfully, we now know how to address.
How Vitamin and Mineral Deficiencies Can Lead to Anorexia
Let’s take just two vitamin and mineral deficiencies commonly caused by low-calorie dieting and trace their course as they trigger the symptoms of eating disorders.
Vitamin B1 (thiamin). Easily depleted by undereating, this is one of the nutrients that your body cannot make itself, so you must get B1 from foods, primarily the whole foods that chronic dieters and people with eating disorders rarely eat enough of: beans, whole grains, seeds, meats, and vegetables.
Common Early Symptoms of Thiamin Deficiency
· Loss of appetite
· Reduced weight
· Abdominal discomfort
· Constipation
· Chest pain
· Anxiety
· Sleep disturbance
· Fatigue
· Lack of well-being
· Depression
· Irritation
At some point in your dieting, your B1 levels may have dropped into the danger zone. You were still the same person, but one day you had just enough B1, the next day you didn’t, and the symptoms of anorexia began to erupt like sores do on the skins of people with vitamin C deficiency. Anorexia actually just means “loss of appetite.” When a condition such as vitamin B1 deficiency kills your appetite, you eat less, particularly if you are dieting to begin with. Suddenly dieting becomes easy. You aren’t fighting a normal appetite anymore. You lost it when you lost too much vitamin B1 from dieting. We literally are what we don’t eat. You can’t control what is lost in a diet. It isn’t just your body fat that gets lost, it’s your muscle and bone, and brain tissue, too. Anorectics have empty spaces that show up on brain scans where they have literally lost brain weight.
Zinc. The mineral zinc is hard to find in foods, even when we are not dieting. Red meat, egg yolk, and sunflower seeds are high in zinc. But these are fatty foods, and red meat has a bad name, so they are not likely to be included in dieters’ meals. According to eating disorders specialist and nutrition researcher Alex Schauss, Ph.D., study results from Stanford University, the University of Kentucky, and the University of California at Davis agreed that most anorectics, and many overeaters and bulimics, were zinc deficient. The influential mineral zinc is the second most abundant trace element in the body. A classic symptom of zinc deficiency is loss of normal appetite. Without enough zinc, the body can register only extreme sweetness, saltiness, or spiciness as having any taste. Simple, healthy food becomes unappetizing. In anorectics, little or no appetite remains at all. Other common zinc-deficiency symptoms are apathy, lethargy, retarded growth, and interrupted sexual development. One five-year study, reported by Dr. Schauss, showed an astounding 85 percent recovery rate for anorexia in patients given zinc supplementation. It concluded: “The zinc supplementation resulted in weight gain, better body function and improved outlook.” At Recovery Systems we, too, have had success using zinc (along with other nutrients) to help stop the cravings of overeaters and bulimics as well as the appetite loss of anorectics. Clients report that junk foods actually begin to be repellent and sweets “too sweet” once they have taken enough zinc.
It’s especially important for teens to get enough zinc. During puberty, reproductive development is at its height. Zinc is crucial for reproductive function as well as appetite, immune function, and mental clarity. If dieting reduces the supply of zinc and other minerals at this nutrient-demanding growth stage, not only can appetite disappear but eventually a girl’s menstruation may taper off, along with her mental function, as an eating disorder sets in. In boys and men, zinc is a key ingredient in sperm and protects against prostate problems as well as weak immunity.
Protein Malnutrition Causes Brain-Power Outage
As the activity of the brain shrinks with dieting, the brain’s mental and emotional stability can falter – even fail. (You can recognize brain chemistry deficiency by its very specific symptoms, such as depression, anxiety, irritability, obsessiveness, and low self-esteem.) My clients who are dieters or have eating disorders always suffer from mood problems, caused primarily by protein malnutrition. The four brain chemicals that dictate your moods are all derived from the amino acids in protein foods. Even nondieters who tend not to eat enough protein can suffer from low-protein brain drain.
Tryptophan Depletion: The Path to Depression, Low Self-esteem, Obsession and Eating Disorders
Serotonin, perhaps the most well known of the brain’s four key mood regulators, is made from the amino acid L-tryptophan. Because few foods contain high amounts of tryptophan, it is one of the first nutrients that you can lose when you start dieting. A new study shows that serotonin levels can drop too low within seven hours of tryptophan depletion. Let’s follow this single essential protein (there are nine altogether) as it becomes more and more deeply depleted by dieting. To see how decreased levels of even one brain nutrient might turn you toward depression, compulsive eating, bulimia, or anorexia.
In his best seller, Listening to Prozac, Peter Kramer, M.D., explains that when our serotonin levels drop, so do our feelings of self-esteem, regardless of our actual circumstances or accomplishments. These feelings can easily be the result of not eating the protein foods that keep serotonin levels high. As their serotonin-dependent self-esteem drops, girls tend to diet even more vigorously. “If I get thin enough, I’ll feel good about myself again!” Tragically, they don’t know that they will never be thin enough to satisfy their starving minds. Extreme dieting is actually the worst way to try to raise self-esteem because the brain can only deteriorate further and become more self-critical as it starves. More and more dieters worldwide are experiencing this miserable side effect of weight reduction on the brain.
When tryptophan deficiency causes serotonin levels to drop, you may become obsessed by thoughts you can’t turn off or behaviors you can’t stop. Once this rigid behavior pattern emerges in the course of dieting, the predisposition to eating disorders is complete. Just as some low-serotonin obsessive-compulsives wash their hands fifty times a day, some young dieters may begin to practice a constant, involuntary vigilance regarding food and the perfect body. They become obsessed with calorie counting, with how ugly they are, and on how to eat less and less. As they eat less, their serotonin levels fall farther, increasing dieters’ obsession with undereating. As their zinc and B vitamin levels drop low as well, their appetite is lost. This can be the perfect biochemical setup for anorexia.
What so many therapists and others have observed as the central issue of “control” in anorexia often comes down to this: just as vitamin C deficiency (scurvy) results in an outbreak of red spots, do does tryptophan (and serotonin) deficiency result in an outbreak of the obsessive-compulsive behavior that we call “control.” There may be psychological elements in the picture, too, but a low-serotonin brain is ill equipped to resolve them.
Tryptophan, Serotonin, Compulsive Overeating, and Bulimia
For reasons we don’t entirely understand, some dieters who serotonin levels drop lose self-esteem and become obsessed with weight loss, but do not lose their appetites. On the contrary, their appetites expand. In the late afternoon and evening, especially in winter and during PMS (low serotonin times for all of us), they can become ravenous and binge on sweets and starches.
One of our clients ate regular breakfasts and lunches but dreaded her evenings, when she would binge on ice cream and cookies, whether she had eaten a normal dinner or not. Terrified of weight gain, she would throw up as soon as she ate.
In one study, bulimics were deprived of the single protein tryptophan. In reaction, their serotonin levels dropped and they binged more violently, ingesting and purging an average of 900 calories more each day. In another study, adding extra tryptophan to the diet reduced bulimic binges and mood problems by raising serotonin levels. Most recently, an Oxford researcher, Katherine Smith, reported that even years into recovery, bulimics can have a return of their cravings and mood problem after only a few hours of tryptophan depletion. She concluded, “Our findings support suggestions that chronic depletion of plasma tryptophan may be one of the mechanisms whereby persistent dieting can lead to the development of eating disorders in vulnerable individuals.
Note that most compulsive eaters do not vomit. They keep it all down. But dieting can lower their serotonin levels, too, causing the same wild cravings and self-hate that bulimics suffer.
As we trace the fate of only one depleted nutrient, tryptophan, and the brain chemical made from it, serotonin, you can again see how easily a dieter can develop an eating disorder. If you consider how many other critical brain and body chemicals are depleted through dieting, you have a more profound appreciation of the dangers you are risking on low-calorie diets.