Hyperinsulinemia And Anorexia?
In the course of a discussion over at Jimmy Moore's forum I came across something I did not know. Anorexics -- the thinnest among us! -- can also become hyperinsulinemic!!!! How can that be?? If it's all about the insulin causing fat accumulation, one would think this condition would result in any dietary intake getting trapped in the fat tissues, making it unavailable to the anorexic for fat-burning, resulting in voracious hunger. But we would expect the anorexic to have very low postprandially-induced insulin levels. No matter what they eat, they don't eat much. So, where is this insulin coming from? It would seem to be, yet again, a defense mechanism of our bodies. I've come across quite a bit of contradictory observations on this. For example, in this article, anorexics had lower postprandial insulin responses and higher metabolic rates of insulin clearance and describe anorexia as being associated with improved insulin sensitivity. They also have decreased basal insulin levels. The authors propose this is an adaptive mechanism to protect the anorexic from hypoglycemia. Here is another article describing improved insulin sensitivity in anorexia. The hormonal levels from that study are shown below. A brief review is made of the role of insulin in satiety and in the control of body weight, and of the newly available techniques to accurately quantify secretion, hepatic extraction, and post-hepatic delivery rates of insulin. Neural, metabolic, and endocrine stimuli affect insulin secretion. The hypothesis is therefore compatible with several etiologic factors leading to hyperinsulinemia in anorexia nervosa and major depression, and resulting in decreased food intake and weight loss. There's also this case study (can't find anything of this paper) How does the hyperinsul Continue reading >>
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In people with eating disorders, hypoglycemia is common. Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body’s main energy source. Hypoglycemia is also called low blood sugar, occurs when your blood glucose (blood sugar) level drops too low to provide enough energy for your body’s activities. Hypoglycemia can have these effects on your brain: Confusion, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as double vision and blurred vision Seizures, uncommonly Loss of consciousness, uncommonly Hypoglycemia may also cause these other signs and symptoms: Heart palpitations Tremor Sweating Hunger Severe hypoglycemia is an important but uncommon complication of anorexia nervosa. It is primarily diagnosed through blood work. According to the Archives of Internal Medicine, in rare cases, patients with anorexia nervosa can go into a hypoglycemic coma and die. Continue reading >>
Physical Dangers And Effects Of An Eating Disorder
IN ENGLISH :: EN ESPAÑOL :: EN FRANÇAIS Dangers :: Deficiencies :: Substitutes Pregnancy :: Medic Alert :: Methods Heart Attack & Stroke Physical Dangers and Effects of an Eating Disorder There are many men and women suffering with all types of Eating Disorders that do not appear in any specific weight range. Those with Anorexia can be slightly overweight... while those with Compulsive Eating can be slightly underweight. Variations for all who suffer can be anywhere from extremely underweight to extremely overweight to anywhere in between. The outward appearance of anyone with an Eating Disorder does NOT dictate the amount of physical danger they are in, nor does is determine the emotional conflict they feel inside. They need not display even close to all of the below symptoms to be in danger. Behaviors Associated with Eating Disorders Starvation and restriction of food, calories and/or fat grams sometimes accompanied by self-induced vomiting, laxatives, diuretics and obsessive exercise with any food intake, or without food intake at all. also see definitions of: Anorexia | Bulimia | Compulsive Overeating Binge and Purge episodes - abnormally large intake of food followed by self-induced vomiting, intake of laxatives or diuretics, obsessive exercise and/or periods of starvation. also see definitions of: Anorexia | Bulimia | Compulsive Overeating Overeating. Binge Episodes - abnormally large, uncontrollable intake of food. also see definitions of: Anorexia | Bulimia | Compulsive Overeating ALL Eating Disorders are Dangerous It is important to understand that even though a person may be suffering specifically with Anorexia, Bulimia or Compulsive Overeating, it is not uncommon for them to exhibit behaviors from each of the three. It is also not uncommon for one Eating Di Continue reading >>
What Research Is Being Done On Hypoglycemia And Bulimia?
Question: A friend of mine has hypoglycemia (it runs in her family) as well as bulimia. Is there any cure or clinical study being done on these medical problems? Dr. Hibberd's Answer: Cures are wonderful, but so often in medicine we need to settle for control while the mechanisms of disease are investigated with a cure as our ultimate target. There are a wide variety of conditions associated with bulimia and hypoglycemia, and while some victims will be cured, many may need to settle for less. Bulimia nervosa is characterized by recurrent episodes of binge eating followed by self-induced vomiting, laxative or diuretic abuse, vigorous exercise, or fasting. Most patients are normal weight as opposed to the emaciated weight loss seen in anorexia nervosa. Complications usually result from the purging behaviors. Electrolyte and renal disorders frequently exist in chronic bulimic patients, and may occasionally be life-threatening. Bulimia usually responds to cognitive behavioral therapy and SSRI medication (antidepressants). Symptomatic hypoglycemia (low blood sugar of less than 50 mg/dl) is not common in bulimia despite the binge/purge cycle that is so typical, mainly because the body has extensive counter-regulatory mechanisms for low blood glucose levels. Patients who are pre-diabetic, diabetic on insulin, and suffer from Addison’s disease or other endocrine dysfunctions, are often victimized by hypoglycemia especially with a precipitating binge cycle. Usually a five-hour glucose tolerance test will unmask symptomatic hypoglycemia. If confirmed, an evaluation for underlying conditions is indicated. Rarely, a 72-hour fast performed in a controlled setting is needed to evaluate hypoglycemia. Recurrent hypoglycemia should be investigated and treated. This is especially true Continue reading >>
Hypoglycemia May Be The Cause Of Death In Anorexia Nervosa
By: Jennifer L. Gaudiani, MD, CEDS Hypoglycemia is a medical term that refers to low blood glucose levels. In effect, a healthy body will metabolize what you eat and break down carbohydrates into sugars, which are absorbed into your bloodstream and form a key nutritional element – glucose -- needed by your cells. The brain in particular can only run on glucose -- not on protein or fat. In between eating, when you’ve fully metabolized your last meal, your liver synthesizes glucose for you and puts it into your bloodstream, so that you always have sufficient blood glucose levels to fulfill your body’s need. To go over all the ways blood sugar goes awry would take textbooks! But let’s talk about what can happen in anorexia nervosa. With anorexia, the liver becomes depleted of the chemical building blocks needed to create glucose, as well as depleted of glycogen, which is key to maintaining a good blood sugar. That means between meals—and for people with eating disorders, those meals are often inadequate, calorie-poor, and imbalanced—your body may stop being able to sustain blood sugar. What the longest “fast” during a 24 hour period? Nighttime. So blood glucose levels can be particularly low early in the morning hours when you’re asleep. Some people get symptoms when they have low blood sugar—sweats, shakes, lack of concentration, irritability—but others have no symptoms at all. Regardless of whether you get symptoms, hypoglycemia can be deadly. If your brain and heart are deprived of sufficient glucose for long enough, they will incur permanent damage. The heart can stop, or you can stop breathing, you can become comatose, or you can get brain damage. Unfortunately, it’s not well known in the medical world that anorexia nervosa carries a serious ri Continue reading >>
What Makes Blood Sugar Levels Get Low?
Hypoglycemia (low blood sugar) is uncommon in persons without diabetes. In otherwise healthy adults, fasting (lack of food) is the most common cause of low blood sugars. Medications such as insulin and drugs like alcohol are other primary culprits. Adults who are critically ill can also develop low blood sugars. In rare instances, hormonal disorders or tumors can be the problem. If for any reason you believe you are having symptoms related to low blood sugar that do not improve after eating, see a doctor for help. Hypoglycemia occurs for a variety of different reasons. Certain medications may cause hypoglycemia like insulin taken to lower the blood sugar in people with diabetes. If you have diabetes, your eating, exercising, and medication must be carefully balanced to keep your blood sugar within the normal range. Too much exercise or not enough food, relative to your medication, can cause low blood sugar. In people who do not have diabetes, certain medications, drinking alcoholic beverages, eating disorders, and tumors can cause hypoglycemia. Problems with your liver, kidneys, or the endocrine system may cause hypoglycemia. Sometimes hypoglycemia may occur when the body makes too much insulin in response to eating. A tendency toward hypoglycemia can be hereditary, but dietary carbohydrates usually play a central role in its cause, prevention, and treatment. Simple carbohydrates, or sugars, are quickly absorbed by the body, resulting in a rapid elevation in blood sugar level; this stimulates a corresponding excessive elevation in serum insulin levels, which can then lead to hypoglycemia. Insulin is the hormone responsible for lowering blood sugar by taking sugar out of the blood and putting it into cells. High levels of insulin mean low levels of blood glucose. Normal Continue reading >>
Common Health Problems When Recovering From Eating Disorders And Type 1 Diabetes
This article first appeared on Walden Behavioral Care's Blog and was written by WAD's Social Media Expert Amy Gabbert- Montag. When I first started eating disorder treatment in 2008, I had an idea of what it would be like: I would go see a therapist for a month or so, they would tell me what was wrong with me, instruct me on how to fix it, and I would magically stop using eating disorder symptoms. I expected I would be done with treatment in a month or two. Of course, that was not the case. In reality, eating disorder treatment is arduous, often lengthy, and full of ups and downs. In addition to seeing a therapist to work on mental health issues, an important part of treatment is mending your physical health. When I look back, I wish I would have known what to expect physically during that time. While there are more resources now than there was when I entered treatment in 2008, there is still a lack of information about ED-DMT1 (eating disorder and diabetes metillus type 1) and how it differs from other eating disorders. Many of the individuals I speak with who struggle with diabetes and an eating disorder have shared their distress when reintroducing insulin into their bodies, and how they wish they’d have known that some of the changes they experienced were to be expected. Here are some common issues that people in treatment with ED-DMT1 encounter: 1. Insulin edema Perhaps one of the most difficult initial hurdles to overcome when in treatment with ED-DMT1 is insulin edema or water retention. Water usually collects in the lower extremities and sometimes your midsection. Due to the constant state of dehydration due to high blood sugars, the body may want to hold on to as much water as possible.Additionally, the extra water is needed to aid in cell repair and to regul Continue reading >>
If anorexia nervosa isn't treated, it can lead to a number of serious health problems. In some cases, the condition can even be fatal. Other health problems Long-term anorexia can lead to severe complications and health problems, often as a result of malnutrition. Some complications may improve as the condition is treated, but others can be permanent. Health problems associated with anorexia include: problems with muscles and bones – including weakness, fragile bones (osteoporosis) and problems with physical development in children and young adults sexual problems – including absent periods and infertility in women, and loss of sex drive and erectile dysfunction in men problems with the heart and blood vessels – including poor circulation, an irregular heartbeat, low blood pressure, heart valve disease, heart failure and swelling in the feet, hands or face (oedema) problems with the brain and nerves – including fits (seizures) and difficulties with concentration and memory other problems – kidney damage, liver damage, anaemia and low blood sugar (hypoglycaemia) Some people with anorexia develop another eating disorder called bulimia nervosa. This is where a person binge eats and then immediately makes themselves sick, or uses laxatives to rid their body of the food. Pregnancy complications If you have anorexia and are pregnant, you'll need to be closely monitored during pregnancy and after you've given birth. Anorexia during pregnancy can increase the risk of problems such as: giving birth early (premature birth) having a baby with a low birth weight You're also likely to need extra care and support during pregnancy if you previously had anorexia and recovered from it. Next review due: 01/01/2019 Continue reading >>
Hypoglycemia In Non-diabetic Cats
If your kitty has hypoglycemia, it means her blood sugar has dropped so low she is having neurological symptoms because her brain isn't getting enough fuel. Hypoglycemia is a symptom, not a disease, and is almost always related to diabetes. But even if your cat isn't diabetic, hypoglycemia in a kitty is always a medical emergency. Copious Vomiting Your non-diabetic cat can have an episode of hypoglycemia if she has an insulin spike. The most common cause of natural insulin spikes is excessive vomiting following a meal. Your kitty's pancreas naturally releases insulin at mealtime to break down her food. When the food comes back up, the excess insulin causes a sudden blood glucose drop. In this case, you'll have to find and treat the cause of vomiting after you stabilize her blood sugar levels. Anorexia Anorexia doesn't mean your kitty's starving herself to fit into that prom dress. In animals, anorexia refers to any refusal to eat for a prolonged period, regardless of the cause. Parasites, bacterial and viral infections, tumors, organ diseases, pain and stress can all cause anorexia. Hypoglycemia can result directly from your kitty's anorexia -- her body simply uses up all its fuel -- or it can be the result of anorexia-induced liver damage. Loss of fuel kills off liver cells, which screws up blood insulin levels, resulting in screwed up levels of glucose. Infections and Tumors Liver and pancreas diseases are major culprits when it comes to hypoglycemia in non-diabetic cats. Any infection or toxin-related damage to these organs can cause an insulin spike and glucose plummet. If your kitty has been accidentally exposed to any poisons or a medication overdose right before a hypoglycemic episode, suspect liver damage. If she's vomiting bile (yellow or green slime), suspect Continue reading >>
Anorexia Nervosa – Medical Complications
Go to: Abstract In contrast to other mental health disorders, eating disorders have a high prevalence of concomitant medical complications. Specifically, patients suffering from anorexia nervosa (AN) have a litany of medical complications which are commonly present as part of their eating disorders. Almost every body system can be adversely, affected by this state of progressive malnutrition. Moreover, some of the complications can have permanent adverse effects even after there is a successful program of nutritional rehabilitation and weight restoration. Within this article we will review all body systems affected by AN. There is also salient information about both, how to diagnose these medical complications and which are the likely ones to result in permanent sequelae if not diagnosed and addressed early in the course of AN. In a subsequent article, the definitive medical treatment for these complications will be presented in a clinically practical manner. Keywords: Anorexia nervosa, Medical, Complications, Gastrointestinal, Cardiac, Osteoporosis Go to: Background Anorexia nervosa and bulimia are both inherently associated with many different medical complications. This review article is part one of a planned three part series of articles in this regard. We will focus solely on the medical complications associated with restricting anorexia nervosa. Part two of this series will be devoted to the medical complications associated with bulimia nervosa and, the third paper will discuss the treatments currently available for the medical complications of both anorexia nervosa and bulimia. Some of this information is based on experienced clinical opinion. Anorexia nervosa is associated with numerous general medical complications . The complications affect almost all major Continue reading >>
Consequences Of Eating Disorders
Psychosocial: Eating disorders profoundly impact an individual's quality of life. Self-image, relationships, physical well-being and day to day living are often adversely affected. Eating disorders are also often associated with mood disorders, anxiety disorders, and personality disorders. Bulimia nervosa may be particularly associated with substance abuse problems. Anorexia nervosa is often associated with obsessive-compulsive symptoms. The scope of related problems associated with eating disorders highlights the need for prompt treatment and intervention. Medical: The process of starvation associated with Anorexia Nervosa can affect most organ systems. Physical signs and symptoms include but are not limited to constipation, abnormally low heart rate, abdominal distress, dryness of skin, hypotension, fine body hair, lack of menstrual periods. Anorexia Nervosa causes anemia, cardiovascular problems, changes in brain structure, osteoporosis, and kidney dysfunction. Self-induced vomiting can lead to swelling of salivary glands, electrolyte and mineral disturbances, and enamel erosion in teeth. Laxative abuse can lead to long lasting disruptions of normal bowel functioning. Complications such as tearing the esophagus, rupturing the stomach, and developing life-threatening irregularities of the heart rhythm may also result. Medical Issues: General Physical Dangers: Sometimes those suffering with Anorexia and Bulimia do not appear underweight - some may be of "average" weight, some may be slightly overweight, variations can be anywhere from extremely underweight to extremely overweight. The outward appearance of a person suffering with an eating disorder does not dictate the amount of physical danger they are in, nor does is determine the severity of emotional conflict they Continue reading >>
What Is Reactive Hypoglycemia?
“What do you mean dinner isn’t ready yet?”, I ask in an aggressive, irritated tone and I can feel my eyes flooding with tears. I am trying to stay calm but I am so angry. My husband has seen this before. “When was the last time you ate?”, he asks as he hands me a few slices of cheese.I grab the food with shaky fingers and wolf it down. I close my eyes and wait for the surge of glucose through my blood stream. I am breathing steadily again. My anger, along with my pounding headache are slowly going away. “About four hours ago.”, I say.”That’s too long, sweetie.” he says gently as he is leading me to the couch.”I know, I know.” I retort sadly, “I just wish I could last without food for a couple of hours and not turn into a monster!” Have you experienced this before? How about confusion, irritability, impatience, shakiness or the inability to compete simple tasks when you miss a meal or just haven’t eaten in a couple of hours? If you or someone close to you who has, let me share what I have learned about this condition. These symptoms are characteristic of hypoglycemia (not to be confused with hyperglycemia, i.e. high blood sugar levels – a very different medical condition we will not be exploring today). What is Hypoglycemia? There are two varieties of hypoglycemia in non-diabetic individuals: Fasting Hypoglycemia and Reactive Hypoglycemia. Fasting Hypoglycemia According to Balch (1997) Fasting Hypoglycemia is rare and is caused by pathogens or disease. Examples of causes include pancreatic tumors, liver disease, adrenal malfunction, thyroid disorders, pituitary disorders, food sensitivities, and allergies. Reactive Hypoglycemia Reactive Hypoglycemia (aka idiopathic postprandial hypoglycemia or functional hypoglycemia) is a condition first Continue reading >>
Hypoglycemia In Adults: Clinical Manifestations, Definition, And Causes
INTRODUCTION In patients without diabetes, hypoglycemia is a clinical syndrome with diverse causes in which low plasma glucose concentrations lead to symptoms and signs, and there is resolution of the symptoms/signs when the plasma glucose concentration is raised . In patients with diabetes, hypoglycemia is defined as all episodes of an abnormally low plasma glucose concentration (with or without symptoms) that expose the individual to harm . In patients with diabetes, the hypoglycemia symptoms and signs occur as a consequence of therapy. The primary task in a patient without diabetes is to make an accurate diagnosis, whereas the primary task in a patient with diabetes is to alter therapy in an attempt to minimize or eliminate hypoglycemia. This topic will review the clinical manifestations, definitions, and causes of clinical hypoglycemia. The evaluation of patients with hypoglycemia, detailed information on specific causes, and the management of hypoglycemia in patients with diabetes are reviewed elsewhere. (See "Hypoglycemia in adults without diabetes mellitus: Diagnostic approach" and "Insulinoma" and "Factitious hypoglycemia" and "Nonislet cell tumor hypoglycemia" and "Management of hypoglycemia during treatment of diabetes mellitus".) Patients who have only sympathoadrenal symptoms (anxiety, weakness, tremor, perspiration, or palpitations) but normal concurrent plasma glucose concentrations have a low probability of having a hypoglycemic disorder. This combination of normal glucose in the face of sympathoadrenal symptoms occurs most commonly in the postprandial state. (See "Postprandial (reactive) hypoglycemia", section on 'Postprandial syndrome'.) EPIDEMIOLOGY Hypoglycemia is common in type 1 diabetes, especially in patients receiving intensive insulin ther Continue reading >>
Hunger In A Person Experiencing An Eating Disorder
The scale described below is as follows: 0 =no hunger 2.5 =minimal hunger 5 = moderate hunger 7.5 =moderately intense hunger 10 =intense hunger Normal Hunger A person, who has a normal relationship with food, may fluctuate on the hunger scale between a 0 for no hunger and approximately a 5 for moderate hunger. This person may eat approximately five times a day. Hunger in Anorexia Nervosa A person with anorexia nervosa may stay between a 4 and a 10 on the hunger scale. To avoid eating, this person may drink low calorie beverages, eat low-calorie foods or take stimulants, gum, etc. The avoidance of food usually occupies the entire day at frequent intervals. Sleep is disrupted secondary to intense hunger and food related dreams. Physical Challenges When a person with anorexia begins to monitor their hunger it can be difficult because they are accustomed to ignoring body signals and talking themselves out of hunger. Also, if this person is at a low body weight (malnourished) they may have an insatiable appetite even while giving themselves full permission to eat. Therefore, they may feel they are obsessed with food but in reality it is their bodies natural response to starvation. Practical Information Constant hunger can be scary because the person may feel that it will never go away and they will gain weight excessively. It is helpful to reassure the person that their unusual hunger will decrease as their body returns to healthy state. It is also important to encourage the person not to initiate any purging behaviors. Reviewing some of the physical challenges (in the Bulimia section below) may help to discourage those behaviors from starting. Hunger in Bulimia Nervosa Hunger, in a person with bulimia, will fluctuate between both ends of the scale because the person avoids Continue reading >>
What Is Hypoglycemia?
Lots of people wonder if they have hypoglycemia (pronounced: hy-po-gly-SEE-mee-uh), but the condition is not at all common in teens. Teens who do have hypoglycemia usually have it as part of another health condition, such as diabetes. Hypoglycemia happens when a person's blood sugar levels are abnormally low, and it's a potentially serious condition. If you know someone who has diabetes, you may have heard them talk about "insulin shock," which is the common name for a severe hypoglycemic reaction. The body's most important fuel is glucose, a type of sugar. When you digest most foods, sugar is released, and that sugar ends up in your bloodstream as glucose. Your body, particularly your brain and nervous system, needs a certain level of glucose to function — not too much, and not too little. If your blood glucose level isn't right, your body will react by showing certain symptoms. People with diabetes may experience hypoglycemia if they don't eat enough or if they take too much insulin — the medicine most commonly used to treat diabetes. What Are the Symptoms? Some symptoms of hypoglycemia are caused when the body releases extra adrenaline (epinephrine), a hormone that raises blood sugar levels, into the bloodstream to protect against hypoglycemia. High blood levels of adrenaline can make the skin become pale and sweaty, and a person can also have symptoms such as shakiness, anxiety, and heart palpitations (a fast, pounding heartbeat). Other symptoms of hypoglycemia are caused when not enough glucose gets to the brain; in fact, the brain is the organ that suffers most significantly and most rapidly when there's a drop in blood sugar. These symptoms include headache, extreme hunger, blurry or double vision, fatigue, and weakness. At its most severe, insufficient gluco Continue reading >>