Summary: Healing patients with eating disorders is a multifaceted endeavor. Behavioral therapy is essential as is replenishing nutrient deficiencies. Zinc, amino acids (protein), fat soluble vitamins, magnesium, and B vitamins are recognized deficiencies in people with Anorexia and Bulimia Nervosa and can be critically valuable in healing the body and mind.
Healing Nutritional Deficiencies in Patients with Eating Disorders
It is estimated that 8 million girls/women in the United States have an eating disorder. (McGuire 2013) Treatment is usually multifaceted, including behavior and family therapy. Nutritional deficiencies should also be addressed.
A study of more than 2,400 individuals hospitalized for an eating disorder identified concurrent disorders in 97%: depression, anxiety, obsessive-compulsive, post-traumatic stress, substance abuse, and attention-deficit hyperactivity Click here. All these conditions can be associated with nutrient deficiencies.
Zinc, similar to calcium, is an extremely important mineral in the normal function of several hundred biological processes. It is required for proper cellular function in the endocrine, immune, and nervous systems. Zinc insufficiency is associated with neuropsychiatric manifestations that can present as altered cognition, behavior, and depression. (Petrilli, Kranz, Kleinhaus, Getz, Johnson, Chao, & Malaspina 2017) Deficiencies in zinc have been recognized as a major issue in patients with Anorexia Nervosa (AN) and Bulimia Nervosa (BN). (McClain 1992) Zinc is also involved in hundreds of enzyme reactions necessary for good health. Zinc is required for cell growth and protein synthesis, making zinc a major player in wound healing. (Murray 2005) Zinc deficiency may act as a “sustaining” factor for abnormal eating patterns. (McClain 1992) The most bioavailable zinc is found in animal protein, primarily meat but also oysters. Plant-based sources include legumes, whole-grain products, wheat germ, and nuts. (McGuire, Beerman 2013) A supplement of zinc picolinate (40-50 mg/day) can be taken with food. (Campbell-McBride 2010) Free-form amino acids (15-20 g/day) can also be supplemented to enhance healing and initiate synthesis of the most urgently needed enzymes, neurotransmitters, hormones, and other protein compounds. (Campbell-McBride 2010)
Dr. Natasha Campbell-McBride, a neurologist, nutritionist, and expert in digestive health, has suggested that eating disorders fall within her categorized GAPS (Gut and Psychology Syndrome) individuals. These individuals are malnourished, often severely. Nutritionally, the goal is to assist the individual by increasing exposure to protein, zinc, fat-soluble vitamins, magnesium, and B vitamins.
Since individuals with AN can be fearful of consuming calories, they should begin with adding bone broth to their diets. Bone broth is low in calories (50-70 kcal/cup), rich in essential amino acids and minerals, inexpensive, and easy to make. Bone broth can soothe and heal the gut, usually without much opposition from the patient. Educating each person on the value of grass-fed meats as cellular building blocks is critical. Organ meat is also extremely nutritious. Healthy fats can be added eventually to aid in absorbing vitamins A, D, E, and K. Whole foods (e.g., colorful vegetables and properly prepared legumes) provide digestive-tract-healing vitamins and minerals, but these foods need to be introduced slowly. Since fear of weight gain can sabotage any dietary regimen, the low-calorie content of these foods should be emphasized. Fear of eating too many calories is managed by starting with clear bone broths (one cup / hour). Over time, meat and vegetables should be added. Adding homemade whey, yogurt, or a teaspoon of sauerkraut juice also supports the healing process. Egg yolks, an excellent source of nutrients, can be added to the broth. (Campbell- McBride 2010)
Begin slowly. Talk with the patient to see how they are feeling as they try these new foods. Teach them how to listen to their bodies as they learn how to heal themselves. Typically, patients with eating disorders have become dissociated with their bodies. Not only is healing their bodies nutritionally imperative, but also helping them reconnect with their bodies is of utmost importance.
Sugary and processed foods can perpetuate malnutrition and the cycle of binging. Avoid such processed and/or packaged foods.
The process of healing takes time. Be patient. Allow for bumps in the road. These individuals, both women and men, need not only loving nutrition, but also loving patience from you as well as from themselves.
References:
Campbell-McBride, N. (2010). Gut and Psychology Syndrome, Natural Treatment for Medinform Publishing. Cambridge, UK
Jantz, G.L., McMurray, A. (2010). Hope, Help & Healing for Eating Disorders Waterbook Press, Colorado Springs, CO. McClain CJ, Stuart MA, Vivian B, McClain M, Alwalker R, Snelling L, Humphries L. Journal of American College of Nutrition (1992) Dec; 11(6):694-700. Zinc status before and after zinc supplementation of eating disorder patients. McGuire, M. & Beerman, K. A. (2013). Nutritional Sciences (3rd Edition) Cengage Learning, Belmont, CA
McQuaid, K. (2012). Approach to the Patient with Gastrointestinal Disease in Goldman’s Cecil Medicine, 24th edition, Elsevier Saunders, Philadelphia, PA 840
Petrilli, M.A, Kranz, T.M., Kleinhaus, K., Joe P., Getz, M., Johnson, P., Chao, M.V., Malaspina, D. The Emerging Role for Zinc in Depression and Psychosis Front Pharmacol Published online 2017 Jun 30. doi: 10.3389/fphar.2017.00414
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