Anorexia may be more metabolic than mental, scientist argues []

By Stephanie Pappas

Anorexia may be a disorder more of the metabolism than the mind, according to a new paper that argues the disease is a sort of cousin of diabetes.

But this theory of anorexia as a fundamentally biological disorder, rather than a psychological one, is untested, psychiatrists warn, and patients with the disease should not stray from proven treatments.

The review of past research on the topic, published in the June issue of the journal Molecular Psychiatry, finds that certain genetic and cellular processes get activated during starvation in organisms ranging from yeast to fruit flies to mice to humans. The idea, said study researcher Donard Dwyer, is that in people with a broken starvation response, a few initial rounds of dieting could trigger a metabolism gone haywire.

In this theory, it’s not stubbornness or a mental disorder that keeps anorexics from eating, it’s their own bodies. The theory could explain why it can be so difficult to convince anorexic patients that anything is wrong with them, Dwyer told LiveScience.

“Unless we conceive of it as more of a metabolic function, I don’t think we’ll get past the first stage of treatment with a lot of the real hard-core patients,” he said.

The diabetes of starvation
In the current understanding of anorexia nervosa, an eating disorder in which patients don’t maintain at least 85 percent of their normal body weight for their height, overachieving personality types attempt to control stress and emotion by restricting food and/or extreme exercising.

Dwyer sees the disease, instead, as a condition similar to diabetes. Someone who becomes obese and is genetically susceptible will develop insulin resistance, which then becomes diabetes. An initial trigger — the obesity — is required, but once the patient has diabetes, you can’t talk him or her out of the disease.

For anorexia, Dwyer said, the potential trigger is chronic undereating or dieting, and the messed-up molecular process could be any number of biological changes that happen during starvation. In the current review, he and his colleagues focus on a cascade of genetic and cellular events called the IGF-1/Akt/FOXO pathway. Organisms from yeasts to humans activate this pathway in response to starvation, triggering all sorts of biological changes, including a desire to look for food. If this pathway doesn’t work as it should, it could theoretically cause the warped approach to eating seen in anorexia. (The so-called epigenome, the supporting actor to our genes, is what helps determine which genes, or pathways, get switched on and off.)

If Dwyer is right, difficult-to-treat anorexic patients may need drugs to get their metabolisms back on track, much as diabetic patients have to take insulin shots. But so far, the idea has not been tested in humans.

“This is, at the moment, speculative,” Timothy Walsh, a psychiatrist at Columbia University who was not involved in the research, told LiveScience. “There’s no human data to support it, and it’s only part of the answer. It’s not proposed as the complete solution.”

Starvation and metabolism
Dwyer is careful to say that much more research is needed. But he says there is good reason to continue the work. Research on obesity has shown that being too heavy is more complex than simply calories in, calories out, he said. There are genetic and metabolic factors involved that make it hard for some people to shed weight. And obesity-related changes to the epigenome (our genes’ on-off switches) can even be passed down from mother to child. The same could be true on the flip side, with starvation, Dwyer said.

The genes linked to anorexia could be the same ones that regulate the metabolism during starvation, he said.

Additionally, studies on starving people suggest that many of the supposed causes of anorexia, including food obsession and anxiety, may be symptoms of starvation. And starving people, like anorexics, often report that they’re doing much better than their physical condition would suggest.

“Here we have our anorexic patients who are not aware of how sick they are despite how thin they have gotten. … We’re not going to be able to convince them otherwise until we understand that better,” Dwyer said. “It’s probably not going to be something we can just talk them out of.”

Psychiatrists Wrestle With Defining Disorders (Again) []

Psychiatrists are in the thick of a years-long effort to produce the latest edition of the essential textbook for diagnosing mental illnesses, the DSM. They’re dogged by controversies over ‘new’ conditions.

By Shari Roan, Los Angeles Times – May 22, 2011

“Where are we going to put the narcissists?”

It was a question asked urgently by one of the hundreds of psychiatrists gathered here last week for their professional society’s annual meeting. With doctors in the thick of a years-long effort to rewrite the essential textbook for diagnosing mental illnesses, questions like these came up time and again in meeting rooms, over drinks sipped from coconut shells, and in other venues during the five-day conference.

Among the myriad proposals now on the table: reducing the number of specific personality disorders from 10 to five, a move that would eliminate the diagnosis of narcissistic disorder.

“Of course there are narcissists!” the psychiatrist insisted in the convention’s vast exhibit hall, where new research papers were displayed next to pharmaceutical-industry booths. “We see them all the time!”

Don’t let the cheery Hawaiian shirts fool you — the nation’s psychiatrists aren’t feeling all that ku’u aku (relaxed) as the deadline nears for the next edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.The first revision in almost 20 years will roll off the presses in 2013. Since the 1994 edition, research has exposed pieces of the biological framework underlying disorders likeschizophreniaanorexia and depression. But molecular tests and brain scans based on those discoveries aren’t yet ready for diagnostic use, and that leaves the authors of the upcoming book with the same problem that vexed their predecessors: how to distinguish a mental illness from the rainbow of normal human behavior.

Much of the discussion at the American Psychiatric Assn. meeting centered on fears that, without solid scientific evidence, additions or deletions in their new bible of mental health could do more harm than good.

“The brain is so darn complicated,” said Dr. David Axelson, director of the Child and Adolescent Bipolar Services program at the Western Psychiatric Institute in Pittsburgh.

As with each edition, the controversies dogging DSM-5 center on the proposed “new” conditions. Among the questions:

• Is there a distinct mood disorder that occurs in some women prior to their periods?

• Is hoarding a brain-based illness?

• Can the sorrow accompanying bereavement swell into a certifiable mental disorder?

Even when concepts are not at issue, nomenclature sometimes is. Suggestions include replacing the word “anxiety” with “worry,” and scrapping the terms “addiction,” “dependence” and “substance abuse” in favor of “substance-use disorder.”

“We have to be very careful about our choice of language and precise criteria,” said Dr. David J. Kupfer, the DSM-5 task force chairman and director of research at Western Psychiatric Institute and Clinic. Slight word changes could translate into making a disorder much more prevalent — or much more rare, he said.

Was the Grandma Bandit a Down-On-Her-Luck Transgender Woman?

While the Atlanta police claim this person was a man, due to their genitalia, the driver’s license lists the individual as Roxanne Taylor.  It appears to me that the Atlanta police need some training on diversity issues.

Below follows the article in the Atlanta Journal Constitution:

The puffy-faced, middle-aged woman at the CVS checkout counter opened a black purse and showed the clerk a rusty gun. She said she was sorry, that she was dying of cancer and had no choice.

Atlanta Police DepartmentSurveillance video showed this suspect, described as a 50- to 60-year-old woman, who is wanted in the robbery of multiple drug stores.

“Don’t be scared,” the woman said, according to police. “Just give me all the money in the cash drawer.”

Roxanne Taylor’s  string of drugstore robberies — daring heists that earned her the nickname “Grandma Bandit” — ended Friday morning after she was fatally shot following a police chase. It was unclear if she died by her own hand or was killed by police, who fired multiple times after hearing a gunshot, authorities said. The DeKalb County Medical Examiner’s Office could not be reached Friday, and authorities were unable to confirm whether Taylor indeed  had a terminal disease.

Authorities were however able to make another determination about the bandit later Friday. In a tersely worded statement, DeKalb police spokeswoman Mekka Parish wrote


Positive identification has been made on the person involved in todays incident on North Druid Hills. After further investigation detectives have determined the person believed to be a female suspect in fact is a male.

His name is Roxanne Taylor, a 57 year old man.

No additional information is available.

Taylor did not look like the typical armed  robber — the jittery young male with a stocking cap or hoodie pulled down low.

Instead, the 57-year-old  holder of a helicopter pilot’s license lived in a trendy loft near the state Capitol. Wearing dark sunglasses and a black University of Georgia ball cap, he had walked up to the checkout counters of at least seven metro pharmacies in recent weeks, exposed the handgun and demanded cash, police said.

There were differing opinions all along on whether the bandit was a woman or a man dressed as a woman.

Sunglasses Can Save You From Migraines []

Tim Barribeau – If you suffer frequent migraines, you probably already know that tinted lenses are your friend – but now we have scientific proof. Precision tinted lenses have been known for years to provide relief for migraine sufferers and people hit with certain reading difficulties, and now we have thefMRI scans to prove it.

For some people, viewing striped patterns like this one can be enough to trigger a migraine, and for others it can even trigger a seizure due to the illusions of shifting color and motion. When you go in for precision tinted lenses, doctors test your eyes to find the perfect hue and saturation that can counteract this effect, reducing the eye-melting optical illusion to something you can handle, and hopefully reducing your chances of getting an excruciating headache too. It’s also thought that some people’s dyslexia is caused by a similar problem, so tinted lenses can help them too.

New research has finally put these theories to the test, providing solid evidence that this improvement exists in the real world. The study compared the fMRI scans of migraine sufferers both with and without the colored lenses. When they had the spectacles on, there was reduced cortical activation in the visual area of the occipital cortex of the brain, which is associated with the onset of migraine.

If you have trouble reading because of visual distortion or get horrible migraines from looking at certain patterns, it might be time to swing by your optometrist and get some sweet looking sunglasses.


Judge Decides Transgender Widow’s Marriage Was Illegal []

Margaret Hartmann – A Texas judge has announced that he plans to nullify the marriage of a transgender woman whose firefighter husband died in the line of duty, on the grounds that they had an illegal same-sex marriage. His family is fighting the widow for inheritance, but the case is also a setback for transgender rights in the state.

Nikki Araguz, who was born Justin Graham Purdue, married Thomas Trevino Araguz III in 2008, and had had a sex change operation two months later. Thomas died while fighting a fire last summer, and now his family and ex-wife, Heather Delgado, are now battling his widow for $600,000 in death benefits and assets, according to the Associated Press. They argue that the inheritance should go to Thomas’ two young sons from his marriage to Delgado because his marriage to Nikki was never valid.

In a draft order issued on Tuesday, District Judge Randy Clapp said he’s found that “any marriage between Thomas Araguz and Nikki Araguz was void as a matter of law” and Thomas “was not married at the time of his death.” At issue is when Nikki legally became female, and when when Thomas found out she’s transgender. In an interview with 20/20Nikki says she told Thomas that she was born male a week into their relationship, and he supported her during the process of getting a sex change operation. His mother, Simona Longoria, and Delgado paint Nikki as a con-artist, and claim Thomas only learned Nikki’s gender history shortly before his death, and was totally shocked. They say after he found out he immediately moved out and planned to get a divorce. Longoria and Delgado claim they were duped by Nikki, but it seems they’re actually having a hard time accepting that Thomas chose to marry a transgender woman and didn’t tell them about her past. Their argument is ridiculous; They seem to think Thomas simply didn’t pick up on any signs that Nikki once had male genitalia, even though he had been to her childhood home where photos of Justin hang on the walls, had a sexual relationship with her, and was married to her while she had a sex change operation.

According to the Houston Chronicle, Nikki’s lawyer argued that her marriage was legal because the Texas Family Code allows transgender people to obtain a marriage license if they’ve had a sex change recognized by the court (Republican legislators are working torepeal this law). The family’s attorney countered with a 1999 Texas case that says a person’s chromosomes, not their genitals, determine the sex at birth.

Nikki had her California birth certificate reissued shortly after Thomas’ death to say that she’s female. The family’s lawyer says this is irrelevant because, “At the time of the marriage, Ms. Araguz was a man.” However, Nikki’s attorney says the document reflects that she was always female. “For all purposes, she’s female going back to the date of her birth,” he says. “She could have gotten that (reissued) birth certificate at any time in California.” Obviously the judge disagrees, but Nikki says she plans to appeal and is willing to take the case to the Supreme Court if necessary. She adds, “With this ruling I continue to be reminded of the bias that exists toward transsexual and intersex people ignoring the laws of Texas that recognize their medical and surgical transition.”

Lawyer: Transgender Widow’s Marriage To Be Voided [AP]
Texas Judge Set To Rule On Validity Of Firefighter’s Marriage To Transgendered Woman, Death Benefits [ABC News]
Judge: Transgender Widow’s Marriage To Firefighter Not Valid [Houston Chronicle]
Wharton Judge Rules Against Nikki Araguz [Dallas Voice]

Earlier: Texas May Ban Transgender Marriages

Mind-Wiped Accident at 22, Woman Discovers Self All Over Again []

Jesus Diaz – When Su Meck got hit with a ceiling fan and woke up one week later with a total memory loss, her husband Jim thought she “was Su 2.0. She had rebooted.”

Back then, she was 22. The accident erased all her memory, reverting her brain to that of a 4-year-old child. She couldn’t read. She couldn’t do anything by herself. Nothing. Except a few phrases, her brain was a tabula rasa. She had to restart her life—a life with two baby sons—learning everything from the start.

Now she’s 45. Two decades later, the woman whose brain was full of cracks “like shaken Jell-O”—as doctors described it—has earned a music degree from Montgomery College with a 3.9 GPA.

Imagine that, waking up one day being a complete different person with no recollection whatsoever of who you were just one week ago, with a husband you couldn’t recognize and two kids who weren’t really yours, even if biologically they were. It sounds like the setting for a Julia Roberts film, but back then it felt like total confusion for Su:

I always wondered: What am I supposed to do now? What is the plan? What is the goal? Am I supposed to be this other person who I was, or am I supposed to be this new person?

In addition to those philosophical and emotional implications—how can you fall in love again with a husband you don’t know? How can you love the children that you don’t recognize as yours?—Su had to deal with the day to day, learning everything from the start.

There was nothing to build on, but she slowly got back on track. She learned to eat by herself again. To dress up, to make phone calls—she couldn’t bear to talk on the phone for the first few years after the accident—to ride a bicycle, to read and write. Everything was hard for her, including the writing, as one of her emails to her mom shows:

The boys play good with Legos now so givs me a chance to rite. I hav to go to mor doctors be case fall lots to hitig head bad head ackes.

But she finally did it. She even learned to drive, even while her kids had to remember where she parked for her. And finally, she got her music degree after four years of studying hard, reading things again and again to keep them in her memory. Now, Su drums to songs of Led Zeppelin and Pink Floyd, and she is planning to get a bachelor’s degree at Smith College in Massachusetts.

Well, Su Meck 2.0, kudos to you. You have our deepest admiration, rocker girl. Here’s some favorite Floyd to honor your amazing spirit and fantastic voyage. [Washington Post]

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