Eating Disorders and Their Associations With Prior Infectious History
People who suffer from eating disorders deserve to be seen through a new lens, coming out from behind the veil that strictly promotes ideas of a mental health issue caused by unrealistic views of “perfect” bodies. There is new research substantiating something I have witnessed empirically for nearly 2 decades, and that is the connection between a prior history of infections and all types of eating disorders.
Holistic health includes the mind and emotions. It is my opinion that all “mental illness” has roots in the body and its biochemistry and that in our health care evolution, we have the responsibility to pay attention to these components, seeking methods of treatment that include the whole person and remove the associated stigmas. The shame that surrounds an eating disorder, as well as other obsessive compulsive disorders (OCD), is wrongly perpetuated by our culture and harmful to our understanding of how these disorders function. For a young girl or boy to suffer this placement of blame, in addition to the tensions underlying the conditions themselves, is detrimental to the healing process as it compounds the existing suffering.
What the Research is Showing
The Journal of the American Medical Association published research results in April 2019 from a huge Danish study of over 525,000 girls from the years 1989 to 2012. This study was conducted in order to determine the significance of childhood infectious history with the increased risk of developing anorexia nervosa, bulimia nervosa, and other unspecified eating disorders. The results indicate increased risks for these diseases with childhood infectious treatments as follows:
23% increased risk for anorexia nervosa
63% increased risk for bulimia nervosa
45% increased risk for not otherwise specified eating disorders
Statistically, these are very impactful numbers with enormous implications.
When Conventional Treatment Isn’t Enough
The research showed the correlation between anti-infectious treatments and development of eating disorders later in adolescence.
While it is possible for some patients to recover from infectious problems and move forward without the complications of of eating disorders, clearly many will suffer. Why is this? Because the immune and nervous systems (as with any body system, potentially) do not always return to homeostasis following an infection or severe exposure.
As part of this study, the group looked at the delivery of conventional medical treatments given to their subjects. These included antibiotic, antiviral, and anti-fungal treatments and medications. Given the research results, we understand that many people can utilize these types of treatments, recover from a serious bacterial, viral or fungal infection, and move forward with normal immune and nervous function. But, when this is not the case, we must consider that additional layers of stress beyond infectious problems can prevent adaptation and recovery. (Please note that it is not the authority nor the opinion of the author to independently determine when conventional medical treatment is advised or not. This is a decision to be made by parents and their child’s medical practitioners.)
Potential layers of stress that may impact the proper recovery of the patient include (but are not limited to):
individual nutritional quality and deficiencies
psychological patterns and lack of recovery skills and/or support and communication
toxic burdens such as heavy metals and petrochemicals preventing breakdown of biofilm
low immune response and resources, including failure of the microbiome to re-balance
high immune and inflammatory response with inadequate resolution phase
failure of the central nervous system/brain to return to a normal, non-inflammatory state
over-correction of the immune system from conventional therapies (unintended but often part of the problem with a one-size-fits-all dose)
depletion of important co-factors due to high psychological stress
Given the number of potential influencing factors, the need for consideration of a holistic approach in treating infectious problems in the body becomes evident. In a separate study, researchers made these statements on their findings relating to the communications generated by bacteria in the gut:
”Gut bacteria may act on the gut–brain axis to alter appetite control and brain function as part of the genesis of eating disorders. As the illnesses progress, extreme feeding patterns and psychological stress potentially feed back to the gut ecosystem that can further compromise physiological, cognitive, and social functioning. Given the established causality between dysbiosis and metabolic diseases, an altered gut microbial profile is likely to play a role in the co-morbidities of eating disorders with altered immune function, short-chain fatty acid production, and the gut barrier being the key mechanistic links.”
We are well aware that the microbiome of the gut has direct influence upon neurotransmission, and once neurotransmission is altered, we are likely to begin to see behavioral and psychological changes. Dopamine, serotonin, norepinephrine, and epinephrine are all powerful neurotransmitters potentially affected by pathogens in the gut. As regulators not only of mood, but also of muscular control, motility in the digestive tract, and nerve cell communications, imbalances in these chemicals can cause a cascade of symptoms and misalignment of metabolic processes. They are endogenous chemicals that transmit signals across chemical synapses, and thus when their production and action in the body are impacted by pathogens, the nervous system becomes deeply involved.
We know that healthy bacteria produce numerous neurotransmitters and neuromodulators, for instance γ-amino butyric acid (GABA) produced by Bifidobacterium spp which helps to control anxiety. Serotonin from Enterococcus spp. modulates mood regulation, acting on afferent axons and interacting with the intestinal epithelial cells to modify neural signaling to the central nervous system. If the colonies of these healthy bacteria are not restored properly following treatment, the modulating effects of neurotransmitters may also not be restored.
What may be happening in many cases of “cleared” infection but ensuing development of an eating disorder is an excess immune and inflammatory response wherein the pathogen is killed but the resolution phase is inadequate. Epithelial cells in the gut generate a substance called NF-kappa B, which stimulates immune cytokines to attack a pathogen. NF-kappa B also stimulates corticotropic releasing hormone (CRH) which drives brain inflammation. Chronicity of this response results in a lowered response to cortisol, and to depression and anxiety. In this case, a child’s medical team can determine that the infection is cleared, but are not monitoring the immune and mood responses that may send red flags for continual inflammatory processes that affect the brain and entire stress response in the body.
When conventional treatment is not adopted in a balanced, modulated fashion, eating disorders may become chronic and cyclical. Again, quoting the authors of the study above, important complicating factors are noted:
“Beyond etiology, eating disorders are further complicated by their instability and chronicity—the illnesses can quickly progress from being active to recovery and relapse, and patients typically undergo repeated relapsing-remitting courses and even transitions from symptoms of anorexia to bulimia, and vice versa, throughout the lifespan. While some complications are a direct consequence of the disordered feeding behaviors, e.g., vomiting and laxative abuse leads to electrolyte disturbance, others are primarily due to poor nutritional intake, notably deranged gastric motility, constipation, and reduced bone mineral density“
Every human being has a unique and highly dynamic gut ecosystem that depends on complex interactions between genetic and environmental factors. When we fail to monitor and support the individuality of the person and their microbiome, we may also fail to provide the best opportunity for full recovery and the prevention of a long path of chronic, cyclical disease and mental illness.
Increase in Incidence of Eating Disorders Alongside Increases in Infectious Diseases
Susan Ice, MD, an expert in eating disorders and medical director of the Renfrew Center in Philadelphia, states: "The incidence of eating disorders has doubled since the 1960s and is increasing in younger age groups, in children as young as seven," she said. "Forty percent of 9-year-old girls have dieted and even 5-year-olds are concerned about diet," she noted. Ice also states that only 1/3 of patients with eating disorders recover after an initial episode. Another 1/3 fluctuate between recovery and relapse, and a final 1/3 suffer chronic deterioration.
While the correlations are still being studied, we also know that there is significant rise in the incidence of infectious disease in children. Notable here are the comments from medical staff at Tufts University that we have to be concerned about the health of our soil and our environment with this trend. Healthy microbes are found in healthy soil, and industrialization is causing a shift in food sourcing and environmental health. Children used to play in the dirt while their elders worked and gardened in the dirt, all activities which encourage uptake of healthy microbes through the skin. With wide-scale industrialization, less local farming/more urbanization, less outdoor play/more media and self-comparison activities, and more economically driven sociocultural changes, eating disorders and increased infections have become negative expressions of these changes.
The Considerations for Holistic Care
First and foremost, as in most of my conversations, we will discuss the need for individualized nutrition. Our bodies are regulated by a number of homeostatic mechanisms, including pH, blood sugar, blood pressure, and electrolytes. Any and all of these can be impacted by pathogenic activity and most certainly by the expression of an eating disorder.
In metabolic nutrition, we look at how the individual needs to be nourished, not at what “Diet Dogma” says is right for everyone. There is no such thing. We are each biochemically unique, and we each require individual approaches to nourish our bodies with the right foods and the right ratios of foods for those needs. This process provides the foundation from which to complete deeper healing - it is not the single remedy, but the one that helps all others to work effectively. Metabolic nutrition helps to balance all homeostatic mechanisms and to provide the optimal production of ATP from food. Every cell in the body utilizes ATP for energy and job completion, no matter where it is in the body or what its function is. Without adequate energy stores (or “gas” in the engines), we cannot heal and rebuild.
A next most important step is to assess and address toxic burdens in the body. In another article, I have explained biofilms and their role in infectious problems and healing. Toxins such as heavy metals become part of the structure of biofilm, and without proper detoxification, the pathogens maintain their “housing” and may begin to replicate again under ripe circumstances. Metals and chemical toxins also demand a large amount of the body’s nutrient cofactors, such as zinc, magnesium, B vitamins, choline, glutathione, etc. When these become low and/or deficient and life/psychological stressors are added to the mix again, a tendency to tip over into negative mental responses may easily occur.
Next, we must consider the need for most human beings to be supported in their souls and their psychology. Even small children experience stressful emotions, yet as a culture we rarely encourage expression and/or support services to give children the tools to gain confidence through such experiences.
There is no doubt that some cases of eating disorders have primary psychological origins. It is not the intention of this article to indicate a strict and reliable connection between pathogens and the development of an eating disorder, but rather to highlight the risk factors of the connection. It has been my clinical experience that some people find psychological and/or spiritual paths of healing that create just as much recovery as a natural medicinal path. The power of healing opportunities cannot/should not be limited in a human being. Yoga, talk therapy, meditation, core belief work, body movement, and journaling are all wonderful options for making connections between all the levels of the self. As self-love and self-esteem increase, stress decreases and critical nutrient cofactors and metabolic processes stabilize in the body.
We must also consider the need to replenish and re-balance the body’s operating systems for anyone utilizing strong medications intended to eradicate infection. Medications have their purpose, yet that purpose does not extend into recolonization of the gut microbes nor into fine-tuned modulation of the immune and nervous systems. An individual approach is needed, and one that is not as simple as “take a probiotic”. For some people, this can cause a new cascade of problems, as probiotics do not address many aspects of a very complicated immune system. Even with the use of “natural” antibiotics, anti-fungals and antivirals, there is still significant disruption to the microbiome and immune system which requires careful support post-protocol use. Without this step, any and all substances used to attack an infection can create vulnerability for imbalance and the risk for a next disease expression, including an eating disorder.
I have supported many young women and men with recovery from eating disorders and other types of OCD illnesses with a comprehensive and holistic approach. If you or someone you know is suffering, there is hope. The veil can be pulled back and a normal, happy life re-established. Please contact me at Julie@truenaturehealthconsulting.com to discuss how to begin this healing today. We provide holistic telehealth services.