Louisville Magazine

FEB 2018

Louisville Magazine is Louisville's city magazine, covering Louisville people, lifestyles, politics, sports, restaurants, entertainment and homes. Includes a monthly calendar of events.

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44 LOUISVILLE MAGAZINE 2.18 It's not uncommon in the eat- ing-disorder community to hear the nickname "Ed." A therapist might ask a patient stuck in anguish over diet and weight: Is that Ed talking? It's a way to separate the disease from its host, because anyone who has experienced one or treated one knows the longer Ed hangs around, the more secure it becomes. Ed is an obsessive puppeteer, and its agenda is weight control, with constant whispers and roars of what's safe to eat, what not to eat, how to rid what's been swallowed. It swirls like a whirlpool, dragging lower and lower, first into malnourishment, then organ damage, then, maybe, death. Eating disorders have the highest mortality rate of any psychiatric disorder. Some studies report that in westernized countries, a person dies every hour due to an eating disorder. About 30 million Americans of all genders and races struggle with eating disorders at some point in their lives. Only a third ever receive treatment. Who wants to reveal that eating — as instinctual as breathing and sleeping — is so crippling? And so the illness festers and grows in secret, eventually eclipsing a person's whole being. Food is the enemy. e body, the battlefield. It is with that scaffolding that life is lived, day and night, for months or years on end. Nothing easily falls back into place. A severely underweight adult with anorexia typically does not respond to therapy alone and needs a team of support, like a dedicated dietician, a psychologist and a psychiatrist who might prescribe medi- cine. And research shows that treatments often used for bulimia only lead to a full recovery about half the time. Eating disor- ders are so challenging to treat that many mental-health professionals choose not to accept those patients. A team of Harvard psychologists followed a group of people for 20 years after an initial diagnosis and two-thirds had recovered. So healing is possible. It's just not simple. Eating disorders are not well-under- stood, and funding to study them has lagged for years. In 2017, the National In- stitutes of Health dedicated $430 million to research depression, $268 million for schizophrenia and $95 million for bipolar disorder. Funding to study eating disorders totaled $30 million. e landscape for treatment in Lou- isville and all of Kentucky is especially bleak. "I would call it a drought," says Alex Pruitt, a local pediatric psychologist who treats children and teens with eating disorders. When eating disorders have become severe, local hospitals can stabilize a patient who's dehydrated, underweight and presenting a heart rate that has dipped dangerously low. But what next? ere are no residential treatment facilities in Kentucky. ose that do exist out of state can cost as much as $30,000 per month and insurance rarely covers the cost. e next best type of program would be a partial hospitalization program, one in which the patient receives six to 12 hours of treatment every day. None of those exist in Kentucky either. One local mother remembers that several years ago, when her 13-year- old was at what was then called Kosair Children's Hospital, a doctor informed her that her daughter would need a higher level of care for her anorexia. "Who do you recommend?" the mother asked. She remembers the doctor saying, "I'm not really sure." She didn't understand. Surely there was someone he could point her to. She repeated the question. e doctor had no answer. "We were dumbfounded," the mother says. Later, someone handed her a brochure for Remuda Ranch, a facility in Arizona. "at's the only information we have in the office," the mother was told. So she and her husband flew to Arizona with their young teenage daughter and "had just five minutes to say goodbye," she recalls. "It was horrible. We cried all the way back to the airport." e four eating disorders are Anorex- ia nervosa, Bulimia nervosa (obsession with weight, bingeing and purging or ex- cessive exercise), binge-eating disorder and other specified and feeding disorders, or OSFED, a disease that includes symptoms like severe restriction of certain foods and purging without bingeing. Anywhere from RUNNING ON EMPTY With so few local options for treating eating disorders, a University of Louisville scientist is determined to help patients recover. By Anne Marshall

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