Teens and Body Image

Coping with fluctuations in our self-esteem is something that almost everyone struggles with. Today's teenagers seem to battle with both body image and self-esteem issues more than ever before. Things like cyber bullying and abusive behavior through the use of social media has only made dealing with this difficult issue even harder for both parents and teens. Portrayals of what "the ideal body" should look like on television shows, movies, and music have only managed to add to the pressure that many teens already feel. Modern media has created an environment for teenagers where they're often made to feel as if they have no self-worth if they're not held to these "ideal" standards. The problem has become so pronounced and widespread among both young men and women that many are calling for a reform of those "ideal" images in favor of healthier role models.
In addition to the media's influence, peer pressure has also contributed to self-esteem levels plummeting. Teenagers are just beginning to enter the stages of puberty; so things like body, hair, and voice changes can already make them feel self-conscious. With pressures from family members, school, and friends, it can often become overwhelming. Sadly, many male and female teens suffer from eating disorders, including bulimia or anorexia, with potentially deadly consequences. All of the pressure to look a certain way and be a certain size has created a new epidemic of body dysmorphic disorder; meaning some teens can only see the flaws in their appearance and often obsess over them to the point where they cannot function normally. In most cases the problems with body image perception from body dysmorphic disorder is simply imagined, and there are, in reality, no serious physical problems; sadly, those with a low self-esteem are often unable to realize this.
Increased self-esteem comes with a sense of belonging. Teens need to feel like they are part of a group and have a solid network of loving, supportive family and friends around them. Sports and other after school programs can help teenagers feel that they are a part of something important - that they've been accepted and valued. It also helps them learn how to build good relationships with their peers.
In order to increase self-esteem, teenagers must learn to love and accept themselves as they are. Building each other up with complements and helping friends who need it are two ways teenagers can help each other feel better as well as themselves. Many teens tend to bully others about trivial things, like someone's clothing choices or hairstyle. If you are getting bullied, it's important that you talk to an adult you trust like a teacher, coach, principal, or your parents. Bullying is never acceptable and no one should be subjected to abusive behavior. Do things that help build your self-esteem, and surround yourself with positive people and things. Over time, you will be able to accept yourself and be happy with who you are.

courtesy of frangrancex.com

Q & A:High-Intensity Resistance Training for Recovering AN Patients?

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 IAEDP

Q. I’ve read that low-intensity exercise is safe for recovering anorexia nervosa (AN) patients, but is more strenuous exercise ever advisable? (GM, Fort Lauderdale, FL)

A. Fat, bone, and muscle tissues are more seriously affected in patients with AN compared with other eating disorders. Relative immobilization during treatment only adds to this. Incorporating regular physical activity or exercise programs into treatment for patients with restrictive-type anorexia nervosa (AN-R) is still controversial. Perhaps because excessive or driven exercise is often encountered as an eating disorder symptom, clinicians have often been very reluctant about exercise in people recovering from AN. Yet it is not clear that a “lifelong abstinence” model make sense in this context. A group at Texas Tech University, Lubbock, TX, recently had excellent early results with a high-intensity resistance training program for a small group of adolescents with restrictive-type AN (Int J Eat Disord 2014; 47601).

Thirty-six female patients with DSM-IV AN-R, who were 16 years of age or younger and with BMIs greater than 14.0, were randomly assigned to an intervention group or to a control group. Before the 8-week intervention program began, all the teens underwent a familiarization period, to minimize any learning effect that could result technical or neuromuscular improvement on the strength and agility tests. The main part of the exercise sessions involved 2 to 3 sets of 5 to 8 repetitions of the exercises used to assess strength. Body weight, BMI, muscular strength, and agility and were evaluated before the exercise sessions, and at the end of the program and at 4 weeks after the training program.

Resistance exercise produced significant improvement in strength and was well-tolerated. For example, lower body strength increased an average of 52% (leg press) and upper body strength increased an average of 37% to 41% (measured by lateral row and bench-press, respectively). 

Four weeks after the intervention period, there had been a small loss of the gains obtained in strength-related variables (an average loss of 15% in the upper body and 7% in the lower body). Just as in the general population, AN-R patients lost muscle strength after the training program ended but some improvements persisted. The intervention was well received: 4 patients in the control group dropped out (1 was hospitalized and 1changed care centers; 2 declined to continue). Four persons in the intervention group also dropped out (1 was hospitalized, 1 discharged, and 2 changed care centers).

Dr. Maria Fernandez-del-Valle and her colleagues argue that exercise programs should target muscular mass and functional recovery. In AN-R, an appropriate exercise program would control caloric intake, avoid high-level exercise, focus on muscle recovery, would be intense and frequent enough to induce adaptations, be individualized and closely supervised. Finally, patients should be monitored after the initial exercise programs are completed. 

Much remains to be learned about prescribing exercise for AN-R patients, including the appropriate dosage and duration of exercise and the beset mixture of types of exercise. Of particular interest is the possibility that exercise could help address osteoporosis. Due to the epidemiologic history of AN (with AN becoming much more common in the last third of the 20th century),relatively few people with AN-associated osteoporosis have yet reached their 60s, 70s, or 80s Because of that, the true magnitude of the burden of osteoporosis in this group is not yet known, but may be very substantial. If so, effective treatment approaches—including perhaps exercise—will be badly needed.

ace-to-Face Therapy vs. Email Therapy for Binge Eating An ongoing trial is comparing efficacy, outcome, and cost-effectiveness.

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 IAEDP

Finding more flexible approaches to treating binge eating may lead to a more patient-centered and cost-effective way to get these individuals into treatment, according to a team of British scientists.

Guided self-help is recommended as a first step for persons with recurrent binge eating, but few studies have examined how best to deliver this treatment. An ongoing clinical trial using a randomized controlled design is now investigating the effectiveness of providing guided self-help either in person or via email (Trials 2014; 15:181). Dr. Paul E. Jenkins and three coworkers at the Cotswold House Eating Disorders Service, Warneford Hospital, Oxford, UK, are conducting the study with two active treatment groups and a waiting list control. Participants are randomly assigned to one of the three conditions: face-to-face guided self-help, email-guided self-help, or a waiting list control. Each treatment lasts 12 weeks, and follow-up is set for 6 months after treatment ends. The researchers are looking at effectiveness, attrition and dropping-out, and the relative cost-effectiveness of the two treatments.

To be eligible for the study, participants must demonstrate a pattern of regular binge eating in the context of an eating disorder and be 17.5 years of age or older. Those with recent rapid weight loss, a body mass index (BMI) lower than 18.5 kg/m2, a major medical condition that might interfere with treatment, excessive drug or alcohol use, and active and untreated psychosis or severe depression are excluded from the trial.

The two treatments

Participants in the face-to-face sessions use a self-help manual, Overcoming Binge Eating (Christopher G. Fairburn, Guilford Press, 2013), and attend 10 sessions of in-person therapy delivered during 20- to 25-minute sessions. The manual is based on cognitive behavior therapy-enhanced and addresses many core elements of an eating disorder, including self-monitoring, psychoeducation, and regular weighing.

In the email-supported treatment group, patient and therapist use the Internet for all contacts (except the initial appointment). Participants are advised to follow treatment closely (“steps”) and to contact the therapist at least once a week. Over 12 weeks the participants will receive feedback from the therapist up to twice a week.

Therapists are advised to follow similar guidelines as the therapists who are using face-to-face contact, such as discussing problems, identifying solutions, and monitoring the participant’s progress—but all via the Internet. The email program is sent through special secure software. If the therapist sees any significant increased risk (medical or suicidal, for example), he or she will immediately schedule a telephone call or a face-to-face meeting with the participant.

The researchers will use a number of self-report measures to evaluate the differences between the two approaches. The primary outcome will be the frequency of objective bulimic episodes, assessed by the Eating Disorder Examination Questionnaire (EDE-Q). Secondary outcome measures include an evaluation of overall eating psychopathology, and other disordered eating behaviors, including self-induced vomiting, psychological distress, changes in self-esteem, functional impairment and healthcare use. In addition to information from the EDE-Q, data will be collected from the Clinical Outcomes in Routine Evaluations-Outcome Measure, a 34-item measure of general psychological distress (BMC Psychiatry 2013; 13:99). Participants review the previous week and rate their symptoms on a 5-point frequency scale. The Rosenberg Self-Esteem Scale includes 10 items that measure global self-esteem and are graded on a 1-to-4-point scale. A third measure, the Clinical Impairment Assessment, is a 16-item self-report in which participants review the preceding 28 days and indicate to what degree symptoms of an eating disorder have affected different areas of their life (Behav Res Ther 2008;46:1105). The Helping Alliance questionnaire is a 19-item measure of therapeutic alliance (Sante Publique 2014; 26: 337[in French]. The authors also developed a questionnaire just for this trial that will assess healthcare use. They will use the results to estimate cost-effectiveness by monitoring how participants use resources –for example, measuring the time therapists spend providing patient care.

The authors hope their results will highlight different ways of delivering first-step eating disorders care. However, they add the caveat that although Internet-delivered interventions hold promise and are highly accepted by patients, there are some drawbacks, including problems inherent with email communication in general. Thus, the participants using email may need guidance with commitment or motivation to continue, as opposed to treatment that requires regular in-person attendance. Thus, “e-therapy” may be appropriate for some patients and not for others.

The clinical trial is now recruiting participants in the United Kingdom, and is scheduled to continue until July 2017.

A Biofeedback Technique to Reduce Anxiety among Patients with AN Adolescents with recent-onset disease had more rapid results.

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 IAEDP

A recent pilot study used heart rate variability (HRV) biofeedback training as a method of reducing anxiety among patients with eating disorders (J Eat Disord 2014; 2:17). The idea behind biofeedback is that, by harnessing the power of the mind and becoming aware of what's going on inside the body, an individual can gain more control over his or her health. 

Heart rate variability (HRV) is the normal phenomenon in which time between one heartbeat and the next changes. Much of this variability is determined by the action of breathing: the pulse speeds up with inspiration and slows down with expiration. Most studies have shown that patients with AN have elevated HRV compared with normal controls. In an effort to alter the variability in heart rate, Dr. Barbara Scolnick and colleagues at Boston University offered HRV biofeedback to 25 inpatients with diagnoses of anorexia nervosa (AN), bulimia nervosa, and binge eating disorder.

HRV biofeedback training uses the breathing aspects of Eastern mediation techniques, and the results are shown on a digital display. A pulse monitor or electrocardiographic lead is placed on the subject and the resulting pulse or tracing and inter-beat intervals are shown on a computer monitor. Slow breathing exaggerates HRV, and at a breathing rate of approximately 6 breaths per minute, the pattern reaches coherence, or forms a sine wave (The sine wave or sinusoid is a mathematical curve that describes a smooth repetitive oscillation.) 

Twenty-four patients agreed to participate in the study. The researchers used a commercially available product, emWave® pro (Heart Math LLC, Boulder Creek, CA) and a computer. Most sessions lasted 10 minutes and were conducted daily or every other day as long as the participant was an inpatient, for up to 12 sessions per patient.

No serious side effects were reported, although one patient, a 24-year-old woman with restricting-type AN and comorbid bipolar disorder, felt faint while performing the feedback portion of the session. Four other participants asked to leave the study early because they did not see any benefits. 

One result that surprised the authors was that success with the technique correlated inversely with aging. Most young adolescents were able to achieve 100% coherence on the first session and seemed to enjoy what one teen called “my unique ability,” but this did not necessarily translate to decreased anxiety. The group of patients who were most enthusiastic about the biofeedback test were in their 20s and highly motivated for change. While none of these patients achieved coherent patterns immediately, eventually they did so and could generate a sine wave by “slowing their breathing and thinking comforting thoughts.” Five patients older than 30 struggled to generate coherence but found the slow breathing calming. Notably, ability to successfully achieve coherence did not appear closely related to subjective benefit.

The hope for a biomarker

There is increased interest in underlying biologic mechanisms and disease markers in psychiatry. The mechanism that transforms this state into one of self-driven starvation has never been explained. The authors note that if a substantial difference is seen between HRV in healthy adolescents, compared to those with AN, HRV might act as a biomarker for the disease.

Tracing Attitudes about Thinness between 13 and 17 Years of Age A South African study found distinct changes by gender and race.

Reprinted from Eating Disorders Review
November/December Volume 25, Number 6
©2014 IAEDP

Western norms of thinness are reaching around the world, including to South Africa, according to the results of a recent study. In a study of black and mixed-ancestry teens, Dr. Tabither M. Gitau and researchers at the University of the Witwatersrand, Johannesburg, South Africa, found that black females were at higher risk of developing an eating disorder, and also had higher BMIs than did black males and mixed-race females of the same ages (PLOS One; doi 10.1371/journal.pane.0109709).

The researchers sought to examine longitudinal changes in eating attitudes, body-esteem, and weight control behaviors among adolescents from 13 to 17 years of age, and then to describe teens’ perceptions of their body image at 17 years of age. The participants in the study included 1435 urban South African black and mixed ancestry boys and girls who were part of the Birth to Twenty longitudinal birth cohort study (Int J Epidemiol 2007; 36:501). 

Height and weight were collected at both time points, and all the teens completed the Eating Attitudes Test (EAT-26) to measure attitudes toward eating (Psychol Med1982; 12:871). A score of 20 or higher was used as an at-risk cut-off point. A body esteem scale was used that consists of 21 questions that measure global feelings about one’s body, satisfaction with weight, and positive self-esteem (Assoc Res Nerv Ment Dis 1983; 60: 115).

All participants were asked a number of questions about their attempts to change their weigh. Some examples of the questions included: “During the last year, have you done anything to try to lose weight?” and “During the past year have you done anything to try to gain muscle?” If the teens responded positively, they were asked to give reasons for their actions. Then, at 17 years of age, boys and girls were asked to select a female body silhouette (Stunkard’s figures) that they associated with a series of different words, such as “looks happy,” looks strong,” I respect,” or “looks weak,” for example.

Results

Underweight at age 13 was seen in 2.1% and 7.4% in black African boys and girls, respectively, and in 3.6% and 6.6%, respectively, in mixed ancestry boys and girls. Of the entire group, 11% reported an EAT-26 score higher than 20. More girls than boys used weight-loss practices and conversely significantly more boys than girls reported trying to gain muscle. For black girls, there was higher risk of eating disorder onset and more weight loss efforts between the ages of 13 and 17. 

At 17 years of age, mixed-ancestry girls and boys had lower body-esteem than did black boys and girls. Males and females shared similar opinions about normal silhouettes being the best, getting more respect, and brining the most happiness, while the obese silhouette was associated with the “worst” and the “unhappiest,” and the underweight silhouette with the “weakest.” Adolescent females engaged in more weight loss practices, whereas males used more muscle gain practices.

A User-Friendly Guide to Medically–Related Terms

By Kathryn Cortese, MSW, LCSW, ACSW

Individuals, who find themselves within the experience of eating disorders, as a patient, family member, friend, loved one, or treatment provider recognize the complexities of these diagnoses. The number of medical concerns one can encounter during the course of one of the illnesses is vast. The following is a go-to guide of some terms that may come up during the course of Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and Other Specified Feeding and Eating Disorders. A brief definition follows each term. Please ask your treatment provider to fully explain any term you hear and do not understand.

Acrocyanosis – blue nail beds, fingers, toes  - “symmetric, painless, discoloration of different shades of blue in the distal parts of the body.”[i]

Amenorrhea – the absence of menstruation – one or more missed menstrual periods.[ii]

Amylase – an enzyme that helps digest carbohydrates. It is produced in the pancreas and the glands that make saliva.[iii]

Arrhythmia – Heart rhythm problems (heart arrhythmias) occur when the electrical impulses that coordinate your heartbeats don’t work properly, causing your heart to beat too fast, too slow or irregularly. Heart arrhythmias may feel like a fluttering or racing heart and may be harmless. However, some heart arrhythmias may cause bothersome – sometimes even life-threatening – signs and symptoms.[iv]

Boorhave’s Syndrome – spontaneous esophageal perforation…is a potentially lethal medical condition[v]

Bradycardia – a slower than normal heart rate. The heart usually beats between 60 and 100 times a minute in an adult at rest. If you have bradycardia, your heart beats fewer than 60 times a minute.[vi]

Caries – tooth decay, a dental cavity

Cathartic colon – anatomical changes “to the colon secondary to chronic stimulant laxative use.”[vii]

Cognitive dysfunction – brain tissue loss – “the loss of intellectual functions such as thinking, remembering, and reasoning of sufficient severity to interfere with daily functioning.”[viii]

Constipation – infrequent bowel movements or difficult passage of stools that persists for several weeks or longer. Constipation is generally described as having fewer than three bowel movements a week.[ix]

Dehydration – Occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions.[x]

Dental erosion – the loss of tooth enamel caused by acid attack.[xi]

Diabetes – also known as diabetes mellitus –“describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body’s cells do not respond properly to insulin, or both.”[xii]

Diuretics – also called water pills, belong to a class of medications that are designed to increase the loss of water and salt from the body. [xiii]

Dysrhythmia – or arrhythmia, is a change in the regular beat of the heart. The heart may seem to skip a beat, beat irregularly, or beat very rapidly or very slowly.[xiv]

Edema – swelling caused by excess fluid trapped in your body’s tissues. Although edema can affect any part of your body, it’s most commonly noticed in the hands, arms, feet, ankles and legs.[xv]

Electrolyte – Electrolytes are minerals in your body that have an electric charge. They are in your blood, urine and body fluids. Maintaining the right balance of electrolytes helps your body’s blood chemistry, muscle action and other processes.  Sodium, calcium, potassium, chlorine, phosphate and magnesium are all electrolytes.[xvi]

Electrolyte imbalance – Levels of electrolytes in your body can become too low or too high. That can happen when the amount of water in your body changes, causing dehydration or overhydration. Causes include some medicines, vomiting, diarrhea, sweating or kidney problems.[xvii]

Emetic – an agent that causes vomiting.[xviii]

Estradiol– an estrogen hormone.[xix]

Estrogen – The estrogenic hormones are uniquely responsible for the growth and development of female sexual characteristics and reproduction in both humans and animals. The term “estrogen” includes a group of chemically similar hormones: estrone, estradiol (the most abundant in women of reproductive age) and estriol.[xx]

Female athlete triad – a syndrome of three interrelated conditions that exist on a continuum of severity, including: Energy Deficiency with or without Disordered Eating, Menstrual Disturbances/Amenorrhea, Bone Loss/Osteoporosis.[xxi]

Gastroparesis – a condition in which the muscles in your stomach don’t function normally.[xxii]

Gastrointestinal bleeding – Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from any of these areas. …GI bleeding is not a disease, but a symptom of a disease.[xxiii]

Hormones – vital chemical substances in humans and animals. Often referred to as “chemical messengers,” hormones carry information and instructions from one group of cells to another. In the human body, hormones influence almost every cell, organ and function. They regulate our growth, development, metabolism, tissue function, sexual function, reproduction, the way our bodies use food, the reaction of our bodies to emergencies and even our moods.[xxiv]

Hypertension – Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Hypertension is another term used to describe high blood pressure. …High blood pressure (hypertension) is when your blood pressure is 140/90 mmHg or above most of the time.[xxv]

Hypokalemia – Low potassium refers to a lower than normal potassium level in your bloodstream. Potassium is a chemical (electrolyte) that is critical to the proper functioning of nerve and muscle cells, particularly heart muscle cells. Normally, your blood potassium level is 3.6 to 5.2 millimoles per liter. (mmol/L). A very low potassium level (less than 2.5 mmol/L) can be life-threatening and requires urgent medical attention.[xxvi]

Hypophosphatemia – a low level of phosphorus in the blood.[xxvii]

Hypotension – Low blood pressure …can cause symptoms of dizziness and fainting. In severe cases, low blood pressure can be life-threatening. Although blood pressure varies from person to person, a blood pressure reading of 90 millimeters of mercury (mm Hg) or less systolic blood pressure (the top number in a blood pressure reading) or 60 mm Hg or less diastolic blood pressure (the bottom number) is generally considered low blood pressure.[xxviii]

Hypothermia – dangerously low body temperature, below 95 F (35 C).[xxix]

Ketoacidosis – DKA – “Diabetic ketoacidosis is a serious condition that can lead to diabetic coma (passing out for a long time) or even death. When your cells don’t get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are acids that build up in the blood and appear in the urine when your body doesn’t have enough insulin. They are a warning sign that your diabetes is out of control or that you are getting sick.”[xxx]

Lanugo – a symptom of deep starvation, is characterized by a soft, downy, fine white/light hair that grows mainly on the arms, chest, body and face of individuals with eating disorders. The body grows lanugo as a means of insulating itself to maintain body temperature as fat stores are depleted. It is most commonly seen in patients with anorexia nervosa.[xxxi]

Laxatives – can be useful constipation remedies, but they are not a substitute for eating enough fiber, getting regular exercise, and drinking plenty of fluid.[xxxii]

Mallory-Weiss tears – Severe and prolonged vomiting can result in lacerations (tears) in the lining of the esophagus. Mallory-Weiss syndrome (MWS) is a tear in the mucous membrane (inner lining) where the esophagus meets the stomach.[xxxiii]

Malnutrition – the condition that occurs when your body does not get enough nutrients.[xxxiv]

Orthostatic hypotension – a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure for the sitting or supine position.[xxxv]

Osteopenia – ”Osteo” means bone and “penia” indicates a state of being low in quantity. The term osteopenia refers to a bone density which is somewhat less, not excessively less, than a “standard” young person (someone in their mid to late 20s) of the same gender…. It indicates a relatively low bone mass.[xxxvi]

Osteoporosis – is a disease of the bones that happens when you lose too much bone, make too little bone or both. As a result, your bones become weak and may break from a minor fall or, in serious cases, even from sneezing or bumping into furniture.[xxxvii]

Prolonged QT syndrome – Your heart beats about 100,000 times a day to circulate blood throughout your body. To pump blood, your heart’s chambers contract and relax. These actions are controlled by electrical impulses created in the sinus node, a group of cells in the upper right chamber of your heart. These impulses travel through your heart and cause it to beat. After each heartbeat, your heart’s electrical system recharges itself in preparation for the next heartbeat. This process is known as repolarization. In long QT syndrome, your heart muscle takes longer than normal to recharge between beats. This electrical disturbance, which often can be seen on an electrocardiogram (ECG), is called a prolonged Q-T interval.[xxxviii]

Renal insufficiency – is poor function of the kidneys that may be due to a reduction in blood-flow to the kidneys caused by renal artery disease. …Patients suffering from renal insufficiency can have no symptoms or mild ones. Others can experience severe hypertension.[xxxix]

Seizure – the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain.[xl]

Syncope – fainting – the brief loss of consciousness and posture caused by a temporary decrease in the blood flow to the brain. Syncope may be associated with a sudden fall in blood pressure, a decrease in heart rate or changes in blood volume or distribution. The person usually regains consciousness and becomes alert right away, but may experience a brief period of confusion.[xli]

Tachycardia – a very fast heart rate of more than 100 beats per minute.[xlii]

Eating disorders have an impact on the body and soul of the individual. They take away a person’s health and selfhood. Be kind to yourself today and know that hope and recovery are real.

About the Author:
Kathryn Cortese, MSW, LCSW, ACSW is a psychotherapist who has specialized in the treatment of eating disorders for over twenty years. Since October 2013, Kathy has been a partner in Salucore, the company that develops and publishes the Gurze/Salucore Eating Disorder Resource Catalogue and maintains EatingDisordersRecoveryToday.com.

Electrolytes and You

What Are Electrolytes?

Electrolytes are the salts in your body. The most common salts are sodium, potassium, and chloride. Often associated with abnormalities in electrolytes are abnormalities in the bicarbonate level. Although not technically an electrolyte, bicarbonate is important in maintaining the body’s acid base balance. Located in the blood and cells, electrolytes are important in keeping your body functioning correctly.

How Are Electrolytes Controlled?

Your kidneys, lungs, and other glands, including the adrenal glands very tightly control the levels of electrolytes in your body. The adrenal glands, which sit on top of the kidneys and secrete hormones, are especially important in controlling electrolytes. For example, if you eat or drink salty foods, the kidneys will excrete the extra salt to prevent excessive sodium and water from being retained, which could otherwise result in fluid overload and heart failure. Another example is sweating. Sweat is composed of both water and electrolytes (primarily sodium chloride, commonly known as table salt). Your body responds to sweating by changing the way the kidneys filter the blood to regulate the amount of water and electrolytes that are excreted in the urine. This results in the concentrated urine you may excrete if you exercise without consuming enough fluids.

Why Are Electrolytes Important?

All cells maintain an electrical charge across the cell membranes that surround them, which permits cells to perform their normal functions, such as allowing nerve cells to control muscles and allowing muscle cells to contract and relax. The electrolytes in the serum (blood) produce this electrical charge, which is literally the energy of life. If electrolytes exceed their normal, tightly controlled range, normal functions will cease. Muscles may weaken and cramp, nerves may fail to conduct impulses correctly, or the brain (which, after all, is a collection of nerve cells) may not function correctly, leading to confusion, lethargy, or even seizures.

What Conditions Cause Abnormal Electrolytes?

The most common medical conditions that cause electrolyte imbalances are persistent vomiting and diarrhea. In either case, one loses not only fluids, but also significant amounts of electrolytes. Many medications, such as diuretics (“water pills”) that are used to treat either high blood pressure or fluid retention, can result in electrolyte problems. Many endocrine diseases, such as diabetes, can also cause electrolyte imbalances. Whatever the etiology, treatment requires replacement of not only the water portion, but also the electrolytes, usually in the form of salty fluids.

Reprinted with permission from Eating Disorders Recovery Today
By Michael Myers, MD
Summer 2004 Volume 2, Number 4
©2002 Gürze Books

Mike Myers, MD, is a family physician in Orange County, CA specializing in weight management and eating disorders for the last 24 years.