Another tragic ending

One of the most heart wrenching things you’ll ever read is the anguish, frustration and anger expressed by Mamavision at the loss of another young anoretic. She emotionally accounts the recent horrifying suicide of the leader of a Live Journal Pro-Anorexia site which was done live, minute-by-minute, on the internet and the reaction of the Pro-Ana site. Knowing Pro-Anas will deluge her with comments, she wrote: “My purpose is to educate. Educate parents, friends, and family on the rampant nature of the Pro-Anorexia community online.”

A few months ago, Newsweek reported that there are more than 200 such websites. In their controversial article, they described a study published in Pediatrics, led by Dr. Rebecka Peebles, a specialists in adolescent medicine at Stanford University's Lucile Packard Children's Hospital, which found that patients who used pro-eating-disorder sites were sick longer. Eating disorder experts have urged Internet service providers and health officials to issue warnings that these sites could contribute to pushing some girls over the edge.

Research can make for dry reading sometimes. But stories such as the recent deaths in the news have put names and faces to the volumes of research reporting the high death rates among anorexia nervosa patients. These are not isolated incidences. Yet the seriousness of anorexia nervosa is often downplayed by the public and some medical professionals, even though anorexia nervosa is known among mental healthcare professionals as the deadliest mental health problem, and one with a protracted recovery period among its survivors.

The research highlights several aspects important for the public, as well as healthcare professionals, to recognize.

For example, David Herzog, M.D., professor of psychiatry at Harvard Medical School and head of the Harvard Eating Disorders Center at Massachusetts General Hospital, led a study examining almost 150 patients seen in Boston centers from 1987 to 1991 and followed them closely for more than eight years. “The mortality rate in the anorexia subjects was close to 12 times that which you would see in a similar age and gender population,” Dr. Herzog told Psychiatric News.

Starvation is not always the cause of death, despite what is popularly believed. Suicide is common. Among the anorexics who died, 40% had died by suicide.

“The suicide rate in our subjects was some 60 times higher than you would see in a similar age and gender population,” said Dr. Herzog.

Another critical point is that anorexics who die are not necessarily severely underweight. “In fact, a number were at about normal weight or even above normal weight,” said Dr. Herzog.

Herzog and colleagues published their findings, accompanied by analyses attempting to identify the factors predictive of suicide attempts, in a 2005 issue of Evidence-Based Mental Health.

While some may dismiss words such as Mamavision for being overwrought with emotion, to do so would miss an opportunity to learn. As the parents of a young bulimic victim wrote at Andrea’s Voice:

Please know that our feelings of frustration, fear, powerlessness, confusion and yes, even anger (or yes, especially anger), are shared by all parents whose children are disordered eaters. Our job is not to yell, threaten, browbeat, inflict guilt, or judge either ourselves or our child. While we learn all we can about Eating Disorders, we can share our honest concerns and provide loving support as well as the support of professionals.

Her parent’s long list of “I wish I had....” is something no parent or healthcare professional would ever want to have to say.