My guest this week is Dr. James Greenblatt, he is a pioneer in the field of functional integrative medicine, a board-certified child and adult psychiatrist, and has treated patients since 1988. Dr. Greenblatt has lectured internationally on the scientific evidence for nutritional interventions in psychiatry and mental illness. He is the author of seven books, and his latest book Answers To Anorexia is released right now. He is also the founder of Psychiatry Redefined, which is a really innovative educational platform dedicated to the transformation of psychiatry, and they offer online courses, webinars, and even fellowships for professionals.
In this episode, Dr. Greenblatt and I discuss his new book, Answers to Anorexia. Anorexia nervosa is on the rise, especially in young children, and the relapse and suicide rates are among the highest for psychiatric illnesses. We discuss warning signs, underlying causes, and effective treatment approaches.
Episode Highlights
Anorexia Affects All Age Groups
Anorexia nervosa is the most life-threatening of the psychiatric illnesses (highest rate of suicide)
Early intervention and treatment is critical
Increasing rates, especially in preteens and younger, but seen in all genders and races
Often starts in adolescence
What is Anorexia Nervosa?
Listed as one of the eating disorders; as a psychiatric diagnosis
Symptoms include distorted body image along with restrictive eating/weight loss
Scientists now can articulate that this is a brain-based illness, that the neurophysiological changes are different in those with anorexia however, this has not been translated into clinical care
Early Warning Signs & Risk Factors
Very high genetic component, whether it is a parent or an aunt/uncle
One of the most dramatic, well-proven risk factors is going on a vegan/vegetarian diet in puberty, certainly pre-puberty
Treatments Historically Have Been Ineffective
Massive lack of proper training about eating disorders and nutrition for practitioners
For anorexia nervosa, there are no approved medications
Dr. Greenblatt’s thesis is it’s a brain-based illness due to malnutrition, and without that nutritional repletion, therapy is often ineffective
High relapse rate especially since typically patients are released with no ongoing care
Lack of treatment centers puts a large time, financial, and stress burden on families to have to travel further
Insurance companies limit treatment
The highest risk of suicide of any psychiatric illnesses
Low levels of those nutrients are associated with a higher risk of suicide
Proper Treatment and Prevention
First, need to address the (chronic) malnutrition and genetic vulnerability as a first red flag as well as changes in diet in early adolescence
All nutritional deficiencies of major nutrients affect brain function and brain distortion
Forcing a patient to eat during in inpatient care to stabilize weight while not addressing a nutrient-dense diet is not an effective solution
Key Nutrients Needed for Recovery
Zinc, especially during puberty
Other essential nutrients: B vitamins, amino acids, and fatty acids
Treatment centers are not necessarily providing nutrient-dense foods or additional supplementation
Magnesium is one of the most common nutrient deficiencies in the U.S., and particularly in those with anxiety, mental health, sleep, or constipation
Where to Start for Support
Schedule a nutritional augmentation consultation
Early interventions with personalized care/therapy and dietitian are critical
Using food as a therapeutic approach along with targeted supplementation and nutrients; nutrition as being profoundly important in even some of these most severe clinical presentations.
Answers to Anorexia
Book: Answers to Anorexia is an overview of the lack of a current effective model and a proposal around a nutritional repletion model
For clinicians, therapists, nurse practitioners, and psychiatrists there is an educational platform (psychiatryredefined.org) with hundreds of hours of content for functional medicine for mental health and functional psychiatry where they can learn a model to dig deeper
RESOURCES & LINKS:
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Dr. Nicole Beurkens [Website] - https://www.drbeurkens.com
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