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ALLERGIC REACTIONS: ANOREXIA-BULIMIA SYNDROME

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Anorexics are a strange breed of dieter. No matter how thin they become, they still feel fat. They literally starve themselves down to nothing, all the while insisting that they 'should really lose a few more pounds'.
When anorexics do give in to hunger, they don't just nibble. They binge compulsively (called bulimia), craving and eating up to several pounds of food. Then, to cancel out their guilty feelings of indulgence and to relieve the bloating the food prod­uces, they force themselves to vomit or purge themselves with laxatives, diuretics and diet pills.
A frightening number of people between ten and thirty years of age, most of them women, have this distorted attitude towards food and body image known as anorexia-bulimia. It's the flip side of obesity. And doctors don't know for certain what causes it - or what to do about it. Because most psychiatrists blame anorexia-bulimia on deep feelings of anxiety, depression and poor self-image, counseling and antidepressant drugs are stan­dard treatment. Sometimes those help, but sometimes they don't. About 65 per cent of the women continue their self-destructive habits, and about half of them eventually die from malnutrition, infection or other kinds of physical breakdown. Anorexia-bulimia is far from a harmless weight loss scheme.
'It's a very tragic illness in that anorexics are usually highly intelligent, creative people,' says Bernard Raxlen, a psychiatrist and director of the Graduate Center for Family Studies in Ridgefield, Connecticut.
Reforming an anorexic-bulimic is about as difficult as reforming an alcoholic, though.
'The compulsive eating and purging is emotionally soothing,' says Dr Raxlen. 'It relieves not only hunger but distressing thoughts and emotions. Normal eating is not enough to dispel that tension, but binge eating is - even though it is accompanied by a constant fear of not being able to stop.'
The binge-and-purge cycle is the sort of addictive behavior that's typical of unsuspected food allergy. Acting on that observation, Dr Raxlen and a colleague, Dr Leonard Galland, tested eight women with anorexia-bulimia for allergies and gastrointestinal problems, among other possible health problems. All the women showed serious abnormalities of some kind or another. Drs Raxlen and Galland then designed an experimental treatment programme that, in addition to psychological therapy, included:
- a Rotary Diet for food allergies;
- immunotherapy injections for foods, chemicals and other inhalants;
- a yeast-free diet with aggressive treatment of abdominal candidiasis (yeast infestation of
  the small bowel); and
- digestive aids, including pancreative enzymes, betaine hydrochloride and Lactobacillus
  acidophilus (a beneficial bacteria commonly found in yoghurt).
While the treatment did not produce dramatic results, three of the women seemed to do much better on the programme, says Dr Raxlen.
The binge-and-purge cycle of anorexia-bulimia may be a bizarre twist in the basic workings of food cravings and allergy. Hopefully, Dr Raxlen's research will stimulate more doctors to investigate food allergy as a possible cause of distorted eating habits in people (usually women) with anorexia-bulimia.

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