July

In a move that may be followed by other states, New York has instituted new restrictions on the sale of ipecac syrup, a drug that is used to induce vomiting in poison victims.  Ipecac, which is derived from a South American plant, has a history of abuse by people with eating disorders.  The bill that was signed by Governor Cuomo will not outlaw ipecac, but it will require pharmacies to move the syrup from open shelves to behind the counter.  The hope is that making the drug less accessible will limit its availability to people suffering from bulimia, anorexia and binge eating.

A New York mother named Debbie Begeny was instrumental in getting the bill before the legislature.  Her daughter Heather, who suffered from anorexia and bulimia, died at age 22 from cardiac arrest.  After her daughter's death, Begeny found 20 bottles of ipecac in Heather's room and realized that she had been using it to induce vomiting in the final weeks of her life. 

Begeny would have liked to have seen ipecac become available by prescription only, but that restriction was removed from the final legislation.  Instead, customers will have to ask a pharmacist or store manager for ipecac.  While Begeny doesn't think this will stop ipecac abuse, she concedes that it's a step in the right direction. 

For years, pediatricians and child-care experts recommended keeping ipecac in the family first aid kit to aid in treating accidental poisoning.  However, the administration of ipecac carries some risk since vomiting should not always take place when a poison is caustic.  Because of the risks in administering ipecac for poisoning and the potential for irreversible damage to the heart when ipecac is abused, in 2003 the American Academy of Pediatrics changed its position on ipecac and no longer recommends that it be kept in the home.

The most famous victim of ipecac poisoning is Karen Carpenter, an American pop singer who died of heart failure in 1983.  Carpenter, who was 32 at the time of her death, had suffered from anorexia for several years.  Although her family thought she used laxatives rather than ipecac to maintain a low body weight, the Los Angeles coroner pronounced the cause of her death as complications from anorexia nervosa and heart damage brought on by emetine, a chemical that is present in ipecac.

According to New York Senator Patrick Gallivan, sponsor of the new bill, ipecac has proven to be only marginally useful in cases of accidental poisoning but is a serious public health concern because of the high rate of abuse.

According to a new eating disorder study, people who are suffering from anorexia nervosa are five times more likely to die each year compared to other people.  The study, which was published in the Archives of General Psychiatry, also reported that people with bulimia are twice as likely to die compared to those without an eating disorder.  

People with anorexia have a distorted body image that causes them to restrict their diet and over-exercise to reduce their weight to unhealthy levels.  The complications that are associated with the disorder include bone and hair loss, anemia and loss of muscle mass.  The heart, kidneys and gastrointestinal system can be seriously damaged by anorexia.  Death due to malnutrition is another risk of anorexia.

For the study, researchers in the U.K. looked at three dozen previous studies published between 1966 and 2010.  The studies tracked over 17,000 people with eating disorders.  The studies did not record the exact cause of every anorexia-related death, but the health problems associated with the disorder were most likely a major factor.   The study also found that 20% of people with anorexia take their own life.

The American Journal of Psychiatry has previously reported that eating disorders in the U.S. have the highest death rate of any mental illness.  In total, 24 million Americans suffer from some type of eating disorder.  This includes anorexia, which strikes nearly one in every 200 women.   Among teenagers, anorexia is the third most common chronic disease.  Females between 15 and 24 who have anorexia are 12 times more likely to die from the disorder than from any other cause.     

Anorexia is a complex disorder that includes both physical and psychiatric symptoms.  Although it involves a preoccupation with food, the roots of the problem are much deeper.  People with anorexia try to control their food intake in order to compensate for overwhelming emotions.  These emotions may be associated with psychiatric problems that can include anxiety, depression and obsessive compulsive disorder.  Only one in 10 people who are affected by anorexia ever receive treatment.

Women in the fashion industry as especially susceptible to anorexia.  The NY Daily News recently reported on four fashion models who have died from anorexia in the past few years.  The most famous was Isabelle Caro, who passed away in 2010 at age 28 after struggling with the disorder for more than 15 years.  In 2007, Caro allowed a photograph of herself at 68 pounds to be published as part of a "No Anorexia" public service campaign.  She wanted to use her suffering to convey the message that the danger of extreme thinness is death.