Tag Archives: mental-health

The Face of Kidney Attack Part III

He didn’t die, quite.  But later thought he may well of.  Steve Gurney’s episode of Acute Kidney Injury (see Part II) didn’t finish him after he was discharged from his third hospital (one each in Malaysia, Singapore and New Zealand) – 4 weeks after the event. While media outlets clamoured to hear the story of this amazing athlete’s brush with death, he had a $92,000 medical bill and was so weak he could barely walk.  He couldn’t return to his own home because it was on a hill and he couldn’t make it up the steep track.

Steve did all the right things.  He began exercising by walking to the letterbox and gradually increased it from there.  He lived on fruit, vegetables, nuts, legumes and meat – nothing pre-processed.  While his body began to be restored, it was the mental anguish – so often hidden from others – that really shook him up.  This from his book “Lucky Legs”:

“I’d gone from top dog in my sport to lowly turtle.  My aim to compete as a mountain biker in the Olympics had disappeared down a mud puddle.  I’d lost 15 kilograms, mostly muscle, there was a possibility of permanent kidney damage and my career as a pro athlete was in question.  My fuzzy mind reasoned that the ‘mat of my expertise’ had been jerked from under my feet now that I had been robbed of my fitness, too.  It was like the bottom had fallen out of my world and I was falling, out of control, with nothing to ground me.  ….The depression went on for six months … death seemed like a realistic solution  … But there was a tiny spark that said, ‘Don’t jump. … hang in there … like a long endurance race …”

Steve’s story of recovery is one of endurance and it is one of reaching out for help.  Some of the help Steve got was from practices which scientifically speaking don’t have a leg to stand on, yet the process of reaching out and talking with people concerned and willing to help was, and is to anyone in similar situations, so very important.  Steve didn’t go for homeopathy, but I’ve been told be someone who acknowledges it is a load of nonsense that they think it valuable to have in the community because of the power of the placebo affect.  She may well be right (needs a study).

Steve wins again

Steve wins again

The story continues and is one of anguish and triumph.  The two time winner of the Coast to Coast returned to it three years after his brush with death and won again, and then won another six years in a row.  Steve’s experiences had strengthened him mentally and focussed him on the things that mattered most to him.  As he said, “Contracting leptospirosis … was a good thing.”

There is an ancient Hebrew concept of health called “shalom.”  Often translated simply as “peace” it is actually much broader than that.  Unlike the common idea of health being merely an absence of illness, it encompasses the notion of being in right relationships – spiritually, physically, environmentally, and communally.  Those of us working in medical science do well to be reminded of shalom.

One third of New Zealanders addicted to food: fact or fiction?

Today’s Press Headlines read “Third of Kiwis ‘need to kick food addiction’”

The quote is attributed to Professor Doug Sellman, Director of the National Addiction Centre and is a call for more funding to support this group. My first reaction was “Give someone a hammer and everything looks like a nail.” Alas, I can’t leave it with my prejudices.

What evidence is there for food addiction and for 1/3rd of NZ’ers being addicted?

I searched the medical literature (PubMed) for any work relating to New Zealand and Food Addiction. I found one article from the NZ Medical Journal co-authored by Professor Sellman: Addictive overeating: lessons learned from medical students’ perceptions of Overeaters Anonymous. (N Z Med J. 2010 Mar 19;123(1311):15-21.). The research is a synthesis of the reports of 72 5th-year medical students who as part of their training attended a meeting of Overeaters Anonymous. The “results” are a series of quotations which pick up on some themes and includes the concept of the attendees talking about the concept of addiction.

A brief look at the review literature on PubMed revealed that the concept of “food addiction” is new and by no means an established addiction. One paper, How Prevalent is “Food Addiction”?  (Front Psychiatry. 2011; 2: 61), talks about how few tools there are to assess food addiction. One tool – a questionnaire –(the Yale Food Addiction Scale) has recently undergone some validation studies. In normal weight participants food addiction, according to this scale, was diagnosed in 8.8 and 11.4%. In one study of obese participants it was 25%. Interestingly there was very little correlation between diagnosis of food addiction and Body Mass Index in these studies. A second freely available review asks the question “Does Food Addiction Really Exist?” (Obesity Facts 2012 19;5(2):165-179). The authors note that in some individuals the underproduction of the hormone, leptin, “has a pronounced effect on the reward system, thus suggesting an indirect link between overeating and ‘chemical’ addiction.” Their major conclusions are:

“Because of the current rather limited evidence of the addictive behavior of specific food ingredients or additives, we currently conclude that food addiction can best be classified as a behavioral addiction at this time. However, because there is not sufficient (i.e., reliable and valid) data on its diagnostic criteria, we would not recommend adding ‘food addiction’ as a diagnostic entity in DSM-V” (the 5th edition of the American Psychiatric Society’s Diagnostic and Statistical Manual of Mental Disorders).

“We conclude that overeating may be viewed as food addiction in a small subgroup of obese individuals”.

Disclaimer: I have no expertise in Psychiatry or eating disorders.

Claimer: I can’t find any published research to support the contention that 1/3rd of New Zealanders are addicted to food.