An estimated 291,000 Iowans suffer from eating disorders, which range from mild to lethal.
Experts are spreading knowledge and information during National Eating Disorders Awareness Week, and calling for additional education, funding and research to combat the problem.
Researchers have not been able to pin down exactly what causes eating disorders, which can range from an unhealthy relationship with food to a lethal obsession with overeating, under-eating, or both; often at the same time.
Lauren Smolar, vice president of mission and education for the National Eating Disorders Association, said the illnesses can show up in a variety of ways, including someone abruptly eating drastically greater or lesser amounts of food than they typically do.
"It could also mean that they are not interested in eating meals with other people anymore," Smolar pointed out. "Drastic changes in shape or weight can be a warning sign of an eating disorder. But even cause for concern can be just changes in mood and shifts in attitudes; the way that they're talking about foods."
One thing researchers agree on is eating disorders are a mental illness, not a choice, and while people often assume young, white females are most frequently afflicted, anorexia and bulimia nervosa, along with a host of other eating disorders, do not discriminate and are common in both genders of varying ages and ethnic groups.
Smolar noted the pandemic heightened awareness of eating disorders and other mental health issues, but added, despite some progress, there is still precious little research, funding and social acceptance of eating disorders as lethal mental illnesses the way, for example, cancer is accepted as a deadly disease.
"But you can see cancer on a physical screening, whereas it's a little harder to show that an eating disorder is there, in essence," Smolar observed. "There is still a lot to be learned about brain chemistry and rewiring of brains and how mental health works, and it's much more normalized to talk about it, but there's just a lot more education that needs to be done."
Smolar said because health care workers are not required to learn about eating disorders as part of their training, early detection is also lacking. The American Society for Nutrition reports more than 10,000 people die each year from eating disorders, the second most lethal mental illness, behind only opioid addiction.
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Four of five Americans surveyed want to know if they face a future with Alzheimer's disease before symptoms arise, according to the latest Alzheimer's Facts and Figures report.
At least 35,000 Nebraskans are living with the form of dementia and want to know what treatment options are available to slow its progress.
Michele Magner, board member of the Nebraska chapter of the Alzheimer's Association, said it is much easier to determine whether someone could develop the disease thanks to a simple blood test.
"They're willing to take that test," Magner emphasized. "Medications are more accessible to them now than they were in the past, so it allows them time to prevent the ongoing impact of the disease process."
The research showed three in five Americans said they would be willing to take a medication to slow the progression of Alzheimer's, even if it came with a risk. The chances of developing Alzheimer's disease are higher if a parent has it.
Magner pointed out the effects of Alzheimer's disease do not stop with the patient because it has a trickle-down effect on Nebraska's unpaid caregivers, usually family members.
"Of our 41,000 reported caregivers in the state of Nebraska, 57.6% are also managing their own chronic health condition," Magner noted. "It's really important to be thinking about not just that person living with dementia, but also the people who are providing their care."
She added more than 35,000 Nebraskans age 65 and older are living with Alzheimer's disease.
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May is Mental Health Awareness Month and the latest state data show the number of Wisconsin youth who are struggling with their mental health has spiked.
The report from the Wisconsin Office of Children's Mental Health showed the numbers have increased dramatically over the past 10 years. While rates of anxiety, depression, self-harm, and suicidal thoughts went up across the board, girls saw an overall higher increase. Wisconsin boys however, are two to four times more likely to die by suicide than girls, according to the report.
Amy Marsman, senior research analyst at the Wisconsin Office of Children's Mental Health, said the trends are worse for LGBTQ+ students and students of color.
"They feel less connected to their school and less likely to report that they feel they belong at their school," Marsman explained. "We know that there are target populations that we should really focus on."
Marsman pointed out teens are also getting less sleep than ever before which is foundational to their mental health. She stressed caregivers should ensure they get sufficient sleep and limit screen time at home.
More than 20% of teens reported self-harm and nearly 25% of girls reported seriously considering suicide, according to the report. Marsman noted factors like rising food insecurity, particularly among students of color, also play a significant role. She added additional support during the pandemic helped to eliminate food insecurity gaps but now, black children in Wisconsin are five times more likely to be hungry than their white counterparts.
"Some of these everyday situations really impact youth mental health," Marsman observed. "Whether you're getting enough sleep, whether you are getting enough to eat, whether there's financial stability in your household, all of those are factors and they are disproportionately impacting kids of color."
Marsman argued tax relief to help families meet basic needs and sustained investments in school mental health are crucial to combating the issue. She emphasized programs like peer mental health groups at the high school level can help prevent suicide and improve school culture.
"Knowing that they have a trusted adult in their school and in their home is essential," Marsman underscored. "It just needs to be one adult that they feel that they can go to, so it's very important that parents are building relationships with the teachers in their child's school."
Wisconsin's "Speak Up, Speak Out" tip line is available 24 hours a day when anyone can report a mental health crisis or threat and receive confidential and professional support.
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As youth mental health challenges rise and federal restructuring threatens key programs, former Ohio Gov. and 2016 Republican presidential candidate John Kasich is urging Congress to act.
He co-chaired a bipartisan task force calling for early intervention and stronger support for young people struggling with behavioral health and substance use issues.
Kasich stressed the need to remove stigma and integrate mental health care into routine pediatric services.
"If we can intervene early, then we can get kids to be able to overcome the challenges, to be stronger, to be able to have healthier, more positive lives," said Kasich. "And there's nothing more important than our children."
The report warns that proposed changes at Health and Human Services could result in funding cuts to programs - like youth violence prevention and crisis response, which are currently supported by the Substance Abuse and Mental Health Services Administration (SAMHSA).
Bipartisan Policy Center CEO Margaret Spellings warned that youth-focused programs could suffer if federal changes move forward without safeguarding behavioral health investments.
"There may be funding cuts ahead that could put critical programs at risk," said Spellings, "including those focused on youth violence prevention, adverse childhood experiences, crisis response, and support for a very much needed workforce."
The report recommends integrating mental health into pediatric care, supporting the behavioral health workforce, and expanding school-based services - steps mental health experts say are vital to improving the outcomes for youth in Ohio and nationwide.
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