Dr. Elizabeth Axelrod Stegmaier, ND

Anorexia nervosa, frequently referred to as anorexia, is a disorder where people severely restrict the types and quantity of food they eat. Those with anorexia have an extreme fear of eating and gaining weight and may repeatedly weigh themselves or engage in harmful behaviors such as excessive exercise or starvation. Those with anorexia often find themselves preoccupied with food, but unable to consume a healthy amount of it. This results in symptoms such as abnormally low BMI, vitamin deficiency, fatigue, fainting, and amenorrhea (lack of menstruation in women). Anorexia may cause bluish discoloration of the hands, brittle and falling out hair, yellowish skin, and lanugo (fine, downy hair). Left untreated, anorexia can lead to organ failure, brain damage, and even death.

Bulimia nervosa, typically called bulimia, is a disorder where people binge (eat large quantities of food) and purge the food that they just consumed by vomiting, laxative abuse, fasting, or excessive exercise. This behavior is usually motivated by a feeling of powerlessness over eating and a fear of weight gain or desire for weight loss. Bulimia can occur in underweight, normal weight, and overweight people. Symptoms of bulimia include acid reflux, intestinal distress, dehydration from purging, amenorrhea, and dental erosion from vomiting. Some people with bulimia have swollen parotid glands (salivary glands near the cheeks) and red scars and marks on the backs of their knuckles. Electrolyte imbalance from bulimia can be particularly severe and may lead to heart attack or stroke.

Binge eating disorder (BED) is the most common eating disorder. People with BED feel that they are unable to control the amount of food they eat and may continue to binge after reaching a point of fullness. BED binges (consuming large amounts of food) are often accompanied by feelings of sadness, guilt, and shame. Symptoms of BED include obesity, acid reflux, weight gain, and dissatisfaction with one's body. People with BED tend to experience cycles of negative emotions and binges. Binges or BED episodes can be provoked by stress, boredom, restrictive dieting, depression, and other triggers.

Other common eating disorders include:

• Pica, eating things that are not food, such as paper, ice, or soil
• Avoidant/Restrictive Food Intake Disorder (ARFID), disinterest in eating and avoidance of food
• Other Specified Feeding or Eating Disorder (OSFED), abnormal eating that does not fall under any disorder

Many people with eating disorders do not consciously develop them, and have difficulty seeking treatment. For this reason, it's important to detect and treat eating disorders as early as possible. Treatment for eating disorders can vary from therapy visits to inpatient treatment, depending on the disorder and its severity. Treatment aims to not only restore physical health and correct negative behaviors, but to also promote psychological well-being and self-confidence.

Heart disease is the leading cause of death in the United States for both men and women. This includes coronary artery disease, heart attacks, congestive heart failure, and congenital heart disease. Some conditions, such as genetics, cannot be controlled. But there are many other things one can do to lower their risk for heart disease. Controlling high blood pressure and cholesterol levels, reducing or stopping smoking, exercising more and losing weight if needed, and eating a diet low in sodium can all protect the heart.

Angina is a squeezing type of chest pain that happens when the muscles around the heart don't get enough oxygen. It can be regular or infrequent. Usually, angina is caused by coronary heart disease. However, not all chest pain is angina. Chest pain can also be caused by a lung infection or panic attack, for example, so it is important to have any sudden pain checked.

Arrhythmia is the word for when the heart beats too fast, too slow, or irregularly with skipped beats. It can feel frightening, and depending on the type it can be dangerous, but in most cases arrhythmia is not serious and can be treated. It is very common, especially in older adults.

Heart valve problems can happen in any one of the the heart's four valves that keep blood flowing where it needs to go. Babies can be born with problems in their heart valves, or valves can be damaged by infections. The valves can stiffen and become less mobile, or they can stop closing properly and 'leak' when the heart beats. Valve problems can usually be repaired surgically.

• Blacklegged (deer) ticks, which spread Lyme disease in the Northeastern, North -Central, and mid-Atlantic United States.
• Western blacklegged ticks, which spread Lyme disease in the Pacific and Coastal regions of the United States.
• A mother infected with Lyme disease may pass it onto a fetus.

As background, ticks lay on the tops of grass and brush, clutching onto leaves with their legs and with their arms outstretched. This formation is called "questing" and allows ticks to quickly latch onto passers-by. Within two hours of biting a person's skin, the tick slowly begins to feed from the blood of its host, which can transmit the bacteria that causes Lyme disease. This tick activity generally occurs seasonally and tick bites mostly occur during the springtime.

After being infected, people with Lyme disease may develop symptoms like fever, exhaustion, headache, joint aches, and skin rash, usually three to thirty days after the tick bite. Lyme disease is characterized by a particular skin rash called erythema migrans, which is an enlarged red rash that starts at the site of the tick bite and expands outwards. The rash is a strong indicator that someone has developed or is at risk of developing Lyme disease.

In the following few months, symptoms may worsen and progress to include:

• Facial palsy (facial droop)
• Headache and neck pain
• Arthritis
• Nerve pain and numbness
• Spinal and brain inflammation
• Abnormal heart rhythm (Lyme carditis)

Most cases of Lyme disease dissipate over a few months. Lyme disease may be cured by a course of oral antibiotics, such as amoxicillin or doxycycline. Other treatments may include:

• Nerve blocking drugs for pain, such as gabapentin
• Topical ointments for rashes

People can take action to prevent Lyme disease by exercising caution when in environments with ticks. Using insect repellant and wearing long socks and protecting clothing can help prevent tick bites. Outdoor enthusiasts should regularly perform "tick checks," evaluating their skin for small ticks, especially in areas where ticks may easily burrow. Showering within two hours of returning indoors also can reduce the likelihood of developing Lyme disease.