Roundup: One doc’s fascinating journey with obese patient; Minnesota children in prison experience more family violence; Newark, OH, op-ed on child abuse and brain damage

In this week’s Journal of the American Medical Association, Peter Vash, a physician at the University of California, Los Angeles, Department of Medicine, described a several-year journey with a morbidly obese patient that ended with the woman losing nearly 160 pounds and living a happier life.

Unlike most physicians, Vash did a detailed history in which he learned that Paula (not her real name) had been sexually molested by an uncle when she was a child. For a very long time, she did not associate her over-eating with her molestation. Vash’s story looks at how she arrived at that knowledge, and how that was critical to her recovering her health. Here’s some of what she told him (she gave Vash permission to tell her story):

“Eating was a big part of who I thought I had to be, how bad I was, and how undeserving I was. Food helped me to fill the emptiness and loneliness that I felt. And my fatness also showed me how unworthy and cheap I felt I deserved to be. I knew no one would want me, and with my eating and my weight, I made sure that no one would want me. But I’ve also come to understand my relationship with food and I’ve made peace with food. Now I can appreciate what food means to me. I think I always knew, but I didn’t know how to put my feelings into words. Not until now.

“You see, when you’re a child, you don’t have a voice, at least one that’s listened to, so food becomes your voice. It does your talking, shares your feelings, and acts as your interpreter. It becomes a trusted friend that never lets you down, abandons you, or leaves you alone. You come to feel that eating protects you and shields you from the ridicule and pain.

“But as an adult, you do have a voice, and food doesn’t have to do your talking. I’ve decided that food will never talk for me again.”

In case you don’t have a JAMA subscription, here’s the article: FillingTheVoid-JAMA.

A MINNESOTA SCHOOL SURVEY shows that children in prison have experienced more violence than those outside, according to this story by Rupa Shenoy on Minnesota.publicradio.org. The study, released by the Minnesota Department of Public Safety Office of Justice Programs, found that “53 percent of children in correctional facilities reported exposure to trauma, compared to 28 percent of youth outside the justice system.”

Experiencing and witnessing domestic abuse are the most common traumas reported by both youth in correctional facilities and mainstream schools.

 The study also found girls in the juvenile justice system were four times more likely to be subject to violence than boys.
THE EXECUTIVE DIRECTOR at Mental Health America of Licking County, OH, did an op-ed about the effects of child abuse on the brain on Newarkadvocate.com. Paddy Kutz reviewed what’s known about child abuse — basically that its effects are devastating and last a lifetime. Citing recent research out of Harvard University, he points out how child abuse damages the developing brain.

Abuse and maltreatment during childhood can shrink important parts of the brain that could lead to psychiatric disorders. The link between childhood abuse and reduced brain volume in parts of the hippocampus could help find new, better ways to treat survivors of childhood abuse, the scientists say. It was found that those who had been abused, neglected or maltreated (based on well-established interviews) as children had reduced volume in certain areas of the hippocampus by about 6 percent, compared with kids who hadn’t experienced abuse.

If this sounds too complex, he notes, this sums it up: “I know you can understand that abusing a child (or an adult) in any way is not good, and it is time to stop.” Well said, Paddy.

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