DEAR DRS. DONOHUE AND ROACH: Please do a column on anorexia. My 19-year-old granddaughter, who had plans of becoming a model, is now hospitalized because of it. She is nothing more than skin and bones. I believe she was about to die. This bright girl, even when she was skinnier than a rail, believed she was too fat. Is there hope for her? — A.N.

ANSWER: Anorexia nervosa is an illness that mostly strikes adolescent girls or women in their early-adult years. When they look into a mirror, they don’t see an emaciated body; they see a grossly overweight body. Their perception of their own body is unbelievably distorted. Anorexia is a mental illness and must be treated.

Anorexia also is a physical illness, an illness akin to starvation. It brings with it a host of body problems. Anorexic young women may feel dizzy and tired all the time. That’s to be expected, as they have no energy stores in their bodies. Menstrual periods often stop. Frequently, the young woman is severely depressed.

I take it your daughter and her husband arranged for the girl’s hospitalization. That was a life-saving decision. She will get the nutritional support she needs to function. Her doctor most likely will begin treatment with cognitive behavior therapy, therapy that roots out from the mind the false impressions your granddaughter has about her body and replaces them with perceptions that reflect reality. She might take medicine for depression, which is common in people with anorexia. Yes, there definitely is great hope for her.

I have addressed this topic as though it were limited to young girls. It can happen to women older than what I described. And it can happen to males, too. For every male who has anorexia, 10 females have it.

DEAR DRS. DONOHUE AND ROACH: I am an 87-year-old woman, very active and in good health. I still maintain my own home, mow my lawn and bowl three times a week.

My problem is damaged nerves in my feet. They keep me awake at night.

My doctor prescribed amitriptyline. It’s addicting. I do not want to be an addict. Is there anything I can do to ease the burning of my feet? — E.D.

ANSWER: Did your doctor say that you had neuropathy? Neuropathic pain does come from damaged nerves, and the damage can take many forms.

Amitriptyline isn’t considered an addicting drug. It doesn’t affect your thinking or your perception. Its main use is for depression. Many depressed people have used it for years and years, and have not developed an addiction to it.

Doctors discovered that amitriptyline controls the pain of neuropathy in many cases. You ought to give it a try. For treating neuropathy, a lower-than-usual dose is used, and it’s most often given at night. It will help you get to sleep. Another medicine used for neuropathic pain control is Cymbalta. It, too, belongs to the family of antidepressants.

Seizure-control medicines like Neurontin and Lyrica also are pain-control medicines. They are not addicting. It might seem strange that drugs can successfully treat unrelated illnesses, but there are many examples of drugs used for two or more unrelated conditions.

Perhaps you have heard of lidocaine, the medicine used to deaden sensations when a tooth is drilled or an incision of the skin is made. Lidocaine comes in patches that can be applied to the skin over the painful area. That’s another possibility you have for relief of neuropathy.

DEAR DRS. DONOHUE AND ROACH: I am a female in my mid-70s. Three years ago, I had my gallbladder removed. My eating habits have not changed, but I have gained 22 pounds. I read that gallbladder removal affects the digestive system. If I’m not digesting food, where does it go, and why have I gained weight? — M.K.

ANSWER: The liver makes bile. Bile is stored in the gallbladder. It aids the digestion of fats. When the gallbladder receives a signal that fat is entering the digestive tract, the gallbladder shoots bile into the tract. Without a gallbladder, bile trickles into the digestive tract on a more or less constant basis, and fat still is digested.

Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475 or email ToYourGoodHealth@med.cornell.edu with medical questions. Readers also may order health newsletters from www.rbmamall.com.

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