Ask Dr Ellie Cannon: Anorexia, HRT and verrucas
Our resident GP gives answers your burning medical questions...
Q While everyone is obsessed with obesity, I am worried my 18-year-old daughter is too obsessed with ‘clean’ eating, daily gym visits and avoiding anything perceived to be a treat or even vaguely unhealthy. She is very slim, but does she warrant medical help?
The medical profession is indeed gripped by the obesity epidemic, as it is thought to affect around 30 percent of the UK population.
The other extreme of malnourishment is certainly no less of an issue for someone like your daughter – it’s just that this issue affects far fewer numbers.
Your description of your daughter illustrates she may have some sort of eating disorder, given her obsession with gym use, low calorie intake and presumably body image.
The are very specific criteria to fulfil a diagnosis of anorexia, including a lack of menstruation, but it may be she suffers from EDNOS.
This stands for eating disorders “not otherwise specified” and describes the whole range of eating disorders and obsessions we now see in teenagers fixated with body image and dietary control.
This has quite clearly been perpetuated by media stories of weight loss and fad diets.
One such condition is orthorexia, where sufferers often start out wanting to be healthy and follow dietary advice, but become obsessively preoccupied with avoiding unhealthy food.
Being underweight for a young woman predisposes her to osteoporosis, which is a thinning of the bones, as well as menstruation and fertility disorders.
A good diet is a balanced one with good quality carbohydrate, protein and fat in the form of healthy oils and dairy, but the clean eating world often advises against much of that.
At this stage it sounds like your daughter would benefit from a visit to the GP and possibly even a referral to an eating disorders specialist.
It is often a misconception teenagers don’t want to talk about symptoms such as this and other psychological symptoms. In fact, often they are crying out to talk about their fears and anxieties.
The physical symptoms of weight control are a manifestation of a mental health problem that needs addressing. Broach the subject of simply “talking” to someone at the GP: a counsellor or a therapist who she can off-load onto.
The word “weight” doesn’t need to be mentioned at this stage.
Q We are at our wits end with verrucas! Can you please advise us what to do, as my son has had one since last summer and it has still not gone. We have used two products, but neither has helped.
Verrucas can be very annoying and troublesome for kids.
They can also be surprisingly painful and can account for kids not wanting to walk much, do sport or run around in the park.
They are slow growing wart viruses and yes they often do take a long time to clear up – often years.
The best products from the chemist are the ones containing salicylic acid.
However it is really important that as well as using the treatment you carefully follow the instructions to file the verruca too, to shed away the infected skin.
Another option is freezing therapy, which is called cryotherapy. This can be done at GP surgeries, but also at a podiatrist. This kills the verruca, but it involves some discomfort and your son has to be able to sit still for a few seconds!
Even this isn’t guaranteed though – sometimes verrucas can be very resistant and need two or three doses of freezing.
You have to ask specifically about cryotherapy at the GP, as it may only be certain doctors in the surgery who offer it.
Finally, have a look online at methods of treating verrucas using duct tape. This might sound odd, but there is some scientific evidence to show that duct tape can help. It’s worth a go and is pretty risk free and painless.
Q Do you think I should take HRT? Many of my friends are taking HRT, but I am worried as there have been many scare stories in the newspapers. I do suffer with daily hot flushes and mood changes.
Starting any medication involves weighing up the risks and benefits. Taking something to help alleviate symptoms of the menopause is perfectly valid: women going through the menopause today are very different to decades ago when women in their fifties were entering “old age”.
Nowadays menopausal women are often at the height of careers, busy with young children or grandchildren and even starting new relationships. Menopausal symptoms can not only be inconvenient, but debilitating for women busy getting on with their lives.
Symptoms can be wide ranging affecting mood and sleep, pain and discomfort within the bladder, as well as sexual issues and the oft-mentioned hot flushes.
Anecdotally I would say the most common symptom women complain to me about in clinic is insomnia, which can be pervasive and often the impetus to ask for help.
HRT has certainly made some headlines over the last few years with studies showing the risks it conveys.
This has meant it has swung in and out of popularity. There are some small increased risks of breast cancer with certain preparations and for an individual this should be discussed before embarking on any treatment, especially if you already have a higher than normal risk, for example from family history.
The medical establishment has agreed that any women taking HRT should take the lowest dose that works and take it for the shortest duration necessary. This may be for a year or two, which can be enough to get you through the worst of your symptoms: it can certainly be worth it for quality of life.
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