Is GRAVITY to blame for baldness? Expert claims downward pull on the scalp causes hair loss as a man ages.

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Gravity pulling down the skin of the scalp is to blame for baldness, an expert has claimed

From poor genes to hormone problems, there are many reasons why a man can go bald.
And now one expert has come up with a somewhat novel theory - gravity.
Dr Emin Tuncay Ustuner, a plastic surgeon in Ankara, Turkey, believes gravity pulling down the skin of the scalp is to blame.
The vast majority of men suffer from male pattern baldness and Dr Ustuner believes his theory is 'unparallelled' in its ability to explain this type of hair loss.
The answer, he says, is the weight of the scalp on the hair follicles.
In younger men, the scalp has sufficient fat tissue under the skin, and it is 'capable of keeping itself well-hydrated,' taking the pressure off the hair follicles.
But as a man ages, the skin and underlying fat become thinner, and the pressure on the hair follicles increases.

Declining levels of the male sex hormone testosterone contribute to thinning of this fat, Dr Ustuner explained.
As the amount of cushioning fat decreases, the hair follicle has to work harder against all the pressure - and needs more of the hormone for normal growth.
To respond to this, a potent form of the male sex hormone testosterone, called dihydrotestosterone (DHT), builds up in the scalp.

 

The hair growth cycle accelerates in response to DHT, but it's not enough to overcome the increased pressure. Over time, the hair follicle becomes smaller and smaller, resulting in progressively increasing hair loss.
But it is a vicious circle - because higher DHT levels also cause fat to melt away, he added. 
If the pressure created by the weight of the scalp is the cause of balding, then hair loss should occur at the top of the head - 'and this is exactly what happens in male pattern baldness', Dr Ustuner points out.

Hair loss patterns are affected by differences in the shape of the head, reflecting variations in scalp pressure. For example, the ears help resist the effects of gravity on the scalp, lessening hair loss on the sides of the head

He believes that individual hair loss patterns are affected by differences in the shape of the head, reflecting variations in scalp pressure.
The weight of the facial soft tissues adds to the pressure at the front of the scalp, contributing to hair loss there.
In contrast, the ears help resist the effects of gravity on the scalp, lessening hair loss on the sides of the head.
The research is published in the journal Plastic and Reconstructive Surgery.

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Is this the best diet news ever? Eating plenty of chocolate can keep you SLIM.

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It seems like news that really is too good to be true.
Rather than being a major factor in piling on the pounds, eating large amounts of chocolate is one of the best ways to lose weight, a study has found.
Spanish researchers examined the diets and healthy activities of 1,500 teenagers aged between 12 and 17 in nine European countries, including Spain and the UK.
They found that people who admitted eating large amounts of chocolate had, on average, far lower levels of fat over their bodies.
In particular, they were trimmer around the stomach area - regardless of whether they had an active lifestyle or were on a diet.
Chocolate was also found to have a positive effect on circulation, blood pressure and heart health.
The study, from the University of Granada, backs up earlier findings from the University of California that suggested regular chocolate eaters have less body fat.
This may be because while chocolate contains more calories than many other foods, it appears to make the metabolism work harder, offsetting the fat that otherwise might hang around.
There's also the issue of denial. A recent poll found that 86 per cent of slimmers who carried on enjoying their favourite treats successfully lost weight.

 

Janet Aylott, a nutrition scientist for Nutracheck, which commissioned the survey, said: ‘Extensive research has proven that diets centred around food elimination are much more likely to fail.
‘The key is to take a more relaxed approach and to have a little of what you like.’ 
Previous research has shown that dieters who completely eliminate treats such as chocolate, wine and biscuits  are often more likely to put on weight as they ‘compensate’ by eating more of  other foods.

Regular chocolate eaters were also were trimmer around the stomach area - regardless of whether they were active or on a diet

One study even showed that as many as 65 per cent of those who give up all treats actually end up ballooning in weight.
Another recent study from the University of Cambridge found people who enjoyed chocolate every day were 29 per cent less likely to have a stroke and 37 per cent less likely to suffer with heart disease than those who avoided it most of the time.
It is the flavonoids in cocoa beans - a key ingredient in chocolate - that seem responsible for the health benefits of chocolate. These flavonoids (also found in tea and red wine) act as antioxidants, which help mop up an excess of cell-damaging free radicals.
As a rule, the higher the cocoa content, the more flavonoids and the greater the health benefits - dark chocolate with 40 per cent cocoa solids contains five times more flavonoids than white chocolate and twice as many as milk chocolate.

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'Taking ketamine meant I needed a new bladder at SEVENTEEN': Teenager’s horror after drug led to incontinence.

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A 23-year-old man has spoken of his horror at needing a new bladder at just 17 after snorting ketamine.
Chris, from Hampshire, began using drugs when he was just 12 years old and his cannabis use quickly spiralled to hard drug abuse.
He began taking ketamine at 16 and within just a year, he had taken so much that he had caused irreversible damage to his body.

Old before his time: Chris needed a new bladder at just 17 after snorting ketamine excessively. He began using drugs when he was 12, his cannabis use quickly spiralling to hard drugs. He began taking ketamine at 16 and within just a year, he had taken so much that he had caused irreversible damage to his body

Ketamine is known for shrinking and scarring the bladder - and Chris' had shrunk to the size normally seen in a pensioner.
At just 17, he needed to have his bladder removed and a new one made from his bowel - or face a life of incontinence.

 

Chris is one of several young people featured in a BBC3 documentary airing tonight. Called Old Before My Time, presenter Cherry Healey follows people who have ailments typically seen in pensioners because of drug abuse.
Although he has a new bladder, he is by no means free of health problems
Every two weeks he must insert a catheter - a thin, flexible tube - into his belly button and syringe out mucus sitting in his bladder.

Chris went to see a specialist who gave him shocking news - his bladder had shrunk to a fraction of its normal size - and was smaller than a pensioner's. A normal bladder can hold up to 500ml - but Chris' could hold just 5ml

Viewers see the stomach-turning moment where the mucus fills the syringe attached to the tube in his stomach – a far cry from the hard core raver he once was just a few years ago.
Ketamine use in the UK has doubled since 2006 – around the time Chris began taking it.
In the documentary, he explains: ‘I started taking drugs when I was 12 – starting with cannabis and gradually working up to heavier things.
‘When I started taking K I took a gram a night, but before long, as I was taking 10-15g a night – I had a wicked time.’
But within months, his body began to object violently to his drug abuse.

At just 17, he needed to have his bladder removed and a new one made from his bowel - or face a life of incontinence

Although he has a new bowel, he is by no means free of health problems. Every two weeks he has to insert a catheter (a thin, flexible tube) into his belly button and syringe out mucus sitting in his bladder

‘I was at a party, tried to go to the loo and it was really painful. Then a big lump of goo came out – blood, mess… it as horrible.’
Chris went to see a specialist who gave him shocking news – his bladder had shrunk to a fraction of its normal size - and was smaller than a pensioner’s.
A normal bladder can hold up to 500ml – but Chris' could hold just 5ml.
Normally, the bladder wall expands when filled with urine and contracts when emptied.
But extreme ketamine use can cause stiffness and scarring in the bladder walls which means it can only expand to a tenth of its normal size.

While the bowel material can act as a bladder, it is probe to collecting mucus that must be washed out

Viewers see the stomach-turning moment where the mucus fills the syringe attached to the tube in his stomach - a far cry from the hard core raver he once was just a few years ago

To avoid a lifetime of incontinence, Chris had two options. He could have a bag attached to his hip – or have his bladder removed totally and a new one made from his bowel – surgery typical in someone 60 or 70 years of age.

He went for the latter – but must now syringe mucus out of his bladder for every two weeks of his life.
His days of playing rugby are over and he is at risk of dangerous kidney infections.
His new bladder won’t forever, either – he will need it replacing again in 20-30 years.
But ketamine doesn’t just cause physical problems such as Chris' – it can severely affect the brain, too.
The documentary also follows 29-year-old Dave, who has been using ketamine for eight years.
He has noticed a disturbing deterioration in his memory – to the point where he can walk into a room 10 times and not remember why he is there.

The documentary also follows 29-year-old Dave, who has been using ketamine for eight years. He has noticed a disturbing deterioration in his memory - to the point where he can walk into a room 10 times and not remember why he is there

Ketamine blocks receptors in the brain that are important for how we learn and respond to new experiences. These receptors are hugely concentrated in the areas critical for memory – the hippocampus – and people who take a lot of the drug can have memory problems as bad as the early stages of dementia.
Like Chris, Dave began taking ketamine at raves – but he soon became addicted.
In memory tests conducted during the documentary, Dave struggles with basic recall tasks such as naming words that begin with the letter F – or thinking of different types of fruit.
Professor Val Curren explains that ketamine users often have problems recalling names, words and conversations – all common signs of dementia in old people not someone in their twenties.
Dave vows to stop taking the drug – claiming he is now only using it once a month. If he doesn’t, the tests show his memory will only get worse and worse.

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How to get Eva Mendes's waist: Secrets of an A-list body.

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Actress - and Vogue cover girl - Eva Mendes works hard to stay in shape.

Hard worker: Eva Mendes runs, does yoga, and visits a gym for boxing workouts

The 39-year-old runs four or five times a week for 35 minutes, as well as doing an hour of weight training at the gym three to four times a week - with 'not too many repetitions' so that she doesn't bulk up. Eva also does yoga and visits a gym in Manhattan for arm-shaping boxing workouts with her trainer.

 

What to try: The side plank with reach-around is a great route to a trim waist like Eva's. Lie on your side and elevate your body, supporting your weight between your forearm and feet.
Keep your body straight with your hips off the floor; your neck and back should be straight. Raise your upper arm straight above you, then bend the arm and drop that hand behind your back. Lift arm back up to starting position and repeat two to three times before changing sides.

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Forget salt and pepper - BACON is the ultimate seasoning: Research shows rashers make almost all food taste better.

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From the humble sandwich to an expensive salad, there are few dishes that don't taste better with bacon.
And now, the point has been even mathematically proven.
A massive number-crunching exercise has revealed that dishes with bacon really do taste better - and very few taste worse.

Better with bacon: New research has found that virtually every dish - especially sandwiches - taste better when a rasher or two is added

Tech magazine Wired teamed up with the Food Network to analyse 50,000 recipes and 906,539 comments on them.

WHY DOES BACON MAKE US SALIVATE?

Previous research has pinpointed the exact chemical reaction that makes bacon so smell so tempting.
Called the Maillard reaction, it occurs between an amino acid and a reducing sugar when heated.

The acid and sugar react to release a huge amount of smells and flavour that make us salivate.
Elin Roberts, of the Centre for Life education centre in Newcastle, explained the reaction releases hundreds of smells and flavours, but it is the smell which reels in the eater.
'If we couldn't smell, then taste wouldn't be the same.'

Explaining how the results were calculated, Wired writer Cliff Kuang said: 'First, we searched out all the recipes that fit a certain description - sandwiches, for example.
'Then, we calculated the average rating for those foods if they did not include the word “bacon.”

'We ran the numbers again using only recipes that did include bacon. Of all the foods we analysed, bacon lends the most improvement to sandwiches.'
Many other dishes also got a boost when bacon was added - when the data was analysed, those with with a rasher or two included got better scores.
There are various theories as to why - not least because of the crunch and flavour bacon adds to sandwiches. It's also a good addition to salads - providing it doesn't go soggy.
Recipes with spinach and asparagus were all rated better when they contained bacon, for example.
But it wasn't all good news. There are foods that get worse with bacon - namely pasta (particularly in creamy sauces) and, rather unsurprisingly, desserts. 
The data analysis also gave a fascinating snapshot into the most popular foods through the last few years.

The data analysis also gave a fascinating snapshot into the most popular foods through the last few years, including the surge in popularity of cupcakes since 2009

Two major trends are the surge in popularity of cupcakes and gluten-free products since 2009, while salted caramel and sriacha (hot sauce from Thailand) have soared in popularity since 2011.
On the other hand, portobello mushrooms and low carb diets were big in 2007, but have nose dived since then.
The trends were calculated by findings the total number of reviews for each food. Wired and the Food Network then calculated what percentage of the recipe reviews came in each quarter since 2007.
But the results clearly show one thing: bacon has always been popular.
Previous research has pinpointed the exact chemical reaction that makes bacon so tasty.
Called the Maillard reaction, it occurs between an amino acid and a reducing sugar when heated. The acid and sugar react to release a huge amount of smells and flavour that make us salivate.

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New toothbrush shaped like a mouthguard cleans your teeth in just six seconds.

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A new type of toothbrush which is shaped like a mouthguard has been developed by manufacturers in the U.S., who claim it will fully clean teeth in a mere six seconds.
The device is lined with 400 bristles that clean the surface of and in between the teeth. The bristles are the same as those on a toothbrush but are attached to the mouthguard at a 45-degree angle.
To use it, you bite down and release 10-15 times - allowing the teeth to move up and down against the fixed bristles, cleaning them and particularly the space underneath the gumline.
While your teeth are closed, you should grind them left and right and backwards and forwards to give an additional clean.
The new gadget - called the Blizzident - is moulded from plastic, and made from an impression of the patient’s own teeth. It is popped into the mouth along with a blob of toothpaste.
The manufacturers claim that tests show the device removes 100 per cent of plaque from teeth in just six seconds.
The device also contains a series of small holes through which dental floss can be inserted and woven through the gum shield.
This means that when the users bite and grind on the device, they can also floss at the same time.
The positions of the 'floss holes’ ensure that the floss tape is applied in between teeth with the correct amount of pressure, say the manufacturers (as flossing by hand can actually damage gums rather than benefit them if too much force is applied).
The tool itself costs around £200 (plus an additional £100 to have an impression taken by a dentist which must then be sent to the company in the U.S.) and should last around a year, after which the bristles can be replaced at a lower price.
Commenting on the gadget, Professor Damien Walmsley, scientific adviser to the British Dental Association, said: 'This is a novel approach to cleaning your teeth, although we need further studies to be done in order to ensure that the device is safe and effective.
'And it is also most important to remember that when it comes to  keeping our teeth healthy, it’s not really what sort of brush you use that counts, but just how well you brush with it.’
Prof Walmsley recommends holding a soft-bristled toothbrush against the gum at a 45 degree angle and then using gentle circular movements to clean the teeth.
'When brushing your teeth it is important to clean the inside, outside and chewing surfaces of all your teeth. It is important to brush teeth in a thorough and systematic manner, and for at least two minutes.’
Professor Walmsley adds: 'Don’t forget to brush the hard-to-reach teeth at the back, and where the tooth meets the gum, areas that are often overlooked.
'Use short gentle strokes, a fluoride toothpaste and wait for an hour after eating before brushing.’
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Meanwhile, studies suggest that high-dose statins may reduce gum disease.
In a study of 59 heart-disease patients, published in the Journal of the American College of Cardiology, the group were given a daily statin for 12 weeks. The health of their arteries was measured, but the researchers also tested their gum health, after earlier studies showed that gum disease is linked to inflammation in the arteries.
After four weeks of taking the statins, all the patients showed improved gum health, and reduced gum inflammation. The health of their arteries also improved.
The researchers behind the study, at Harvard Medical School, are unsure why the statins produced an improvement in gum health, but say this study provides further evidence that there is a crucial link between gum disease and heart health.

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Ask the doctor: How can I stop my knee from suddenly locking up?.

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A few weeks ago my knee completely locked, leaving me in excruciating agony and unable to straighten or stand on it for quite a few hours. It finally clicked back but was extremely sore.

After tests my doctor told me it was caused by arthritis - and that there was nothing they could offer me apart from painkillers. My knee is still very sore, and I am terrified it could lock again at any time. It also keeps giving way and clicks when I walk. Is there really no treatment that could help me?

I am 57.
Hazel Banks, by email.

Agonising: When a knee locks, it is usually due to a loose fragment of some material getting jammed in the joint hinge

From the description you have given it sounds to me as if further investigation is needed, as I believe that other factors are at work.
Osteoarthritis, which is caused by the shock-absorbing cartilage in the knee becoming damaged due to age-related wear and tear, causes a number of symptoms. It would make a knee painful, swollen and cause it to click (due to the damaged cartilage rubbing together), but worn-away cartilage would not alone make it lock.
When a knee, or any joint, locks (which as you know, is an agonising experience), it is usually due to a loose fragment of some material - often cartilage, but sometimes bone - becoming jammed in the hinge of the joint.
These fragments can be the result of arthritis, but they often also appear in non-arthritic knees through some injury or trauma. This loose, floating piece of cartilage can be hard to spot, as it won't be seen on an X-ray (only very dense tissue, such as bones, can be detected using this).
Instead, an MRI (magnetic resonance image) of the knee is needed, as this reveals all of the structures of the knee - bone, ligament and cartilage - and will usually identify a loose body.

CONTACT DR SCURR

To contact Dr Scurr with a health query, write to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk — including contact details.

Dr Scurr cannot enter into personal correspondence.

His replies cannot apply to individual cases and should be taken in a general context.

If a fragment has been spotted, and you continue to experience symptoms, you may need to undergo a keyhole procedure known as arthroscopy - where the loose piece of cartilage is removed under general anaesthetic.
However, the decision whether to operate can only be made after an MRI has been performed.
Given your history, and the extent of your continuing symptoms, I suggest that you seek referral, as dealing with these symptoms is a routine matter for a knee specialist.

For the past two years I have suffered with a very sore mouth. My GP diagnosed oral thrush, which I was told may have been caused by using my asthma inhalers. I was given an anti-fungal gel, but it wasn't highly successful.

However, I've been told, after a recent appointment with my dentist, that I also have another type of rash over my mouth, called lichen planus, for which there is no cure. Is there anything I can do to minimise the soreness, and is there really no medication I can take? 

I am reluctant to go back to my GP as it took long enough for them to investigate my symptoms in the first place. I also have coeliac disease, which was diagnosed 35 years ago. I am aged 69.
Mrs J. Gascoigne, by email.
What a confusing situation you're in - but don't give up hope, as I believe there may be options available to you.
Lichen planus causes painful, inflamed areas on the skin or lining of the mouth.
The condition is most common in middle-aged adults (three quarters of cases are in women) and causes white marks or patches in the mouth, usually both sides, and most often on the areas lining the cheek; it can also trigger painful ulcers.

 

In some individuals the lichen planus erupts on the genital area or scalp.
We believe the condition occurs when the immune reaction mistakenly starts attacking the body's cells. Why it does this is unclear, but it could be triggered by an infection, medicine, or perhaps even a type of chemical or food, although nothing is yet proven.
In severe cases the patches can lead to scarring, and leave permanent dark patches.
There is a potential link with coeliac disease (an allergy to gluten, a protein found in wheat), which is not surprising as both conditions involve a malfunctioning immune system.
Try not to lose faith in your GP, as the condition is often confused with oral thrush.
This looks very similar to lichen planus, though it is a fungal infection caused by the yeast Candida albicans.
Your doctor is correct in that it is especially common in people using asthma inhalers, which contain steroids, as these suppress local defence systems in the mouth, allowing the fungus to take hold.
Although there is no cure for lichen planus, the symptoms can be minimised, usually with steroids.
These can be applied as either a gel or ointment, three or four times daily to the affected areas, using a fingertip or cotton wool bud.
Your dentist or GP must prescribe the medication, and the duration of treatment will depend upon the rate and extent of improvement, which I hope will be significant.
However, not all patients respond to steroids, in which case a specialist must be involved.
They will try other medications that suppress the malfunctioning immune system, such as tacrolimus or cyclosporine (these drugs were developed for use after transplants to stop the immune system attacking the new organ), or they may try injections of steroids directly into the lesions in the mouth.
Meticulous oral hygiene is also essential - brush carefully with a soft brush twice daily at least, and use dental floss every day.
Do try to conquer your reluctance to see your GP for further help as now that your dentist has made the diagnosis it will be clear that you merit a specific treatment - and perhaps even referral to a specialist.
By the way...Stop doling out Ritalin so readily

This week I was asked on three separate occasions to write repeat prescriptions for young patients taking daily medication for ADHD - attention deficit hyperactivity disorder.
The condition leads to hyperactivity, a short attention span and restlessness, and the drug most commonly prescribed by specialists is methylphenidate (Ritalin) or a variation of this. The medication appears to boost concentration by altering levels of brain chemicals.

Misdiagnosis: A great proportion of children are wrongly labelled ADHD and given tablets linked to insomnia, irritability and other undesirable side-effects

Twenty years ago I had hardly heard of the condition; and when I was a medical student the phrase had not even been coined. These problems of attention and behaviour were then just considered to be part of life and a characteristic of an individual's personality - but now we diagnose them as a mental illness.
The foundation of this new world occurred in the 1990s when the condition was first described and defined in the Diagnostic and Statistical Manual of Mental Disorders (the 'psychiatrist's bible', it is produced by the American Psychiatric Association, and is known as DSM).
The view emerged that ADHD is common, the diagnosis was being missed - and something had to be done. True, some children were correctly identified and diagnosed, and the medication reduced restlessness, helped with temper tantrums, and improved learning. But a greater proportion of children are misdiagnosed, wrongly labelled, and given tablets linked to insomnia, irritability, abnormal heart rhythms, and other undesirable side-effects.
The most recent evolution has been the tendency for undergraduates to request - or more often demand - Ritalin to help them concentrate when studying, with the threat that if we don't prescribe they will obtain the pills illicitly.
Doctors must stand firm, reduce inappropriate diagnosis, and avoid excessive use of medication. I, for one, will only prescribe when the patient has been seen and assessed by a psychiatrist who is an expert on this condition; there is no place for prescribing as a 'therapeutic trial' - to see if it works. Shoot first and aim later is not an option.

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Having your hair done - or reversing a car. The unlikely triggers that can give you a stroke.

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Nurse Cija Smith had always longed to try bungee jumping, so when she was travelling in New Zealand earlier this year, she took the plunge.
The experience was every bit as exhilarating as she'd hoped. But immediately after, she started to have tunnel vision.
'I couldn't see at the side, just ahead. I thought I was maybe feeling a bit faint because of the jump,' recalls Cija, 32.

Months of treatment: Cija Smith, a 31-year-old nurse, had intensive speech and language therapy at the hospital and at home

'Then a few hours later I developed a  throbbing headache on the left side, but I had been travelling for a few months by then and thought I was just tired and ready to go home, so I took a paracetamol and went to bed.'
A week later, on April 1, she was back at home in Starston, Norfolk, with boyfriend Byron Trigg, 43, a scaffolder, when she woke up in the night feeling unwell.
'I just didn't feel right and went to get out of bed and collapsed,' says Cija.
'My right side was totally paralysed and my speech had gone - but luckily Byron, who was downstairs, heard me fall.'

 

Cija was rushed by ambulance to her local hospital where a CT scan revealed a tear in an artery in her neck which had caused a blood clot and a stroke.
'Being a nurse I knew as soon as I collapsed that it was a stroke,' says Cija. 'I'd worked on a stroke unit during my training and I'd seen people left unable to speak at all and stuck in a wheelchair for the rest of their life.
'I was hoping that it was a minor stroke, and that I'd be fine, but I was terrified.'

Trigger: Cija's bungee jumping escapade resulted in a tear inside an artery, leading to her strokes

Fortunately, her movement returned within hours, but while her speech showed some improvement - within a day she could say the odd word - it was very slurred. Then, three days after the initial stroke and while she was still in hospital, Cija felt tunnel vision coming on again.
'I felt this pain building in my head. Then I lost my speech completely again and my body went into spasm; my right side was completely paralysed, but whereas after the first one the paralysis eased off, this time that didn't happen,' she says.
Swelling from the initial stroke had caused a second one and Cija was moved to Addenbrooke's Hospital in Cambridge, which had the facilities for surgery should the swelling increase.
'I kept thinking: “This can't be happening to me,” ' recalls Cija. 'It was so scary because I had no means of telling people what I was thinking or feeling.'
Strokes are usually associated with old age, but while the rate in older people has declined by 40 per cent since the mid-Nineties, the figure for younger people is rising; the number of those aged 20 to 64 affected is up by a quarter worldwide, according to new figures.
As many as a quarter of strokes in the UK each year are in the under-65s. Obesity and other lifestyle factors are thought to be the primary cause. A stroke occurs when blood flow to the brain is interrupted, usually because of a blood clot.
And in around a quarter of cases in the under-45s, the cause is a tear - or 'dissection' - inside an artery; this slows the blood flow, leading to a clot. (The dissection rate in the under-45s is much higher than for all age groups, where it is 2 per cent).

'I kept thinking: “This can't be happening to me.” It was so scary because I had no means of telling people what I was thinking or feeling.'

'The tear will be triggered by some form of trauma that can be quite trivial,' explains Dr Richard Perry, a consultant neurologist at University College Hospital London.
'We hear quite a lot of people going to the hairdresser, putting their head back to have their hair washed and suffering a dissection. Doing the butterfly stroke swimming can also trigger it as it requires people to put their neck up quite suddenly.'
There have also been stories of strokes following a visit to the chiropractor where people have their neck 'cracked', he says. 'The symptoms of the stroke normally come on hours rather than days after the event,' adds Dr Perry.
But most people can go through their life going to the hairdresser or even bungee-jumping without a dissection or a stroke, he says.
'That's why there is the idea -not proven - that there must be some predisposition,' he says.
A study of people who'd had a dissection found they had very minor abnormalities in their collagen, a fibrous protein found in skin and blood vessels.
'There is also a theory that an infection may temporarily weaken the blood vessels - and if you ask someone who has had a dissection if they have had a chest infection in the preceding six weeks, a disproportionate number will tell you that they have,' adds Dr Perry. 'But with most people there is no way of telling they are at risk - not that this is that useful to know, because you can't tell people to spend the rest of their lives wrapped in cotton wool.
'We see people involved in horrific accidents who don't get one, and then we have someone who had one as they turned their neck reversing out of their drive.'
The effects of a stroke depend on the part of the brain damaged - in Cija's case it was the central and left side, causing problems with language and movement on her right side. She spent six weeks in hospital having intensive physiotherapy, and when she was discharged, she could only walk the odd step with help, and was also unable to use her right arm. 'But my inability to speak fluently was by far the most disabling thing,' she says.

Butterfly stroke: Swimming this way can trigger a stroke because it requires people to put their neck up quite suddenly

'In the beginning I could use the odd word, but it was slurred and I could not put a sentence together.  Slowly, I got better, but I still found I struggled to find the right words. Once, a friend came to see me and rather than saying “You have lost weight”, I said “You have gained weight”.
'The physical effort of trying to find the right words was exhausting. Yet before my stroke I had been a talkative, sociable person.'
Around a third of stroke survivors are left with speaking difficulties, or 'aphasia'. There are several forms - receptive aphasia, a difficulty understanding what is said, expressive aphasia (which Cija had), which causes difficulties expressing yourself, or a combination.
And not only do some have trouble finding their words, they may also slur. 'Life can be really frustrating for people left with speech difficulties,' says Katherine Staley, of the Stroke Association.
'Often symptoms will get worse under pressure - for example, if they are at the front of a long queue at the bank.'
Speech and language therapy can help, providing exercises to improve muscle co-ordination around the mouth, for instance.
But access to speech and language services is 'very patchy' across the country, says Ms Staley. 'Some people with difficulties will be discharged from hospital without ever seeing a speech and language therapist again.'
And some stroke units have no speech and language therapists at all. Cija, however, was lucky - she had intensive speech and language therapy at hospital and at home.
But it hasn't been easy. 'I avoided people to begin with because I was embarrassed at how little I could say,' she says. Her speech has recovered enough that she can handle most situations, 'but it requires thought and effort to talk'.
It's good progress, probably helped by her young age. As Dr Perry explains: 'I see young people who have lost half a brain to a stroke, but two years later they walk back into my office and talk to me as normal.
'This would not happen with an older person. A lot of the recovery from a stroke is about the brain rewiring itself, and the younger brain is better at doing that.'
Six months since her stroke, Cija can walk independently but slowly. She hasn't regained the use of her right arm or hand so can't use a knife and fork or put on make-up.
She takes a daily aspirin to prevent another stroke and hopes to return to work in the New Year.
Despite what has happened she's glad she went bungee-jumping - 'although obviously I wish this hadn't happened to me'.
She adds: 'Sometimes I get upset as this has affected me in so many ways - we were talking about trying for family before this, but we have put that on hold.
'But I'm determined to get on with life and make the best of it.'

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How Hush a Bye Baby is the best medicine: Lullabies lower heart rates and ease pain in children.

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Lullabies don’t only help babies get off to sleep, they also ease pain.
A study found that Twinkle, Twinkle Little Star, Hush a Bye Baby and other well-loved children’s songs helped patients in Great Ormond Street Hospital feel better.
Heart rates dropped and the children, including toddlers waiting for heart transplants and babies as young as a week old, were in visibly less pain.
In contrast, reading stories complete with pop-up pictures and animal sounds had no effect.

Musical medicine: Twinkle, Twinkle Little Star, Hush a Bye Baby and other well-loved children's songs helped to ease pain in sick children

The researchers say this shows that the effect can’t be explained by the children simply being soothed by the extra attention.
Instead, there is something special about being sung to.
Researcher Dr Nick Pickett, who has provided music therapy at the world-famous hospital for two decades, said: ‘Parents have been singing to their children for thousands of years and they have always instinctively known that it helps their children relax – but it is exciting to have some scientific evidence that lullabies offer genuine health benefits for the child.’

 

Dr Pickett sang a selection of lullabies to 37 patients at Great Ormond Street Hospital and monitored their heart rate and signs of pain, including crying, grimacing and squirming.
The tests were also done when the youngsters were read to and when they were left to sit quietly.
Only the lullabies reduced their heart rate and the amount of pain they were in, the journal Psychology of Music reports.
It is thought that the calming tones ease pain by distracting the children from their illness.
Ian Bowers, whose three-year-old daughter Keira has been in hospital since June, said: ‘It perks her right up.  It makes her feel wanted.  It does leave a lasting impression.’

Soothing: It's thought that the calming tones of lullabies ease pain by distracting the children from their illness

Professor Tim Griffiths, a neuroscientist with the Wellcome Trust told BBC Radio 4’s Today programme that music seems better than story-telling at tapping into the brain’s emotional centre.

Dr Pickett said that live music is likely to be better at easing pain than recordings.
He said: ‘Babies and young children respond to the singer’s voice first and instruments second.  
‘More than one instrument can actually become quite confusing and less effective.
'Facial expressions and visual stimulation during the performance of a lullaby are just as important and live performance allows the adult to adapt their singing depending on the child’s mood.’
Other studies to find that music benefits children’s health include one from the US, in which newborns played lullabies put on more weight and were discharged more quickly from intensive care.
Although some hospitals do offer music therapy on children’s wards, it is generally paid for by charity money, rather than the NHS.

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Are video games bad for your health? Virtual worlds cause us to ignore symptoms of illness and make us care less for others.

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Spending too long in a virtual world could bad for your real life health, warns a new study.
Researchers found computer games and simulations may be duping players into ignoring their own vital health signs.
A series of experiments by researchers from Melbourne University showed playing immersive games can actually dampen someone’s response to pain and lead to them potentially caring less about others.

Research carried out by Melbourne University found that video games have become so advanced they are leading people to be 'detached from their bodies.' It adds the lines between human and machine are becoming blurred, which in turn leads to people becoming less aware of their own body, potentially missing health issues

Experts claim it is because virtual characters in role-playing video games and online services have become so advanced they are leading people to be detached from their bodies and have less empathy.
The artificial nature of virtual avatars, with their 'mechanistic inertness, rigidity and a lack of emotion and warmth', means extended periods of exposure to them numbs game players.

 

Experts say as people take on the role of virtual characters during immersive video games and begin identifying increasingly with the non-human characters on the screen, it leads them to forget about their own important body signals in real-life.

Experts say as people identifying increasingly with non-human characters onscreen, such as Trevor from GTA V pictured, it leads them to forget about their own body signals in real-life

This is down to the 'human-machinery' boundary being blurred, either by people putting themselves in virtual environments with avatars or adding human-like features to inanimate physical objects like toys and gadgets, claimed the study’s lead researchers.
Psychologist Dr Ulrich Weger warned of the profound effect the virtual world could be having on human nature.
He said: 'We see this blurring as a reality of our time, but also as a confused and misleading development that has begun to shape society.
'We believe this should be balanced by other developments, for example, by working on our awareness of what it really means to be human.
'We should also look into how we can best make use of the beneficial applications of robotic or artificial intelligence advances, so as to be able to use our freed up resources and individual potentials wisely rather than becoming enslaved by those advances.'
Along with Dr Stephen Loughnan from Melbourne University in Australia, Dr Weger used a simple pain-threshold experiment to see if playing the games had a measurable effect on someone’s ability to recognise their own vital signs.
Volunteer gamers were asked about their playing habits and took part in a pain tolerance test that involved retrieving paperclips from a bucket of iced water.
In a second experiment they played either an immersive or a non-immersive computer game before repeating the paperclip test.
Their results, published in the journal Psychonomic Bulletin and Review, showed the immersive gamers could remove 'significantly' more paperclips from the bucket, while they were also indifferent to other people’s unhappiness.
The researchers said this suggested the immersive gamers were acting from the perspective of an automaton-like avatar and were desentised to both their own feeling and others’.

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How a 20% sugary drinks tax would reduce the number of obese Britons by 180,000.

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The number of obese adults in the UK could be reduced by 180,000 if a 20 per cent tax on sugary drinks was introduced, researchers say.
Such a tax could also raise more than £275 million for the Treasury, the study found.
A tax on sugary drinks - such as fizzy drinks, squashes and cordials - has been proposed because these products have been shown to increase the risk of obesity, diabetes, heart disease and tooth decay.

The number of obese adults in the UK could be reduced by 180,000 if a 20 per cent tax on sugary drinks was introduced, researchers say

They are linked to obesity because they are calorie-heavy but do little to suppress appetite or add any valuable nutrients to people’s diets.
Experts from the British Heart Foundation Health Promotion Research Group at the University of Oxford and the University of Reading used a large survey of the shopping preferences of families in the UK to estimate how purchases of sugary drinks would change in response to a 20 per cent increase in their price.

 

They also looked at how purchases of other drinks, such as orange juice, milk and diet drinks, might change in response to a price hike.
They then used this information to estimate the change in average calorie intake and in national obesity rates.
They found that purchases of sugary drinks would fall by about 15 per cent with people mainly switching to diet drinks and tea and coffee.

Such a tax could also raise more than £275 million for the Treasury, a study found

The expected reduction in energy intake would be 28 calories per person, per week.
The researchers estimate this would reduce the number of obese adults across the population by 180,000 - or 1.3 per cent of all obese adults in the UK.
The impact on obesity is likely to be much greater in younger adults as they drink larger quantities of sugary drinks than older adults.
On average, people aged 16 to 29 years drink 300ml of sugary drinks a day, compared to just 60ml in those aged over 50.
The Oxford and Reading research team also investigated the effect on obesity among different income groups.
The study indicates that there would be similar health improvements across all groups.
The estimated increase in the amount people would spend on drinks would be an extra 9p a week – less than £5 a year - for those in the lowest income group.
It would be 6p per week for those in the highest income group.
Dr Adam Briggs of the British Heart Foundation Health Promotion Research Group at Oxford University, and joint first author of the study, said: ‘Sugar sweetened drinks are known to be bad for health and our research indicates that a 20 per cent tax could result in a meaningful reduction in the number of obese adults in the UK.
‘Such a tax is not going to solve obesity by itself, but we have shown it could be an effective public health measure and should be considered alongside other measures to tackle obesity in the UK.’
Dr Oliver Mytton of Oxford University, and the other joint first author, said: ‘Younger adults and children consume much greater quantities of sugary drinks.
‘This is a concern for their health, not only in terms of diabetes and obesity, but also tooth decay.’

A tax on sugary drinks has been proposed because these products have been shown to increase the risk of obesity, diabetes, heart disease and tooth decay

Professor Richard Tiffin of the University of Reading said: ‘Obesity is a ticking time bomb. Doing nothing risks condemning millions of people to poor health and an early grave.
‘This is a complex battle in which a soft drinks tax could be a useful weapon, but on its own would not go far enough in the face of such a massive problem.’
The news comes just days after Nestle announced that it is changing the recipe of Kit Kats to cut the amount of saturated fat they contain.

Nestle just announced that it is changing the recipe of Kit Kats to cut the amount of saturated fat they contain

The move is part of the Department of Health's Responsibility Deal - a partnership with the food industry aimed at reducing the nation's consumption of saturated fat.
The deal will also see Tesco, Sainsbury’s and Morrisons reduce fat levels in their products.
Mondelez International, which is part of Kraft and owns the Cadbury brand, will reformulate products such as Belvita breakfast biscuits and Oreo chocolate cookies.
Subway will cut the amount of saturated fat in their ‘Kids Pak’ children’s meal by more than 70 per cent, and catering giant Compass – which serves more than a million meals a day across their 7,000 sites - will promote healthier menus as part of the pledge.
As well as this, Unilever and Aldi have promised to reformulate products and look at reducing portion sizes.
The Responsibility Deal is particularly important as it is being introduced at a time when the vast majority of adults in the UK have no idea how much saturated fat they should be eating every day.
A poll conducted by Sainsbury's revealed that 84 per cent of people do not know that men should eat no more than 30g of saturated fat a day and women should eat no more than 20g per day.

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Why illnesses get worse at night: From arthritis to colds and even heart disease, changes in your body clock - and the fact you're lying down - can send symptoms soaring.

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Any A&E doctor will tell you the revolving doors really start spinning after midnight as patients with severe asthma, acute heart failure, and COPD (chronic obstructive pulmonary disease) start being admitted to hospital with life-threatening problems.
This is also the time when waiting times are longest - official statistics show patients visiting A&E face much longer delays in the early hours compared to the daytime or evening.

Nocturnal health deterioration: There are physiological reasons which help to account for the rise in patients with severe problems at night time

Lack of staff and specialist services are largely to blame, and there have been growing calls for high-quality emergency care to be available seven days a week (this week the doctors' union, the British Medical Association, published a report backing this, too). But there are also physiological reasons why illnesses deteriorate at night - not least the fact that you're lying down. Here we look at some of the conditions which deteriorate when dark descends, and how to reduce symptoms.

ASTHMA

Night-time coughing is common in people with asthma, with 61 per cent saying it prevents them sleeping well.
Every day in the UK, 200 people with asthma are hospitalised because they are struggling to breathe - many arriving for emergency treatment during the early hours.
'People with asthma tend to experience worsening symptoms at night, including breathlessness and wheezing, which may lead to A&E attendance,' says Deborah Waddell, a specialist asthma nurse at Asthma UK.

Night-time wheezing: Coughing at night is common in people with asthma

'There are theories this could be related to the body's circadian rhythm (24-hour cycle). Levels of hormones such as the stress hormone cortisol change at night, which impacts airways.
'After midnight breathing rates are at their slowest, resulting in less effective transfer of oxygen into the bloodstream and carbon dioxide out of the body through the lungs.'
Bedrooms are also full of common asthma triggers - including house dust mites in bedding, mattresses, soft toys, carpets and curtains.
Ventilation is often poor - made worse by double-glazed PVC windows which do not permit draughts - and mould spores proliferate in warm, damp environments.
A horizontal posture may contribute. 'The cough, when lying down, could be due to pressure on the diaphragm (the muscle separating the chest and abdomen), especially if someone is overweight, has gastric reflux, or post nasal drip, where mucus runs from the nose into the back of the throat.'
Research shows people who have personal asthma action plans - detailing steps to take when symptoms worsen - are four times less likely to be admitted to hospital as an emergency, Deborah Waddell says.

ARTHRITIS

Around 10 million Britons suffer from arthritis, which causes painful inflammation in cartilage and bone in the joints. The most common form is osteoarthritis due to wear and tear, often in the knees, hips and hands -this usually affects the over-50s.
'Periods of prolonged rest, like sleep, can make pain worse,' explains Philip Conaghan, professor of musculo-skeletal medicine at the University of Leeds and spokesperson for Arthritis Research UK.
'We're not sure why, but it's probably due to joint linings becoming congested with excess fluid used to bathe cells, and protein waste products when joints are immobile for a length of time.
'These are always present but are usually flushed away from joints and excreted by the body's mechanisms. This process slows down at night, leading to stiffness and pain which can wake people.'
Other musculoskeletal conditions such as bursitis in the shoulder - inflammation of tiny fluid-filled sacs responsible for smooth action of joints and tendons - can become more uncomfortable at night. 'The pressure of the person's weight causes problems, and turning over can be painful.'
Disturbed sleep patterns due to pain can cause fatigue and depressed mood, making daytime symptoms worse. Professor Conaghan advises people with night-time arthritis pain to talk to their GP about swapping from short-acting pain killers, such as paracetamol, to ones that are long lasting.
'If you are getting severe pain in the middle of the night, see your GP and discuss your concerns,' he says.

MENOPAUSE

The menopause: This often leads to severe night sweats

Waking drenched in sweat is a common symptom of the menopause, caused by the body's inability to regulate body temperature.
'We're not sure about the mechanism but it seems the hormone oestrogen, which falls during the menopause, plays an important role in the functioning of the hypothalamus, the temperature regulation system within the brain,' says Dr Edward Morris, a consultant obstetrician and gynaecologist at Norfolk and Norwich University Hospital.
Night sweats are similar to hot flushes in daytime, but they can feel worse. 'When in bed, fully insulated by your duvet, you prevent heat loss,' he explains.
'You're also asleep, so not aware your temperature is rising until quite a long way down the process. If women are awake during the day when the same thing happens, they simply open a window or remove clothing.'
As well as hormone replacement therapy, which boosts oestrogen levels, remedies include 'icing' bedding - popping pillows and sheets in the freezer for an hour before bed - and a well-ventilated bedroom.

HEADACHES

One of the most painful types of headache, cluster headaches (also known as alarm clock headaches) typically occur around 2am.
'These are excruciating headaches which can occur at the same time each night. They are so painful they are sometimes known as suicide headaches because people who have them literally want to die,' says Dr Andy Dowson, director of headache services at King's College Hospital and chairman of Migraine Action's medical board.
In fact, 50 per cent of people who suffer from migraines - first cousins of alarm clock headaches - say that their condition regularly wakes them from sleep during the night.
'This may be related to sleep cycles; when people move between periods of deep sleep, rapid eye movement sleep (REM), and almost waking,' says Dr Dowson.
The area at the bottom of the brain, known as the brain stem, is involved in regulating this sleep cycle and it also plays a role in influencing migraine. 'In trials we have found that the early stage of migraine originates in the hypothalamus, which is in the brain stem,' says Dr Dowson.
Common triggers include skipping meals, certain foods and bright or flickering lights. Unfortunately some triggers, such as changes in weather, may bring on migraine attacks but can't be avoided.
Medications that make migraine less likely to occur include anti-depressants, beta-blockers and anti-histamines. In 2010 the National Institute for Health and Care Excellence approved the use of Botox as a preventative for chronic migraine.
When an attack has started, a class of drugs called triptans (available over the counter) can help to alleviate the symptoms.

HEART DISEASE

Attack at first light: Most heart attacks occur in the early hours of the morning

Around half of heart attack deaths occur within one hour of the attack, and most heart attacks occur in the early hours of the morning, from 4am onwards - when A&E staff levels are lower.
Early morning heart attacks are linked to the platelets in the blood becoming stickier and more prone to clotting.
This is possibly because of  overnight fasting or hormonal changes linked to the body's  24-hour clock.
'Additionally, the effect of medication taken the day before starts wearing off at this time. The combination of effects means heart attacks are more likely in the hours before dawn,' explains Martin Cowie, professor of cardiology at Imperial College, London.
Taking aspirin daily helps make platelets less sticky; taking high blood pressure drugs at night could help, but speak to your doctor before changing your routine.

GASTRIC REFLUX

Reflux of stomach acid into the throat is a common cause of indigestion and heartburn.
It happens when the muscular ring (sphincter) at the lower end of the gullet relaxes too much, allowing the stomach's acidic contents to flow back up.
It doesn't necessarily mean the valve is faulty - smoking and pregnancy hormones (which relax all muscles in the body) can cause it to relax, while eating too much at one time can make the valve open, say researchers at the Mayo Clinic in the U.S. If you are susceptible, reflux can worsen at night because of gravity - being horizontal makes it easier for stomach contents to pass sideways into the throat. Elevation can prevent this. Tim Worthington, a consultant gastrointestinal surgeon at the Royal Surrey County Hospital in Guildford, suggests using a pillow to prop yourself up.
Lifestyle changes, such as not eating too late at night, sticking to a low-fat diet, avoiding caffeine, alcohol and acidic foods, can help.
Over-the-counter remedies tend to contain calcium carbonate or foaming agents that neutralise acid in the stomach.
Prescription drugs reduce stomach acid production - these include H2 receptor antagonists (Ranitidine), proton pump inhibitors (Omeprazole) and anti-acid medication. In very serious cases, surgery can tighten the sphincter.

SHINGLES/COLDS

Horizontally challenged: Colds are worse at night because when you lie down your airways are less effective at removing debris and fluid

Many people say symptoms of viruses such as shingles and colds are worse at night. A study published in 2008 in the Journal of Pain and Symptom Management showed pain from shingles, caused by the same virus as chicken pox and affecting older people, does worsen at night.
Shingles pain can lead to unintentional weight loss, sleeplessness, depression and disability.
'It is not clear why shingles pain gets worse at night, but it could be to do with levels of neurotransmitters, chemicals that transmit signals from a neuron to target cells, and hormones involved in pain perception, rising at night,' says John Oxford, a professor of virology at Queen Mary College University of London.
He adds that people can become more anxious at night, which amplifies pain sensations. With colds, he says, the explanation may be more prosaic. 'The lining of your airways constantly carries debris and fluid out of the lungs into the throat. This process becomes less effective because you're horizontal, causing congestion and coughing.'
For shingles, calamine lotion and anti-histamines (a medicine often used to treat allergies) may prevent itching, while paracetamol can help to reduce painful symptoms.
Some shingles pain may be eased by tricyclic anti-depressants because they affect levels of certain chemicals in your body.

HEART FAILURE

Around 750,000 Britons suffer from heart failure, where the heart is too weak to pump enough blood around the body.
When the heart can no longer pump out enough of the blood it receives from the lungs, fluid builds up in the chest, known as acute heart failure, which can be life-threatening.
Patients with acute heart failure are most likely to need emergency hospital treatment at around 3am.
'Heart failure patients often have congestion of fluid in their legs and ankles during the day,' explains Professor Cowie. 'If they go to bed at 10pm and lie horizontally, this gradually moves into the chest.
'Three to five hours later, pressure in the blood vessels has built up so much it can force fluid through the lung tissue and into airways.' Sleeping propped up on pillows can help.
The problem is that if you need to go to hospital, though you're more likely to see an experienced consultant after midnight than you would have been ten years ago, 'you may not see a specialist when you need it, which can make a big difference to outcomes,' says Professor Cowie.

BRONCHITIS

Chronic obstructive pulmonary disease (COPD) describes a collection of conditions causing lung damage, including chronic bronchitis and emphysema, causing inflammation in the lungs, often along with permanent damage to the airways.
In a recent study, 76 per cent of COPD patients reported frequent night-time wakening because symptoms worsened at night.
Studies have found less air passes through lungs during deep sleep, and dropping body temperature at night affects lung function.
The body also responds less efficiently to increasing carbon dioxide levels in the blood during sleep, so breathing rates do not rise in the same way as during the day to expel it from the body.
Excess carbon dioxide eventually causes someone to wake up, often gasping for breath and 'oxygen-deprived'. This leads to exhaustion and worse symptoms during the day.
Dr Nick Hopkinson, spokesman for the British Lung Foundation and a consultant chest physician at the Royal Brompton Hospital, London, says: 'Most patients don't find they're breathless when they go to bed, but if they wake out of breath, it suggests their COPD is getting worse or could indicate another condition exacerbating symptoms, such as heart failure or asthma.

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Comfort eating: The new mental illness. You eat a biscuit - then can't stop until you finish the packet. Don't assume it's lack of willpower. Doctors now say it's a psychiatric condition that needs treatment.

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When life gets stressful, do you find yourself reaching for the biscuit tin, or for a large bag of crisps? Or maybe you'll treat yourself to a big bowl of ice-cream after a bad day at work. But then that one biscuit leads to another - and another. Do you ever find you just can't stop?
You are far from unique. Experts say that for a significant number of people - potentially 1.3 million in Britain - a treat can repeatedly turn into a full-blown food binge.
Indeed, so common is this behaviour that it has now been officially classified as a new type of eating disorder: binge eating disorder.

Widespread problem: For potentially 1.3 million Britons, a treat can repeatedly turn into a full-blown food binge

The diagnosis has recently been added to the influential U.S. Diagnostic and Statistical Manual of Mental Disorders (the psychiatrists' 'bible'), and it is widely expected that a similar classification will shortly be introduced in the UK by the National Institute for Health and Care Excellence.
This will give binge eating disorder the same psychiatric importance as anorexia and bulimia. So what characterises this new disorder, and will the diagnosis really make a difference to sufferers?
'People suffering from binge eating disorder tend to be overweight and, in addition to this, have phases when they regularly binge eat - but without the purging behaviour associated with bulimia,' explains Christopher Fairburn, professor of psychiatry at Oxford University and a leading authority on binge eating.

 

Those affected often suffer from depression, and the binges are almost always done in secret. People who are extremely self-critical may be particularly prone.
Sufferers have a long-standing tendency to turn to food in response to emotional issues, says Professor Fairburn.
'When binge eating, people can't stop eating once they've started - and many can't resist starting in the first place,' he says.

IT'S NOT THE SAME AS BEING GREEDY

Hayley Bennett: Obsessed with food

Binge eating disorder causes great distress - and prompts a huge amount of self-loathing afterwards. 'This is different from greed, which is about letting your hair down, going for it and enjoying it,' Professor Fairburn explains.
Self-loathing is certainly an emotion that  23-year-old Hayley Bennett recognises only too well from her own eating problems.
These date back to when she was eight years old and was called 'fat' by another child at school. The taunt led to a preoccupation about her weight, and she became introverted and miserable. Food became both her comfort and her 'enemy'.
'At the age of eight, I was a bit chubby but unaware of it,' she says. 'Maybe I'd just have lost that weight naturally in time, but as it was, I became obsessed with my body - and with food. I thought about it all the time, but I never ate from hunger.'
Hayley says that starting a binge - which she always did in secret - would bring a sense of relief and satisfaction, but afterwards she would find herself filled with self-hatred.
'I did have some hurtful comments from others about my weight, but it was mostly that I was so hard on myself; so self-critical. I felt I could never live up to having the perfect, slim body that I wanted.
'Like me, my parents thought that if I lost weight I would be healthier and happier. Like me, they had no idea I had an eating disorder.
'My mum and my teachers tried to help me by encouraging me to eat healthily. In retrospect, though, saying that I couldn't have a dessert when other children were having them just made me want one all the more.'
By the age of 11, Hayley was already 'sneaking' food. 'I couldn't just have one KitKat, I'd have to have a pack of six,' says Hayley, an English graduate who lives in Bristol with her parents.
Her worst binge was a large family bag of Doritos and two of the biggest blocks of Dairy Milk chocolate, one after the other.
Hayley's binge food of choice was almost always chocolate - and there are good biological reasons why it's fatty and sugary foods that binge eaters choose, say doctors.
Fat and sugar trigger the release of endorphins and dopamine - the body's feel-good chemicals, inducing a natural high. But when this recedes, guilt and depression set in.
'You feel like you've just sabotaged yourself again,' says Hayley. 'You just feel disgusted with yourself, and out of control.'
Perhaps not surprisingly, those who suffer from binge eating disorder are usually overweight (although they can also lose weight, even significant amounts). The weight gain is because they overeat generally, not because of the binge episodes, says Professor Fairburn, who is director of the Centre for Research on Eating Disorders at Oxford (CREDO).
This excess weight means they are also at risk of other serious health risks associated with obesity, including type 2 diabetes, high cholesterol, heart and gallbladder disease.

WHY DIETING WON'T HELP

Lack of awareness: Many GPs think sufferers just need support dieting

Most sufferers who seek help from their doctor, think - like Hayley - that they just need support with dieting. Often, too, GPs are unaware of the existence of binge eating disorder.
Experts stress, however, that it's vital the underlying psychiatric problems are tackled first.   
'I knew that what I was doing was not normal or right, but it never occurred to me I might have an eating disorder,' says Hayley. 'I thought I had a weight problem.'
Professor Fairburn says a great deal of research has gone into how to help people lose weight and to discover why some people overeat.
'Some researchers believe it's a genetically-determined problem, while others think it is more the product of our food-rich environment,' he says. 'In fact, it is likely to be the result of both. Moreover, obese people do not all behave in the same way.'
Hayley agrees: 'I feel many health professionals don't understand that you can be overweight and have an eating disorder.
'I also think people in general see a fat person and think you're lazy and greedy, and that you've got into this situation because you just love food.
'I didn't love food, although I was obsessed with it.'
Treatment that encourages a person who is already obsessed with food to focus on it still further could do more harm than good, says Julia Buckroyd, emeritus professor of counselling at the University of Hertfordshire.
In many cases, dysfunctional eating patterns were developed in childhood. Professor Buckroyd says that a number of recent studies have highlighted the fact that obesity and overeating are attempts to 'control an overwhelming internal anxiety state'.
'Typically, many people who are significantly obese are emotional eaters,' she says.
'Human behaviour - however bizarre or destructive it may be - does have meaning. These people are trying to make themselves feel better, even if, of course, they're not doing this in actual fact.
'They need help to find ways of coping other than food.'

BINGE EATERS ARE NOT ALWAYS FAT

Another complication is the fact that people with eating disorders do not always fit neatly into the established diagnostic categories.  
Binge eating is common to those with binge eating disorder and bulimia, for instance - and it occurs in some people who've tried and failed to keep to a strict diet.

Depression: Keith, pictured at his biggest in 2009, binged because he was unhappy and viewed food as a pleasure

It is therefore interesting that people with binge eating disorder can, and do, lose weight periodically - and often dramatically.
Hayley herself has successfully lost weight three times on very low-calorie diets, losing two or three stone in as many months - only to find it creeping back on again.
'Although binge eating disorder sufferers have a tendency to be overweight, it is also common for them to have periods of successful dieting which may last for months at a time, and periods of overeating when they also binge,' says Professor Fairburn.
'As a result, their body weight may change markedly from month to month and year to year.'
But how important is it, in fact, to have a diagnostic label for patients with binge eating disorder?
'I'd say the disorder is right on the edges of what one would want to call a mental illness,' admits Professor Fairburn.
'People with binge eating disorder undoubtedly have a problem - but whether you would want to call it a mental illness is questionable.
'If raising it to a diagnosable condition helps them get the help and recognition they need for their problems, then yes, I'd say it's a good thing - and its inclusion in the DSM is helpful.
'This should, in the future, help GPs to recognise it as a separate disorder and enable the patients to get the correct help.'
He adds that this ought to help prevent people being prescribed antidepressants unnecessarily. 'Antidepressants have a valuable role to play in treating many conditions, but they will not tackle the root cases of binge eating disorder,' he says.
(Before bulimia became a recognised illness, sufferers were often prescribed antidepressants, but this changed once the condition became understood.)
Men who are affected might find it doubly hard to get the correct diagnosis and treatment, as many health professionals associate eating disorders with women, says Sam Thomas of the charity Men Get Eating Disorders Too.
In fact, binge eating disorder affects men and women equally, whereas with anorexia and bulimia it is predominantly women who are affected.
'Many men don't realise they have an eating disorder,' says Mr Thomas. 'They'll know that they have issues with food, but it often won't occur to them to think that they could be suffering from an eating disorder and need help.'

PEOPLE BINGE WHEN UPSET

Indeed, it was Keith Addison's wife Suzanne who first realised her husband had a problem.
The 34-year-old father-of-three from Newcastle-upon-Tyne had begun bingeing when he was 14, around the time his parents split up.
Initially, the bingeing was masked by the fact Keith played a lot of rugby so was seen as a 'chunky rugby player'. But he was bingeing daily - saving up his dinner money and bus fares to blow on food to eat at home in the evening.
'I wasn't very popular at school and used to get bullied, so this was my treat for getting through the day,' he explains.

Tackling the problem: Keith's wife Suzanne is helping him control his weight and, as a result, he's lost 4.5 stone

On a bad day, he would eat a sponge cake, a tin of custard, two dozen packets of crisps, two packets of biscuits, a packet of dry crackers, a block of cheese, a packet of instant mashed potato, a packet of stuffing with gravy, and a 24-pack of chicken nuggets.
'Mum never saw because she got home from work late,' he says.
With hindsight, Keith says the problems relate to the changes in his family life after his parents split. Instead of sitting down to meals together, he'd eat alone while his mother was at work.
'I started to focus on food as a pleasure because it reminded me of the happy meals we'd had as a family. When you first start on a binge, it feels like a huge release - and I felt on top of the world. But immediately afterwards, you are overwhelmed with disgust.'
Keith's bingeing was compounded by depression, and over the past ten years he has been prescribed anti-depressants by his GP on four occasions.
'But they didn't tackle the real problem of my eating disorder - and the depression would return.'
Suzanne has taken practical steps to help Keith control his weight - including doing all the family shopping - and he's lost 4½ stone. His weight had reached 22 st, but today he weighs 17½ st and he's recently started seeing an NHS psychologist to help him understand what makes him binge eat.
For Hayley, finding someone to talk through her problems also marked a turning point. At 19, she sought help from a student counsellor and was offered cognitive behavioural therapy (CBT).
This helped her take her first steps towards recovery - part of which has involved sharing her eating experiences in a blog (doesmybumlookbiginthis.org).
Today, she is about to start a new job in a call handling centre and feels her future is looking brighter than for many years.
Professor Fairburn's book, Overcoming Binge Eating, has a self-help programme based on cognitive behavioural therapy. It sets out key strategies including monitoring eating patterns, weighing yourself every week and establishing a habit of eating three proper meals a day.
Other sufferers may need a personally-tailored programme devised by a psychologist. Professor Fairburn suggests they contact Beat (b-eat.co.uk) - a charity for people suffering from eating disorders - to find a qualified professional in their area.
'The important thing is to empower people to gain lasting control over their eating and  take charge of their health,' he says.

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