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“This isn’t just a wellness routine gone too far. It can result in significant medical issues, social isolation, and psychological impairment, on par with the other eating disorders we treat every day.”

Zoo as No. 1 on its “10 Worst Zoos for Elephants” list for the second year in a row this year, citing Billy’s and Tina’s poor health and social isolation.

For example, studies in mice show that stress from early-life separation from their mothers, social isolation in adolescence and cocaine exposure in late adolescence can all decrease sex differences in the expression of genes in a part of the brain associated with addiction.

Counsellor Angela Mcmillan, who developed the AR therapy app, said the idea came from support sessions with young people in the south Wales valleys who had been struggling to attend school due to anxiety and social isolation.

Social isolation and loneliness are increasing problems in the United States and other countries as well.