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This study compared 40 female participants in a behavioral weight loss program who frequently reported craving sweets to 40 who rarely reported craving sweets using 2-week behavioral eating diaries. The two groups were compared on physiological, demographic, and questionnaire measures and no significant differences were found. There were no significant differences in macronutrient intake either overall or in a wide range of specific situations. The relative proportions of carbohydrate, protein, and fat consumed in association with craving sweets differed only slightly from the composition of other meals and snacks. Carbohydrate and protein intake when craving sweets was similar to breakfasts while the relative amount of fat consumed when craving sweets was comparable to episodes of overeating. The two groups differed in their reporting of moods with the high-craving group reporting more boredom and less stress than the low-craving group. The relationship between situational and mood variables and reports of craving sweets did not differ between the two groups. Craving sweets was negatively associated with hunger and was not associated with meal skipping. A sequential analysis demonstrated that eating in response to craving sweets triggers an abstinence violation effect. These data are not consistent with the hypothesis that sweet craver's consume high-carbohydrate, low-protein meals and snacks in order to self-medicate depression caused by serotonin depletion. Instead, the data suggest that we should further explore the role of food palatability and food-related cognitions in order to understand craving sweets.
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PMID:A sequential behavioral analysis of craving sweets in obese women. 846 79

The loss of appetite occurring severe depression was investigated with an experimental method comparing the eating behaviour of 12 melancholic inpatients to 12 matched normal controls. Food intake and appetite, divided into more basic components such as desire to eat, hunger, satiety, prospective food consumption and pleasure from eating, were monitored during a test meal. Patients ate less than controls, but the difference was not significant. The pattern resulting from the temporal tracking of the appetite ratings indicated that patients were disturbed at the beginning of the meal and showed a decreased desire to eat, hunger and prospective food consumption and an increased satiety and that their pleasure from eating was diminished. These findings suggest that the loss of appetite induced by melancholia follows a specific pattern.
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PMID:The loss of appetite during depression with melancholia: a qualitative and quantitative analysis. 847 22

Although mental health problems constitute 8.1% of the global burden of disease (GBD), mental health has been largely missing from the international health agenda. The discrepancy between needs and services is likely to increase in the next millennium. Depression alone is currently the fourth leading cause of disability-adjusted life-years (DALYs) the world over and is projected to become the second leading cause by the year 2020. The nations of the world must make a major commitment to upgrade the quality of mental health services, including early detection and prevention of psychiatric problems in childhood and adolescence; to institute the collection of systematic data on the global burden of alcohol and drug abuse and to develop innovative treatment and preventive measures; and to provide substantial support for research on treatment effectiveness. Because hunger, deprivation, and violence affect women disproportionately, there is a pressing need for coordinated efforts to improve state gender policies (including equal educational opportunity and improved health care for women) and to interdict domestic violence. In the words of Boutros Boutros Ghali, the Secretary General of the United Nations: "Medical and social issues which are often viewed separately must be dealt with as a whole...the priority of mental health must be heightened...development policies must...protect and promote mental health."
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PMID:Psychiatry and health in low-income populations. 905 23

In response to evidence linking obesity and high amounts of dietary fat, the food industry has developed numerous reduced-fat and nonfat food items. These items frequently derive a relatively large percentage of their energy from sugars and the effect of these sugars on weight regulation is not well known. We studied the comparative effects of high- and low-sucrose, low-fat, hypoenergetic diets on a variety of metabolic and behavioral indexes in a 6-wk weight-loss program. Both diets contained approximately 4606 kJ energy/d with 11% of energy as fat, 19% as protein, and 71% as carbohydrate. The high-sucrose diet contained 43% of the total daily energy intake as sucrose; the low-sucrose diet contained 4% of the total daily energy intake as sucrose. Twenty women aged 40.6 +/- 8.2 y (mean +/- SD) with a body mass index (in kg/m2) of 35.93 +/- 4.8 consumed the high-sucrose diet; 22 women aged 40.3 +/- 7.3 y with a body mass index of 34.93 +/- 4.4 consumed the low-sucrose diet. Mixed-design analysis of variance showed a main effect of time (P < 0.01), with both diet groups showing decreases in weight, blood pressure, resting energy expenditure, percentage body fat, free triiodothyronine (FT3), urinary norepinephrine, and plasma lipids. Small but significant interactions were found between group and time in total cholesterol (P = 0.009) and low-density lipoprotein (LDL) (P = 0.01). Both groups showed decreases in depression, hunger, and negative mood, and increases in vigilance and positive mood with time (P < 0.01). Results showed that a high sucrose content in a hypoenergetic, low-fat diet did not adversely affect weight loss, metabolism, plasma lipids, or emotional affect.
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PMID:Metabolic and behavioral effects of a high-sucrose diet during weight loss. 944 Mar 91

This study sought to experimentally validate 2 self-reported trigger factors of headaches, namely negative affect (anxiety, depression, and anger) and hunger, and to investigate whether these triggers activated the same or different physiological mechanisms. Students (38 women and 18 men) who had suffered from frequent headaches (migraine or tension type) for 6 months or more were randomly assigned to 4 conditions, which involved manipulating hunger by means of 19 hr of food deprivation and negative affect by means of a stressor (difficult to solve anagrams). The findings were consistent with self-reports that hunger and negative affect can precipitate headaches in individuals who suffer from both migraine and tension-type headaches. The physiological responses to the experimental conditions differed, but the findings were not conclusive with respect to whether the trigger factors operated by means of a common biological pathway.
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PMID:Effects of food deprivation and a stressor on head pain. 923 82

This review summarizes studies on the psychological effects of weight cycling (i.e., weight loss and regain) in obese persons and proposes an agenda for future research on this topic. Among general psychological constructs, the current literature suggests that weight cycling is not associated with depression, other psychopathology, or depressogenic cognitive styles. Weight cycling is associated with decreased perceptions of health and well-being, although the clinical significance of this relationship is uncertain. Among weight- and eating-related constructs, weight cycling does not appear to be related to restraint, hunger, or personality traits associated with eating disorders. Weight cycling, however, does appear to be associated with clinically significant reductions in eating self-efficacy and weak but consistent increases in binge eating severity. Definitive conclusions about the presence or absence of the psychological consequences of weight cycling are premature, given the small number of studies, as well as a variety of methodological and interpretive concerns. A new generation of research is necessary to determine the extent and nature of the psychological sequelae of weight cycling.
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PMID:Psychological effects of weight cycling in obese persons: a review and research agenda. 938 25

This study identified predictors of weight gain versus continued maintenance among individuals already successful at long-term weight loss. Weight, behavior, and psychological information was collected on entry into the study and 1 year later. Thirty-five percent gained weight over the year of follow-up, and 59% maintained their weight losses. Risk factors for weight regain included more recent weight losses (less than 2 years vs. 2 years or more), larger weight losses (greater than 30% of maximum weight vs. less than 30%), and higher levels of depression, dietary disinhibition, and binge eating levels at entry into the registry. Over the year of follow-up, gainers reported greater decreases in energy expenditure and greater increases in percentage of calories from fat. Gainers also reported greater decreases in restraint and increases in hunger, dietary disinhibition, and binge eating. This study suggests that several years of successful weight maintenance increase the probability of future weight maintenance and that weight regain is due at least in part to failure to maintain behavior changes.
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PMID:What predicts weight regain in a group of successful weight losers? . 1022 27

To investigate palatability influences on the ad lib eating behavior of free-living humans, 54 French participants were paid to maintain food intake diaries for four 7-day periods. They recorded their intake along with palatability ratings, on a seven-point scale, of each individual item eaten and also a global rating of the palatability of the entire meal. Higher levels of palatability were found to be related to larger meal sizes, durations, and deprivation ratios, smaller satiety ratios, greater hunger, and lower depression and anxiety. The global palatability rating was found to be superior to individual item palatability ratings as a measure of the palatability of the meal. Although palatability was found to have fairly large effects on intake, it accounted for less than 2% of the variance. It was concluded that, in the natural environment, there are a large number of other powerful variables present that add variance. In addition, people tend to self-select only a restricted range of highly palatable foods. As a result, in the natural environment, the influence of palatability on intake is limited.
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PMID:Palatability and intake relationships in free-living humans: measurement and characterization in the French. 1071 35

The Beck Depression Inventory (BDI), the Three-Factor Eating Questionnaire (TFEQ), and the Eating Disorder Examination (EDE) were administered to 50 morbidly obese patients before and after gastric bypass surgery. Subjects were classified as non-binge or binge eaters prior to surgery. Though the two groups differed markedly before operation, they were largely indistinguishable 4 months afterward. All binge eating had ceased and mood had improved markedly. TFEQ Restraint scores increased, and Disinhibition and Hunger scores decreased. EDE Eating Concern, Shape Concern, and Weight Concern scores dropped. EDE Restraint scores decreased in non-binge eaters and increased in binge eaters. The overall findings indicate that gastric bypass surgery had a positive short-term impact on non-binge and binge eaters alike.
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PMID:Effects of bariatric surgery on binge eating and related psychopathology. 1072 71

BACKGROUND: Although treatment failure after Vertical Banded Gastroplasty (VBG) is not uncommon, the safety of the procedure makes it the most widely used form of bariatric surgery. The reasons for failure may be either technical, such as staple-line dehiscence, or psychological inability on the part of the patient to adjust to the small stomach pouch and to its consequences. METHODS: We carried out prospective testing of a cohort of consecutive VBG candidates, using a battery of psychological tests consisting of the 'Three Factor Eating Questionnaire', 'Hopkins Symptom Check List (HSCL)', 'Mood Adjective Check List (MACL)', 'Karolinska Scales of Personality (KSP)', and two projective tests, the 'MetaContrast Technique (MCT)' and the 'Perceptgenetic Object Relation Test (PORT)'. The patients had been scheduled for surgery on clinical considerations only, and the results of the psychological testing were not disclosed to the surgeons until after the follow-up. RESULTS: Mean preoperative Body Mass Index (BMI) was 42.0 (SD 9.9). Patients were extensively tested during the 3 weeks prior to surgery. There were no operative complications. Patients were tested psychologically again after 3 years. Their mean BMI then was 32.3 (SD 6.6). Thirteen patients had lost more than 50% of their overweight (BMI mean 29.6; SD 1.1), seven patients had lost less than 50% (BMI mean 37.0; SD 1.6; p = 0.0043). These two groups were compared. The single factor that correlated consistently with an unsatisfactory weight loss was preoperative signs of depression (p = 0.04). Stepwise discriminant analysis using three preoperative factors (Hunger, Verbal aggression and Socialization) correctly classified 90% of the patients who had lost < 50% of their overweight. Other variables (impulsivity, Emotional detachment and Maladaptive psychological defense) identified patients who were later to suffer from dysphoric mood (n=5) or disturbed eating behavior (n=ll).These factors may compromise a sustained ability to tolerate food restriction. Despite the operation's disadvantages, all patients considered it worthwhile and displayed improved psychosocial adaptation post-operatively. CONCLUSION: We conclude that extensive psychological testing can accurately predict the intermediate-term weight outcome following VBG and that even patients who show little weight loss benefit from the procedure.
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PMID:Weight Loss After Vertical Banded Gastroplasty Can Be Predicted: A Prospective Psychological Study. 1072 65


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