Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020175 (hunger)
 5,670 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Leptin is an adipocyte-derived hormone, which is involved predominantly in the long-term regulation of body weight and energy balance by acting as a hunger suppressant signal to the brain. Leptin is also involved in the modulation of reproduction, immune function, physical activity, and some endogenous endocrine axes. Since anorexia nervosa (AN) and bulimia nervosa (BN) are characterized by abnormal eating behaviors, dysregulation of endogenous endocrine axes, alterations of reproductive and immune functions, and increased physical activity, extensive research has been carried out in the last decade in order to ascertain a role of this hormone in the pathophysiology of these syndromes. In this article, we review the available data on leptin physiology in patients with eating disorders. These data support the idea that leptin is not directly involved in the etiology of AN or BN. However, malnutrition-induced alterations in its physiology may contribute to the genesis and/or the maintenance of some clinical manifestations of AN and BN and may have an impact on the prognosis of AN.
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PMID:Leptin functioning in eating disorders. 1520 12

Topiramate is a new anti convulsant agent that acts on the voltage-activated sodium channels and on the glutamate and GABA receptors; it is furthermore able to reduce hunger and therefore contributes to loss of weight. The authors report the case of a patient suffering from binge eating disorder, who was unresponsive to several therapeutic plans but was successfully treated with topiramate.
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PMID:Topiramate for binge eating disorder. 1569 44

In this study we describe the frequency of eating disorders (EDs) in a group of bipolar (BP) patients. We evaluated a sample of 51 outpatients, diagnosed as having BP I disorder on the basis of the Structured Clinical Interview for DSM-IV (SCID). Each of these subjects was administered the Binge Eating Disorder Clinical Interview (BEDCI) to determine the presence of binge eating disorder (BED) or bulimia nervosa (BN). Of the 51 BP patients, 14 (9 BED, 5 BN) met criteria for an ED. Most patients developed binge eating coincident with the first episode of BP disorder or after the onset of it. This was true for those who developed BED as well as BN, and involved both manic and depressive phases. All BN patients were women (5/5), and family history of binge eating was present in 80% of BN subjects, but only in 22.2% of BED and 29.7% of non-ED BP patients. We found a high frequency of concordance between BP illness and binge eating problems in our sample of BP patients. Given the temporal sequence of the mood disorder, which generally preceded the ED, we suggest a model in which the ED evolves due to modulation of emotions with food, as well as use of medications to treat BP disorder that disrupt hunger and satiety mechanisms. Given differences in gender distribution and family history, cultural and familial influences may also be significant in the minority of BP binge-eating patients who develop BN.
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PMID:Relationship between bipolar illness and binge-eating disorders. 1592 56

The authors compared eating patterns, disordered eating, features of eating disorders, and depressive symptoms in persons with binge eating disorder (BED; n = 177), with night eating syndrome (NES; n = 68), and in an overweight comparison group without BED or NES (comparison; n = 45). Participants completed semistructured interviews and several established measures. Depressive symptoms were greater in the BED and NES groups than in the comparison group. NES participants ate fewer meals during the day and more during the night than BED and comparison participants, whereas BED participants ate more during the day than the comparison participants. BED participants reported more objective bulimic and overeating episodes, shape/weight concerns, disinhibition, and hunger than NES and comparison participants, whereas NES participants reported more eating pathology than comparison participants. This evaluation provides strong evidence for the distinctiveness of the BED and NES constructs and highlights their clinical significance.
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PMID:Binge eating disorder and night eating syndrome: a comparative study of disordered eating. 1639 84

While there is considerable evidence that bulimic behaviors serve the function of modifying internal states (e.g., satiety, mood), there is less clarity over the roles of the different behaviors across the binge-purge cycle. The present study examines the impact of bingeing and vomiting upon these internal states at different time points, and evaluates the potential reinforcement of those behaviors by the changes in internal states. Twenty-three women with diagnoses of bulimia nervosa completed a diary of all binge-vomit episodes over the course of 7 days, rating their internal states (satiety, negative mood, positive mood) at four time points during each episode. There were substantial changes across the cycle in levels of hunger, fullness, guilt/shame, anxiety/worry, and happiness/relief, but not in other states. The changes indicate that the binge-vomit cycle is maintained by the effects of both behaviors, but that the vomiting behavior evokes the strongest pattern of reinforcement. Further research is needed to determine the levels of internal states during the binge itself.
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PMID:Changes in internal states across the binge-vomit cycle in bulimia nervosa. 1677 63

High androgen levels in women with bulimia nervosa may promote bulimic behavior. The aim of the present study was to investigate the effects of an antiandrogenic oral contraceptive (OC) on appetite and eating behavior in women with bulimia nervosa compared to healthy controls. Twenty-one women with bulimia nervosa and 17 healthy controls matched for age and body mass index participated in the study. Basal and meal-related appetite and secretions of the satiety peptide cholecystokinin (CCK) and the appetite-stimulating peptide ghrelin were studied before and after 3 months of treatment with an antiandrogenic OC (30 microg ethinyl estradiol combined with 3 mg drospirenone). Bulimic behavior was evaluated in relation to changes in hormone levels. Before treatment, bulimic women had higher frequency of menstrual disturbances, acne and hirsutism and higher levels of testosterone but lower meal-related CCK secretion than controls. OC treatment reduced meal-related hunger and gastric distention in bulimics. CCK secretion in response to the meal was unchanged in bulimic women but decreased in the controls. Ghrelin secretion was comparable between groups and did not change in response to OC treatment. The treatment improved bulimic behavior in relation to a decline in testosterone levels in the entire group. Our results support the suggestion that androgens play a role in bulimic behavior. Treatment with an antiandrogenic OC may serve as a new strategy for treatment of bulimia nervosa and particularly in those patients with hyperandrogenic symptoms.
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PMID:Effects of an antiandrogenic oral contraceptive on appetite and eating behavior in bulimic women. 1747 12

Nocturnal eating is common among obese patients prior to bariatric surgery. Little is known about the relationship between nocturnal eating, eating-related and general psychopathology, and health-related quality of life (HRQOL). A group of 148 obese patients (mean BMI 49.3, SD 7.8) prior to bariatric surgery were investigated. We compared patients who reported nocturnal eating at least once in the last 4 weeks with patients without nocturnal eating episodes. Patients completed a battery of questionnaires assessing eating related and general psychopathology and quality of life. Twenty-nine (19.6%) patients reported nocturnal eating (eating after waking up at night) during the last 28 nights, men and women did not differ in frequency of nocturnal eating. Patients with nocturnal eating reported a significantly higher BMI (kg/m(2)), more feelings of hunger, and significantly more impairment in the mental aspects of HRQOL. The other measures of HRQOL showed only minor differences. Measures of general psychopathology (depression and anxiety) also differed significantly with nocturnal eating patients reporting significantly more impairment. Binge eating disorder and nocturnal eating showed no association.
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PMID:[Nocturnal eating in obese patients prior to bariatric surgery]. 1794 8

This paper addresses current issues regarding the diagnosis and management of binge eating disorder (BED). Controversies in diagnosis include the lack of empirically validated criteria, the lack of a universally recognized operational definition of a "binge episode", and the lack of age-appropriate assessment instruments in light of growing reports of BED among children and adolescents. For adults with BED, several pharmacological and behavioral treatments have shown promise in reducing binge frequency and related psychological symptoms of disordered eating (i.e., disinhibition, hunger, depressed mood). Second-generation antidepressants and cognitive behavioral therapy are among the most widely studied treatments. However, no behavioral interventions have demonstrated efficacy with respect to weight loss (which is a critical concern for many BED sufferers who are overweight). Furthermore, randomized controlled trials for BED have been plagued by high drop out and placebo response rates, as well as by insufficient follow-up after active treatment ends to determine long-term outcomes. Therefore, the long-term utility of the various intervention strategies studied thus far remains unclear. More research is needed on innovative medications and behavioral treatments that explore novel modalities to reduce the subjectively reinforcing properties of binge eating. In addition, expanded use of information technologies may be particularly instrumental in the treatment of patients who experience marked shame, denial, and interpersonal deficits, or who face limited access to specialty care. Ultimately, examining BED within the broader context of the current obesity epidemic will be an important area of study.
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PMID:Diagnosis and management of binge eating disorder. 1818 31

Attention deficit hyperactivity disorder (ADHD) is a heterogeneous highly heritable disorder which has recently been described to be comorbid in obese subjects. This study investigated phenotype/genotype associations in a consanguineous family with genetic obesity due to the melanocortin-4-receptor (MC4R) (C271R) mutation. MC4R deficiency disrupts hunger/satiety regulation resulting in abnormal eating behaviors. To date, the behavioral/psychiatric characteristics of MC4R deficiency have not been described except for a possible association with Binge Eating Disorder. Twenty-nine subjects of a family known to carry the MC4R (C271R) mutation, were genotyped for the mutation and underwent extensive evaluations in search for physical/psychiatric phenotype characteristics. Subjects originated from proband nuclear families with morbid obese children (BMI percentile > 97%). All probands were homozygous for the MC4R (C271R) mutation. ADHD prevalence was higher than expected only in the groups carrying the homozygous or heterozygous mutation (P = 0.00057, 0.0028, respectively). An obvious difference was observed between the homozygous group and the rest of the family in terms of obesity: homozygous subjects had childhood morbid obesity whereas heterozygous subjects included lean, normal weight and later onset obese subjects. A significant difference was found in ADHD prevalence between the homozygous MC4R (C271R) group (80%) and the rest of the family (22%) (P = 0.033) and a significant trend was found between ADHD prevalence and the number of MC4R (C271R) alleles (P = 0.0267). We conclude that in our sample, the MC4R (C271R) mutation causing obesity, is in association with ADHD. Identifying specific subgroups in which the comorbidity of obesity and ADHD occur may contribute to the understanding of the underlying molecular mechanisms.
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PMID:Attention deficit hyperactivity disorder in obese melanocortin-4-receptor (MC4R) deficient subjects: a newly described expression of MC4R deficiency. 1877 18

Over the last 30 years, several questionnaires have been developed and validated in order to assess many aspects of the motivation to eat that might be susceptible to impair adequate food intake and body weight control. A few of such questionnaires are described here, in particular, the "Three Factor Eating Questionnaire" also called the "Eating Inventory", and the "Dutch Eating Behavior Questionnaire". Critical aspects of the motivation to eat assessed by these tools are presented, such as dietary restraint, disinhibition, hunger, vulnerability to eat in response to external cues or emotional states, etc. These questionnaires were developed for use in the general population with the aim to identify critical aspects of the motivation to eat that might predispose to weight gain. They have been widely used in many countries and have allowed an improved understanding of the individual characteristics that predispose to body weight gain or resistance to weight loss. Originally, poor body weight control was attributed to a high level of dietary "restraint", or in other words, the tendency to deliberately restrict one's food intake for body weight control purposes. Such dietary restraint was suspected to lead to a number of physical and psychological difficulties, among which poor self-esteem and a paradoxical tendency to gain weight, resulting from the incapacity to maintain strict restraint over time. More recent studies have established that a motivational trait called "Disinhibition" is a strong predictor of body weight gain over time and of poor outcome of dieting. "Disinhibition" corresponds to a tendency to lose control over one's eating behavior and ingest excessively large quantities of food substances, in response to a variety of cues and circumstances. In addition to its untoward effect on weight, disinhibition also predicts various risk factors and pathologies, such as hypertension and diabetes. Other potentially critical dimensions for adequate body weight control are "emotional eating" and "externality", which represent an individual's vulnerability to eat in response to emotional states or external cues, respectively. These questionnaires have been translated into French and validated for the French population. Average data are available for normal weight and obese French men and women. A gender difference is often reported: women, and even young girls, tend to have higher scores than males for most dimensions. These questionnaires have been extensively used in populations without psychiatric disorders, with the only exception of diagnosed eating disorders such as anorexia and bulimia nervosa. The questionnaires have not been used until now in populations with other types of psychiatric disorders, such as schizophrenia or bipolar disease. Their relevance for such populations is now an important question, since last generation pharmaceutical treatments of such psychiatric disorders seem to adversely affect body weight control. It then becomes critical to know whether the psychological dimensions assessed by such questionnaires reflect the action of pharmacological agents that induce weight gain. A research project is now in progress at Sainte-Anne Hospital to investigate many dimensions of the motivation to eat, as assessed by the questionnaires, in psychiatric patients receiving various types of antipsychotic agents. The results of this original study might provide hints about the mechanisms that lead to body weight gain in patients receiving certain types of antipsychotic pharmacological agents and potentially help in preventing or reversing the weight gain associated with such treatments.
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PMID:[Assessing various aspects of the motivation to eat that can affect food intake and body weight control]. 1939 89


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