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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The evidence suggests that poor diabetic control in adolescence is often associated with omissions of insulin, overeating and other failures in adherence to the treatment regime in the context of some kind of emotional disturbance. Six young patients with diabetes mellitus and an eating disorder (anorexia nervosa or bulimia), who failed to control their diabetes in order to lose weight and to compensate for bulimic episodes, are discussed. Other noteworthy features were their feelings of hopelessness and their unco-operativeness with treatment. Our knowledge of the pathogenesis of anorexia nervosa and of the special problems faced by diabetic adolescents would lead to a prediction that a combination of the two disorders should arise more often than could be accounted for by chance.
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PMID:Anorexia nervosa and bulimia in diabetics. 639 33

Thirty-two patients who complained of episodes of ravenous overeating which they felt unable to control (bulimia) were asked to describe their behaviour and symptoms. There was considerable variation both between and within individuals, but a number of factors were defined which appeared to be common to all with the complaint. It is difficult to set up strict criteria for the recognition of bulimia, and those that have recently been proposed are criticized in the light of our present findings. Bulimia is usually associated with an excessive concern about body weight. It occurs in patients with anorexia nervosa, in whom it is often a relatively early feature of the illness, but it is also found in subjects of normal weight or obese subjects who have never been emaciated. Episodes of bulimia are usually preceded by dysphoric mood states. The gorging may alleviate the dysphoria temporarily, but many patients later experience negative feelings such as depression and self-depreciation. The ability to induce vomiting after a bulimic episode is a major influence determining the clinical presentation.
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PMID:How patients describe bulimia or binge eating. 695 5

This study examined binge eating and weight cycling in a community-based sample of successful (46 women, 44 men) and unsuccessful (29 women, 25 men) dieters. Successful dieters had lost at least 15% of body weight, kept the weight off for at least 1 year, and regained no more than 10 lb (average weight loss = 48 lb). Subjects completed a written questionnaire and were interviewed by phone several weeks later. Unsuccessful dieters were more obese when starting on a diet (average body mass index = 35.6 compared to 32.1) and were much more likely to have lost and regained 20 lb. Six-month prevalence of binge eating disorder (BED) was 19% for unsuccessful dieters and 6% for successful dieters; lifetime prevalence was 15% and 13%, respectively. Unsuccessful dieters were two to three times more likely to perceive a lack of control during an episode of overeating, to be disgusted with themselves for overeating, and to eat alone because they were embarrassed. Encouraging dieters to set realistic goals, identify potential relapse situations, and interpret lapses may help them succeed.
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PMID:Binge eating disorder in a community-based sample of successful and unsuccessful dieters. 758 19

Both systemic and intracranial administration of morphine can result in spontaneous feeding in non-deprived rats. The present investigation was conducted to examine the involvement of the striatum in this phenomenon. Morphine sulfate (0, 0.5, 1.0, 5.0, 10.0, and 20.0 micrograms/0.5 microliters) was microinjected into five discrete striatal subregions in non-deprived rats: the nucleus accumbens, the ventromedial striatum, the ventrolateral striatum, the anterior dorsal striatum, and the posterior dorsal striatum. Feeding, drinking, locomotion, rearing, and food intake were measured over 4 h after infusion. Results indicate that the striatum is a heterogeneous structure with regard to the regulation of opiate-induced feeding behavior and locomotor activity. Morphine infusion into anteroventromedial regions including the nucleus accumbens resulted in a marked hyperphagia that was generally delayed in onset; much smaller increases or no change in feeding occurred after administration into more dorsal, lateral and posterior areas. It is hypothesized that there may exist within the striatum an anatomical gradient that is most sensitive to opiate-induced feeding within the anteroventromedial sector. Since this area has extensive connections with other brain sites sensitive to opiate-induced feeding, it may be a critical part of an opiatergic feeding system within the brain. In addition, a possible role for the anteroventromedial striatum in compulsive feeding and bulimia is discussed.
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PMID:Striatal regulation of morphine-induced hyperphagia: an anatomical mapping study. 787 Sep 54

With Russell's description of bulimia nervosa in 1979, followed by the DSM-III diagnosis of bulimia, a "new" eating syndrome found its official acceptance in the scientific world. In the two preceding decades clinicians and researchers gradually payed more attention to special forms of overeating. In the 1970s the nosographic conceptualizations of binge eating, bulimia, compulsive eating, or hyperorexia clearly shifted from a symptom level--closely connected to anorexia nervosa and/or obesity--to a syndrome level. Around the same time and independently from one another, clinicians from different countries proposed various descriptive labels for this new diagnostic entity, which, finally, became accepted as bulimia nervosa.
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PMID:Emergence of bulimia nervosa as a separate diagnostic entity: review of the literature from 1960 to 1979. 798 45

Sleep-related eating disorders distinct from daytime eating disorders have recently been shown to be associated with sleepwalking (SW), periodic limb movement (PLM) disorder and triazolam abuse in a series of 19 adults. We now report eight other primary or combined etiologies identified by clinical evaluations and polysomnographic monitoring of 19 additional adults (mean age 40 years; 58% female): i) obstructive sleep apnea (OSA), with eating during apnea-induced confusional arousals (n = 3); ii) OSA-PLM disorder (n = 1); iii) familial SW and sleep-related eating (n = 2); iv) SW-PLM disorder (n = 1); v) SW-irregular sleep/wake pattern disorder (n = 1); vi) familial restless legs syndrome and sleep-related eating (n = 2); vii) anorexia nervosa with nocturnal bulimia (n = 2) and viii) amitriptyline treatment of migraines (n = 1). In our cumulative series of 38 patients (excluding six with simple obesity from daytime overeating), 44% were overweight (i.e. > 20% excess weight) from sleep-related eating. Nightly sleep-related binge eating (without hunger or purging) had occurred in 84% of patients. Onset of sleep-related eating was also closely linked with i) acute stress involving reality-based concerns about the safety of family members or about relationship problems (n = 6), ii) abstinence from alcohol and opiate/cocaine abuse (n = 2) and iii) cessation of cigarette smoking (n = 2). Current treatment data indicate a primary role of dopaminergic agents (carbidopa/L-dopa; bromocriptine), often combined with codeine and clonazepam, in controlling most cases involving SW and/or PLM disorder. Fluoxetine was effective in two of three patients. Nasal continuous positive airway pressure therapy controlled sleep-related eating in two OSA patients.
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PMID:Additional categories of sleep-related eating disorders and the current status of treatment. 810 56

One hundred obese women with a mean age of 39.2 years, and a mean body mass index (BMI) of 35.9 kg/m2 were evaluated before entering a treatment study for weight reduction. According to the results of a structured interview, subjects were divided into four groups: (1) no overeating episodes, (2) episodic overeating episodes without the feeling of loss of control, (3) overeating plus the sense of loss of control (binge eating), and (4) full diagnostic criteria for binge eating disorder (BED). One-way analyses of variance (ANOVAs) revealed significant positive associations between binge eating and eating/weight-related characteristics such as a history of frequent weight fluctuations, the amount of time spent dieting, drive for thinness, and a tendency for disinhibition of eating. Furthermore, subjects exhibited more feelings of ineffectiveness, stronger perfectionistic attitudes, more impulsivity, less self-esteem, and less interoceptive awareness the more problems with binge eating they reported. The results support the idea that binge eaters might be a distinct subgroup among the obese population, and corroborate the utility of a diagnosis of BED in identifying the most disturbed obese subjects with regard to the variables tested.
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PMID:Eating related and general psychopathology in obese females with binge eating disorder. 812 26

Hypothesizing the existence of a subgroup of female smokers for whom nicotine masks, and abstinence unmasks, a tendency toward hyperphagia and perhaps even subthreshold disordered eating, we compared female "weight-control smokers" (WC; n = 46) and "non-weight-control smokers" (NWC; n = 52) on smoking- and eating-related variables. We also examined the relationship between weight-control smoking and withdrawal symptomatology during 48-hours of nicotine abstinence (n = 23). Although WC were not more depressed, anxious, or nicotine-dependent than NWC, they were significantly more likely to report weight gain and increased hunger during abstinence; they also scored higher on Cognitive Restraint and Disinhibition (Three-Factor Eating Questionnaire). The expected correlation of cotinine with weight emerged for NWC but not for WC. Weight-control smoking correlated with increased eating during abstinence. Our findings suggest that WC use dietary restraint as well as smoking to manage weight, and that abstinence may precipitate episodes of disinhibited or binge eating. If WC overinclude women vulnerable to excess or unpredictable eating and consequently to substantial weight gain that can be managed by nicotine, highly focused treatment strategies may be helpful.
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PMID:The female weight-control smoker: a profile. 818 73

A group of obese people who had not sought treatment, an obese group who had sought treatment in a professional, hospital-based program, and normal-weight controls (N = 547) were compared in regard to level of psychopathology, binge eating, and negative emotional eating. Because the groups differed significantly on several demographic variables, 3 demographically matched groups were created and compared (n = 177, 59 per group). In the matched subgroups, obese people who had sought treatment reported greater psychopathology and more binge eating than did those who had not sought treatment or did normal-weight controls. Both obese groups (including those who had not sought treatment) endorsed more symptoms of distress, negative emotional eating, overeating, difficulty resisting temptation, and less exercise than did normal-weight controls.
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PMID:Obese people who seek treatment have different characteristics than those who do not seek treatment. 822 57

We assessed the correlation between a self-report questionnaire and an expert-rating including an initial interview and a longitudinal evaluation on the diagnosis of binge eating disorder (BED) in a sample of 100 obese women participating in a treatment program for weight reduction. The level of diagnostic agreement between patient-rating and expert-rating with regard to the presence or absence of BED was modest, with a kappa value of .57. According to Shrout, Spitzer, and Fleiss (Archives of General Psychiatry, 44, 172-177, 1987) this represents fair to good agreement beyond chance. The self-report instrument did not produce higher estimates of the frequency of BED in this selected sample of treatment seekers than the expert-rating, as observed in studies on the epidemiology of bulimia nervosa in community samples. The questionnaire identified 40 cases of BED, the expert-rating 43 cases. The results indicate that the disagreement between self-report and interview was mainly due to discordances in three of the diagnostic criteria of BED--namely loss of control, marked distress regarding binge eating, and the frequency requirement of two binge eating episodes per week for a 6-month period. Inconsistencies between subjects and clinicians with regard to the definition of an overeating episode and with regard to the behavioral indicators of loss of control did not lead to differences between self-report and observer-rating in the final diagnosis of BED.
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PMID:Diagnosing binge eating disorder: level of agreement between self-report and expert-rating. 827 65


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