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

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

d-Fenfluramine is a 5-HT agonist which decreases food intake and excessive carbohydrate intake in humans. A placebo-controlled trial of d-fenfluramine (45 mg/day) was conducted in 43 patients with bulimia nervosa. The patients entered an eight-week trial of medication during which they also received cognitive-behavioural therapy. Treatment response was assessed using food diaries to record eating behaviour, and self-rating questionnaires to measure psychopathology. The drug trial, and a follow-up assessment after a further eight weeks, were completed by 39 patients. Abnormal eating behaviour and psychopathology improved significantly in both the d-fenfluramine and placebo groups during the treatment trial. The study failed to show that the addition of d-fenfluramine affords an advantage over brief psychotherapy alone. Although d-fenfluramine is effective in suppressing the overeating, excessive snacking, and excessive carbohydrate consumption which are frequently found in overweight or obese patients, this study suggests that the drug is not an effective treatment for bulimia nervosa.
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PMID:A placebo-controlled trial of d-fenfluramine in bulimia nervosa. 825 96

One hundred significantly overweight patients sequentially applying to a very low calorie diet (VLCD) program were interviewed to learn how the onset of obesity correlated with other life events. By comparison with a control group of 100 always-slender adults, the obese applicants were found to be different at a highly significant level in the prevalence of childhood sexual abuse, nonsexual childhood abuse, early parental loss, parental alcoholism, chronic depression, and marital family dysfunction in their own adult lives. The obese patients commonly reported using obesity as a sexually protective device; many reported overeating to cope with emotional distress. Inquiry into depression, past sexual abuse, and past or present dysfunctional family life should be added to the current medical evaluation of all obese patients. The resultant findings are likely to be relevant to their treatment, whether for obesity or for other medical conditions.
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PMID:Childhood sexual abuse, depression, and family dysfunction in adult obese patients: a case control study. 820 85

There is persuasive evidence that much obesity is due to underexercising rather than overeating. In a series of randomized, controlled trials we found that sedentary men who take up jogging lose body fat in proportion to miles run, increase their energy intake, and improve their lipoprotein pattern. In a 1-year comparison of fat loss by dieting vs. fat loss by exercise without dieting, both methods were found to be effective in moderately overweight men, and both approaches raised plasma HDL cholesterol. We also demonstrated in overweight men and women losing weight on a prudent diet (low fat, low cholesterol) that adding exercise to energy restriction further increased loss of body fat and reduced waist-to-hip girth ratio, especially in men. Risk of coronary heart disease was also substantially further reduced by addition of exercise, in both sexes. These studies suggest that regular exercise is a valuable addition to dietary change for weight control and reduction of risk of chronic disease in people of all ages. In this article I shall describe studies done by our group in the past 10 years to investigate the effects of varying energy expenditures and varying caloric intakes on body composition, in particular body fat content. The intervention studies are of relatively long duration (1 or 2 years) and have been conducted in free-living men and women. Such long-term investigations are rare in children and adolescents. Although experience in adults cannot be translated directly to children, our findings may indicate profitable research directions for future obesity research in the young.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of experimental manipulation of energy intake and expenditure on body composition. 835 99

The aim was to examine attitudes towards eating in a group of obese and nonobese female adolescents (N = 200), in particular whether obese subjects have characteristic attitudinal patterns associated with obesity. Analysis concluded that our sample, both overweight and normal subjects, share the negative stereotypic attitudes towards obese persons. However, there was a considerable difference in emotional evaluation of eating behaviour. If normal subjects attribute a strong negative emotional connotation, obese subjects not only did not recognise the "abnormality" of overeating, but preferred it. This can be explained by the presence of an association of strength and power with overeating: at the moment of eating, obese subjects feel themselves "strong" and even "superior," thereby compensating for their rather weak and fragile personalities. The emotional evaluation of eating behavior did not change after a 10-week dietary/behavioural treatment.
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PMID:The role of emotional and socio-cognitive patterns in obesity: eating attitudes in obese adolescents before and after a dietary-behavioural therapy. 887 86

Eleven individuals with Prader-Willi syndrome and 10 control subjects who had mental retardation due to other causes (with and without overeating histories) participated in two experiments on food preferences. They gave preference rankings for various foods, then chose between a small amount of their most preferred food and an alternative choice of a larger amount of mixed-preference foods (Experiment 1) or an alternative choice of a larger amount of their least preferred food (Experiment 2). Unlike overweight-prone control subjects who selected sweet food over a larger quantity of unpreferred food, subjects with Prader-Willi syndrome selected preferred items only over least-preferred items (Experiment 2) but not over mixed-preference items (Experiment 1). Implications for treatment were discussed.
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PMID:Food preferences among individuals with and without Prader-Willi syndrome. 888 73

America's overweight problem is universally recognized and escalating, despite billions of dollars spent to combat it. For the past century, a unidimensional paradigm was predominantly used to correct the overweight problem by reducing calories through dieting. As a result of the profound failure of traditional diet programs, a phenomenon known as weight cycling was born. In this article, a multidimensional paradigm is emphasized to address weight cycling. Reversal theory extends a new theoretical basis that can account for unpleasant feelings, or tension stress, as a trigger of overeating in women who weight cycle. A case example demonstrates how reversal theory explains overeating as a response to high-tension stress. Results of two studies are presented, describing overweight and normal-weight women's reversal theory states during self-reported episodes of overeating and resisting overeating. The multidimensional paradigm calls for emotional overeating behaviors to be addressed in weight management.
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PMID:Overeating, reversal theory, and weight cycling. 947 68

The purpose of this study was to describe overeating episodes of overweight women who weight cycle compared with women of normal weight. Repeated overeating can be a major source of excess calories that may lead to weight gain in women who have weight cycled. Interview transcripts about overeating episodes of 45 women were subjected to a content analysis in a qualitative secondary analysis of data. Four patterns emerged from the data: planned overeating, power/control, relationships with others, and unpleasant feelings. Three intervention strategies are described to assist women who have weight cycled to understand and deal with feelings that trigger overeating, including strategies to stop overeating, feel their feelings, and fight fairly.
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PMID:Triggers of overeating and related intervention strategies for women who weight cycle. 962 33

Dietitians are developing a philosophy and a practice protocol of weight management. A professional philosophy of weight management addresses questions about the social, psychological, and biological spectra of weight management: Should overweight be considered in terms of size acceptance or gluttony and sloth? How should emotional overeating and obsessive restriction be managed? Should obesity be considered a chronic disease, or should the idea that health at every size is possible be espoused? A professional practice protocol addresses another set of questions: Is obesity to be viewed as a short-term and long-term health challenge? Regarding the spectrum of antiobesity agents and antidieting approaches of weight management, what professional position and individual practice will be adopted? Should professional contact with patients be continuous or aimed toward self-care? What measures of successful outcomes will be used: weight change or life quality improvement? How should professional responsibility be balanced with personal concerns about eating and health behaviors that affect body weight? What are examples of closing the gap between the vision and the reality of the roles and goals of the dietitian on a weight management team? Dietitians are translating philosophy into practice. Because dietary control alone has a record of limited success in weight loss and less success in maintaining weight loss, the dietitian's expanded role includes helping patients manage weight with coping skills, motivation techniques, physical activity, and food behavior change. The challenge is integrating functional components of practice with dietitians' unique food and nutrition skills that include selection of alternative foods, portion control, and preparing acceptable, tasty foods for lifelong weight management.
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PMID:The dietitians' philosophy and practice in multidisciplinary weight management. 978 37

Cholecystokinin (CCK) is suggested to be involved, e.g. in the central nervous modulation of food intake, possibly by acting within specific hypothalamic nuclei. Perinatal overnutrition predisposes to permanent obesity and hyperphagia, while underlying mechanisms are unclear. By reducing the litter size from the 3rd to 21st day of life, early overnutrition was induced in newborn rats. At weaning, clear overweight (P < 0.001), hyperglycaemia (P < 0.05), hyperinsulinaemia (P < 0.001), and insulin resistance (P < 0.001) occured. These early signs of obesity were associated with a significantly decreased number of CCK-positive neurons in the paraventricular hypothalamic nucleus (P < 0.002). In conclusion, due to neonatal overfeeding malformation of CCKergic neurons at the end of the critical hypothalamic differentiation period occurs. Long-term consequences on CCK-related neuroendocrine regulations could be suggested, including those affecting food intake and body weight gain.
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PMID:Reduction of cholecystokinin-8S-neurons in the paraventricular hypothalamic nucleus of neonatally overfed weanling rats. 987 40


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