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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a retrospective study of case notes a number of experiential and psychological factors were discerned of possible importance to the psychogenesis of anorexia nervosa. These factors included issues of dependence and independence, sexual challenge, concern about obesity, and a variety of other, less specific stresses. Attempts to confirm the findings by means of a prospective study were impeded by difficulties in defining the onset of the illness. While in some patients the occurrence of anorexic type behaviour led immediately to weight loss, in others there was a significant delay between the onset of behavioural change and consequent emaciation.
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PMID:The onset of anorexia nervosa. 28 28

Obese patients who voluntarily reduce to a normal weight may develop secondary amenorrhea. Six young women who dieted to lose from 13 to 50 pounds, including four from an obese weight, were evaluated because of absent cervical mucus ferning, hypoestrogenic vaginal smears, and failure to have withdrawal menses from a progestogen. Serum FSH values were normal in all, while four had normal serum LH and two had low serum LH levels. T4 and/or T3 uptake was normal in all. The pituitary-adrenal axis was apparently intact since baseline urinary steroids were normal as was the response to both ACTH and metyrapone. Fasting serum growth hormone was markedly elevated in two and slightly elevated in three, with the other patinet demonstrating an unusually high response to glucagon/propranolol in the 30 minute specimen. These endocrine findings are similar to those observed in patients with anorexia nervosa, but the weight loss is entirely voluntary and there was no associated psychiatric abnormality.
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PMID:Amenorrhea secondary to voluntary weight loss. 48 81

We studied secretion of growth hormone (GH), insulin, and prolactin in eight women with anorexia nervosa and nine women with refractory obesity before and during treatment with bromocriptine, 10 mg/day. In the anorexic patients the raised plasma GH concentrations occurring during an oral glucose tolerance test fell significantly while on bromocriptine treatment, but there was no change in plasma insulin or blood glucose concentrations. In the obese patients, however, plasma GH concentrations remained low during the oral glucose tolerance test, and were not modified by bromocriptine. Blood glucose and plasma insulin concentrations were also unchanged. Plasma GH and plasma 11-hydroxycorticosteroid responses to insulin-induced hypoglycaemia were unaffected. Serum prolactin concentrations which were raised in five anorexic patients and marginally raised in two obese subjects, fell significantly in both groups during treatment. We observed no consistent weight changes in either groups.
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PMID:Growth hormone, insulin, and prolactin secretion in anorexia nervosa and obesity during bromocriptine treatment. 57 73

Adolescent attitudes to body shape and weight are radically different between the sexes. Females, within a very short time of crossing their pubertal "threshold", usually wish to minimise their shape and often construe themselves as "fat" when it is evident that they are not in fact obese. The majority attempt to "diet" and often succeed, at least intermittently, in substantially reducing the amount of carbohydrate in their daily food intake. This "fatness" of females has important biological and social functions, being closely related to sexual reproductive tasks and being also an important aspect of their appearance and "attractiveness". In contrast, males rarely have such concern about their shape unless they are massively obese or have major gender identity problems. Fatness in both sexes is also associated with growth rate, being greater in those who reach puberty early. Such "puppy fat" together with the commonplace adolescent female's attitude to her own shape are, in the face of adolescent psychosocial stress, contributory factors to the development of anorexia nervosa (the thin/fat syndrome) in many such women who would otherwise tend to obesity. The relevance of body weight and fatness for the pubertal "threshold" process and the mobilisation of this as a central mechanism within the disorder is discussed.
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PMID:Some psychobiological aspects of adolescent growth and their relevance for the fat/thin syndrome (anorexia nervosa). 61 34

The literature on primary anorexia nervosa in the male is reviewed and the case histories of 3 new patients are reported. Most surveys comment on the rarity of the syndrome in the male, with the sex ratio in the range of 1 in 10 to 1 in 20. The patients reported here had certain features in common. All the mothers and fathers were overweight, but obesity was marked only in the fathers, who also showed moderate to severe degrees of alcoholism. The mothers were oversensitive, insecure individuals, and the marriages suffered in proportion to the severity of the husband's alcoholism. Preoccupation with food was observed on home visits. There was overt mutual hostility between each father and anorexic son; the boys showed pronounced obsessional traits in their personalities. Dieting in order to ameliorate real or feared obesity was a first step in the development of the syndrome in each boy. In the past 3 years an equal number of boys and girls (new patients) have been referred for treatment in the psychiatric unit. Speculative reasons for this are discussed.
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PMID:Anorexia nervosa in boys. 64 14

In 17 normal subjects and 126 patients with various endocrine disorders, including 13 patients with Cushing's syndrome, plasma levels of fluorogenic corticosteroid were measured at 9 AM and midnight, and again at 9 AM the following morning, after the patient had received 1 mg of dexamethasone by mouth immediately after the midnight sampling. Basal morning levels of plasma corticosteroids were of little diagnostic value in differentiating between Cushing's syndrome and non-Cushing's states because of the wide overlap of values observed. At midnight the overlap almost completely disappeared. After overnight suppression, only one patient with a mild form of Cushing's disease had normal (false-negative) results in two of four instances. There were virtually no false-positive results, except for two patients with anorexia nervosa showing minor abnormalities of the test. The results were in general agreement with those of the classic Liddle test. However, one patient with Cushing's disease had repeatedly abnormal responses to overnight suppression and normal responses to the Liddle test. When the inhibitory tests gave equivocal results in the differential diagnosis between exogenous obesity and Cushing's disease due to adrenal hyperplasia, the response of plasma corticosteroids to hypoglycemia, normal in obesity and absent in Cushing's disease, proved to be an excellent ancillary test in differentiating between the two conditions.
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PMID:Clinical experience with a simple screening test for Cushing's syndrome combining the determination of plasma cortisol circadian rhythm with the overnight dexamethasone suppression test. 66 10

There is increasing evidence suggesting that the perceptual-cognitive experiences of people with anorexia nervosa and juvenile onset obesity may differ from those of people without eating disorders. The research related to several perceptual-cognitive dimensions is critically examined. These include body image perceptions; perception of hunger and satiety cues; perception of external cues; and certain personality variables which may be related to self-perception. The implications of these perceptual-cognitive variables for the treatment of anorexia nervosa and obesity are discussed. The relative efficacy of some behavioural and medical therapies may be related, in part, to their effects on perceptual-cognitive parameters. Recommendations are also made for investigations to further delineate the role of perceptual-cognitive difficulties in people with eating problems.
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PMID:Perceptual experiences in anorexia nervosa and obesity. 66 83

There is some evidence for the existence of a precise weight/fat threshold for puberty. Following puberty, body weight and shape take on important new psycho-social significances for both males and females. Adolescent females usually strive to reduce their 'fatness' even it is not excessive from a biological standpoint. Super-obesity and anorexia nervosa are two human disorders of weight and fatness, more common in women, and importantly related to disturbances of sexual behavior, metabolic, social and experiential. These latter aspects sometimes at least reflect the presence of several factors which have contributed to the development of the disorders. Anorexia nervosa in particular reflects the adaptive psychosocial needs of the person concerned. Attention to this aspect during treatment will often allow the patient to tolerate the major weight gain required for recovery, thereby at the same time providing a paradigm for aspects of the pubertal process which can then be studied. The results of some such investigations together with related studies of the super-obese are reported here.
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PMID:Some aspects of the relationship between body weight and sexual behaviour with particular reference to massive obesity and anorexia nervosa. 71 53

Rate of weight gain, together with metabolic rate before and after a glucose meal, were studied in a group of 15 female anorexia nervosa patients as their weight was being restored to normal levels. The previously obese anoretic patients gained weight more rapidly, on the same food intake, than those who were of normal weight before their illness began. The increase in metabolic rate (as treatment progressed) was less in the previously obese patients, who also showed a tendency for the metabolic rate to increase less after a glucose meal than the patients with no history of obesity. The thermic effect of glucose was greater in patients with anorexia nervosa than in a comparable control group of six female students.
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PMID:Weight gain, thermic effect of glucose and resting metabolic rate during recovery from anorexia nervosa. 83

Two alternative explanations of the body-image abnormality in anorexia nervosa patients are outlined: namely, the 'abnormal sensitivity' and 'adaptational failure' hypotheses. Evidence relating to these 2 conflicting hypotheses was obtained from body-perception measurements carried out on groups of pregnant women. In the first study 40 pregnant women, at approximately 4 month's duration, were found to overestimate their bodily dimensions, albeit to a lesser extent than the previously tested group of anorexia nervosa patients (Slade & Russell, 1973a). When they were subdivided on the basis of a history of weight change over the previous 12 months, the 'stable weight' subgroup was found to overestimate significantly more than the 'weight gain' and 'weight loss' subgroups. In a second study 16 of the original group of pregnant women were retested at approximately 8 month's duration. Although their weight and bodily dimensions had increased on retesting, their tendency to overestimate was found to be significantly reduced. It was concluded that the phenomenon of body-image disorder is not specific to anorexia nervosa, extending not only to patients with obesity and to some normal women, but also to women during pregnancy. Moreover, the 'abnormal sensitivity' hypothesis was considered to fit these and other recently accumulated data better than the alternative 'adaptational failure' hypothesis. Some of the theoretical and clinical implications of these findings are discussed.
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PMID:Awareness of body dimensions during pregnancy: an analogue study. 87 87


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