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

In the introduction classification of socalled "psychosomatic" disorders in ICD-9 and DSM-III are critically reviewed and supplemented by the author's proposal. Furthermore, main findings coming from international epidemiological research on diseases usually involving tissue damage (bronchial asthma, peptic ulcer, neurodermatitis) and the eating disorders (anorexia nervosa, bulimia nervosa, obesity) are reported. Findly, some conclusions with regard to treatment of the afflicted clientele and research are drawn.
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PMID:[Classification and epidemiology of psychosomatic disorders in children and adolescents]. 278 84

The decisions of an individual about his food intake depend upon a variety of internal and external signals. The present contribution describes the physiological mechanisms controlling food intake to preserve body composition and performance. Centers within the hypothalamus including their connections to higher and lower structures within the central nervous system, especially to the limbic system, are involved in the control a food intake. Neuropeptides and neurotransmitters usually initiate more complex actions including the search for food and satiety phenomena. Their production and release are influenced by food consumption as well as intake of specific nutrients, sensorial perceptions, and a variety of other factors. Vagal reflexes and gastro-intestinal hormones, fat cell size, physical activity, and thermogenesis also influence perceptions of hunger and satiety. A model satisfactorily describing the interactions between all known factors that control food intake is still missing. The path from hunger to satiety could be described as sequences of cascades similar to the various steps in blood clotting. Control of food intake during early life dependably relies on energy requirement, and can be utilized for ad-libitum feeding. Obesity and anorexia nervosa are manifestations of disturbed control over food intake. Neuropharmacology offers several therapeutic approaches to specific conditions. However, by and large abnormalities of food intake control have to be treated by behavioral modification.
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PMID:[Control of food intake]. 287 89

Nine patients (4F, 5M) aged 12-17 years with "fear of obesity" were studied with a sequential stimulation test utilizing insulin, LRH, TRH, and L-dopa. The comparative groups were nine female with classic anorexia nervosa, five males with undifferentiated nutritional dwarfing, and nine children (1F, 8M) with constitutional growth delay. The serum TSH, glucose, cortisol, somatotropin, prolactin, LH, and FSH were sampled periodically over 2 hours. Basal T3, T4, transferrin, and Somatomedin-C levels were also obtained. The "fear of obesity" patients did not have any pituitary function changes that were unique. These patients, as well as the comparison groups, revealed a delayed TSH response in proportion to the weight deficit which, when expressed as an integrated response, correlated well to the weight deficit for height (P less than 0.001) and to the ability to recover from hypoglycemia (p less than 0.001). The Somatomedin-C level was low and correlated to the T3 level (p less than 0.05) and not correlated to the elevated Somatotropin levels. The pituitary response to combined stimulation in patients with fear of obesity was determined to be a component of the spectrum starting at normal and proceeding to the extreme undernutrition of anorexia nervosa. Pituitary responsiveness, therefore, changes not as a function of the etiology of the malnutrition, but simply as a function of its severity.
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PMID:Pituitary-hypothalamic response in adolescents with growth failure due to fear of obesity. 310 48

Obesity is not a single disease, but a variety of conditions resulting from different mechanisms and associated with various types and degrees of risks. To determine who should lose weight, how much weight should be lost, and how to undertake weight loss, the following types of information are needed: personal-demographic data, developmental patterns, family history, energy balance, body composition/fat distribution, psychological/behavioral measures, endocrine/metabolic measures, complications and associated conditions. Weight reduction should be undertaken by women with morbid obesity, with complications secondary to the obesity, with a strong family history of conditions associated with obesity, or with increased abdomen:hip ratios. In contrast, women who have excess weight localized in the hips and thighs and no personal or family history of associated conditions may not benefit from dietary restriction. Low calorie diets result in adaptive changes, "designed" to prolong survival in the face of famine. These include changes in water balance, metabolic rate, and appetite. Metabolic rate declines, allowing the individual to burn fewer and fewer calories. Each time a woman diets she tends to lose weight less rapidly than the time before. "Restrained eating" predisposes binge eating. Indeed, bulimia rarely occurs in the absence of prior caloric restrictions. Current medical definitions of obesity do not consider these nuances. Existing definitions "over-diagnose" obesity in women, in general, and in older women and nonwhite women, in particular. For example, by existing standards, more than 60 percent of black women more than 45 years of age are considered obese. In contrast, the health risks of similar degrees of obesity are substantially greater for men than for women. Part of the problems lies in the fact that many women have pear-shaped fat distribution,a pattern which is not associated with increased health risks.Current cultural definitions of obesity for women distort the picture even further. In the past 20 years,there has been a progressive decline in the weight-for height of such "culture models" as Playboy centerfold subjects and Miss America contestants. Attempting to achieve such low weights predisposes women to an endless cycle of dieting and regaining, and contributes to the growing problems of eating disorders, including anorexia nervosa and bulimia.
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PMID:Obesity. 312 Feb 16

Thirteen black patients were referred over 5 years to the eating-disorders unit at the Maudsley Hospital. Two suffered from anorexia nervosa and 11 from bulimia nervosa. This group was compared with a matched white control group from the total clinic population during that period. The Blacks had more commonly experienced parental divorce or separation, and premorbid obesity, and were more likely to be referred by the emergency services. Their lower educational achievements, and fathers of lower socio-economic status, reflected variation among the general black and white populations in this country, but their educational levels and social statuses were higher than in the general black population.
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PMID:Anorexia nervosa and bulimia nervosa in British blacks. 316 7

Though education for healthy body weight traditionally has focused on obesity, the increased incidence of anorexia nervosa and bulimia among young women suggests education also is needed to address the opposite end of the spectrum. Anorexia nervosa and bulimia are complex and multidimensional disorders associated with individual, family, and sociocultural factors. This article examines the cultural pressure for dieting and thinness currently experienced in America and its impact as a possible predisposing factor for developing eating disorders among adolescent females. Literature is reviewed related to the changing American standard of attractiveness for females reflected by 20th century mass media and its subsequent influence on adolescent concerns for dieting and thinness. Preventive strategies are recommended to help adolescents balance the cultural pressure for thinness and their own desires for attractiveness within the larger context of overall good health.
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PMID:Education for healthy body weight: helping adolescents balance the cultural pressure for thinness. 321 26

A screening of Bulimia, an eating disorder associated to Obesity and Anorexia Nervosa, has been carried out in the city of Buenos Aires. The data were obtained by means of the questionnaire of Pope & Hudson, administered to young women who attend diet and physical activity programs. Control groups were constituted by female university students and boutique employees. The results indicate that diet and physical fitness searchers are groups at risk of Bulimia. It is concluded that proper preventive measures can be taken by informing and training the personnel, professional or not, in charge of those institutions, and also by promoting the adequate information within the population.
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PMID:[Characterization and detection of bulimia in the city of Buenos Aires]. 325 26

This report investigates childhood and adolescent obesity through a comparison with anorexia nervosa, an eating disorder typically associated with the opposite end of the eating behavior spectrum. Many similarities in the etiologies of the two conditions are discussed, particularly with regard to the influence of family interactional patterns. More specifically, it appears that the families of both anorexics and the obese are characterized by overprotectiveness and enmeshment, resulting in a poor sense of identity and effectiveness. Such children, usually compliant and dependent in childhood, misuse the eating function in an attempt to assert their independence and gain control of their lives in adolescence. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), anorexia nervosa, but not obesity, meets the definition of an eating disorder. Although it appears that DSM-III-R is accurate in not classifying obesity as an eating disorder, it is important to keep the etiological similarities of the two conditions in mind when treating obesity.
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PMID:Determinants of adolescent obesity: a comparison with anorexia nervosa. 328 9

In the past decade much has been learned about the clinical features, diagnosis and understanding of people with anorexia nervosa and bulimia nervosa. In order to provide the next level of improvement in our care for these patients, our understanding of certain problems must be addressed by empirical research. Areas which require further study include the definition of high risk groups, the refinement of diagnoses, understanding factors which result in chronicity, determining the complications of chronicity and comparative evaluations of different treatments. These five areas are outlined in this article. Populations at risk for anorexia nervosa and bulimia nervosa may be those who must be thin and achieve according to career choice, those with a particular family and personal psychiatric history; obesity and chronic medical illnesses may be further risks. Improved diagnostic understanding has occurred by the differentiation of bulimic from restricting subtypes of anorexia nervosa. Further work must determine the relationship between the bulimic subtype of anorexia nervosa and bulimia in normal weight women and to further clarify the relationship between eating disorders and affective disorders. A number of factors may result in a chronic illness. These have been described on a variety of levels. The consequences of starvation in altering an individual's thinking, feeling and behaviour do play a role. It is not clear what factors at a neurochemical level contribute to this. Elevated endogenous opiates decreased noradrenergic function and decreased serotonin may be important. Information about the chronic complications is required for clinicians to understand the broad range of difficulties that may develop over time so that clinicians may use this information in planning treatment strategies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Eating disorders: implications for the 1990's. 331 72

Sixty-three percent of a random sample of 866 members within three practice groups of The American Dietetic Association responded to a survey designed to assess (a) perceived competency of nutrition management in 20 major areas of adolescent health, (b) desire to increase skill level in each area, and (c) preferred approaches for continuing education activities. Of the 549 respondents, 92% were registered dietitians (R.D.s), 5% were registration-eligible, and more than half (51%) had advanced degrees. Twenty-five percent or more of all practitioners reported deficiencies in 17 of the 20 categories. The five top areas in which respondents believed that they had insufficient skills were psychosomatic problems (87%), handicapping conditions (82%), sports nutrition (81%), alcohol/drug abuse-related nutrition concerns (80%), and anorexia nervosa/bulimia nervosa (72%). The strongest desires to improve skills were in the areas of obesity, poor dietary patterns, sports nutrition, food fads, supplement misuse, alternative diets, and eating disorders. There was low interest in strengthening skills in family planning, psychosomatic problems, and handicapping conditions. The implications of the results are discussed. Continuing education methods respondents believed to be most beneficial for learning were small conferences, lectures with ample discussion, and "hands-on" workshops.
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PMID:Adolescent nutrition: self-perceived deficiencies and needs of practitioners working with youth. 336 17


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