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

To test the applicability of indirect estimation of daily energy expenditure from average daily heart rate (HR) and individual O2-intake/heart rate (VO2/HR) regression lines in subjects with metabolic disorders, VO2/HR regression lines were determined on 2 consecutive days in 17 subjects (five healthy, five with obesity, five with untreated thyrotoxicosis, two with anorexia nervosa). Daily energy expenditure was calculated by means of the average 24 h HR. Generally, there was a high correlation coefficient for the relationship between VO2 and HR, but the slopes and intercepts varied considerably from day to day, leading to poor agreement between duplicate estimates of energy expenditures, and not infrequently to physiologically meaningless values. Further studies, comprising determination of the VO2/HR regression lines in three different body positions on 7 different days in one experienced test subject showed great variability of the VO2/HR regression lines, both in the same position and in different positions. The applied procedure seems unsuitable for metabolic studies in individual patients who engage in ordinary daily activities with low energy expenditure.
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PMID:A critical evaluation of energy expenditure estimates based on individual O2 consumption/heart rate curves and average daily heart rate. 682 89

Bulimia is a poor prognostic sign in anorexia nervosa. This raised the question of whether bulimia represented an "end stage" of chronic anorexia nervosa or whether bulimic patients were a distinct subgroup. All subjects seen by us personally from 1970 to 1978 were included in this study provided they met modified criteria of Feighner et al (1972). Of this group, 68 experienced bulimia and 73 did not (restricters). Bulimic patients had a history of weighing more and were more commonly premorbidly obese. Bulimic patients were those who vomited and misused laxatives. The bulimic group displayed a variety of impulsive behaviors, including use of alcohol and street drugs, stealing, suicide attempts, and self-mutilation. With regard to family history, the high frequency of obesity in the mothers of bulimic patients was noteworthy. The two groups share features common to patients with primary anorexia nervosa. However, these results suggest a different group of women are predisposed to have anorexia nervosa develop with bulimia.
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PMID:The heterogeneity of anorexia nervosa. Bulimia as a distinct subgroup. 693 88

This article presents a psychodynamic approach to the understanding and treatment of abstaining and bulemic anorexics. While the abstainer starves herself to the point of emaciation and the bulemic may gorge to the point of obesity, the underlying emotional conflicts of the two groups of patients are the same. The ego (character structure) of the bulemic is not as perfectionistic and rigid as that of the abstainer, so the patient is periodically overwhelmed not only by impulses to gorge but also by impulses of all kinds. A description of the clinical syndrome, the physiological findings and details of the laboratory diagnosis of anorexia nervosa are provided. Family psychodynamics which are viewed as etiologic are presented. A psychodynamic therapeutic approach is described and examples of the treatment of an abstaining and bulemic patient are detailed. The crucial therapeutic role of the family physician is explored with emphasis on the importance of the physician's encouraging the patient to bring up questions about food and eating with the psychiatrist because such preoccupations mask other conflicts.
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PMID:Abstaining and bulemic anorexics. Two sides of the same coin. 695 65

Synthetic LRH was infused into normal women and women with obesity and anorexia nervosa to determine the distribution volume (DV), metabolic clearance rate (MCR) and half disappearance time (t 1/2) of plasma LRH. In normal women, the DV of LRH ws 12.1 +/- 0.9 (mean +/- SE) 1, the MCR was 1478.9 +/- 39.8 ml/min (28.5 +/- 1.2 ml/min/kg body weight) and the initial t 1/2 was 5.6 +/- 0.4 min. In obese patients the DV (20.6 +/- 1.5 l) was significantly higher than that in normal subjects (P < 0.005), but the MCR and t 1/2 were not significantly different from those in normal subjects. In patients with anorexia nervosa the DV and MCR were 6.5 +/- 1.1 l and 621.8 +/- 110.5 ml/min (17.9 +/- 2.4 ml/min/kg body weight), respectively, which were both significantly lower than those in normal subjects (P < 0.02), while the t 1/2 (7.3 +/- 0.1 min) was longer than in normal subjects (P < 0.02). These data suggest that 1) the abnormal responses of some hormones to provocation tests observed in obese patients and patients with anorexia nervosa should be evaluated in consideration of changes in the DV and metabolic clearance of hormones in these conditions, and 2) in patients with anorexia nervosa changes in MCR and t 1/2 may reflect low metabolism of LRH.
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PMID:Distribution volume, metabolic clearance and plasma half disappearance time of exogenous luteinizing hormone releasing hormone in normal women and women with obesity and anorexia nervosa. 700 93

It has been suggested that the well-documented relationship of dietary composition to the incidence of human breast cancer is mediated by the effects of dietary constituents on hormone levels. There is fairly good evidence for diet-hormone relationships in animals, but the evidence in humans is unconvincing. In this paper, we describe three of our findings relating nutrition to hormone levels: (a) that obesity causes retention of a tracer of estradiol in women but not in men, a finding we attribute to the presence of specific estrogen receptor in the adipose tissue of women but not men; (b) that obese men have elevated plasma estrone and estradiol levels but obese women do not, a finding we attribute to greater androstenedione-to-estrone conversion in the adipose tissue of men than in that of women; and (c) that cachectic girls with anorexia nervosa fail to have the normal nocturnal surge of prolactin secretion, a finding that we attribute to deficiency of tryptophan, which is an adequate stimulus for prolactin secretion. These findings give support to the concept that dietary factors affect hormone secretion and/or metabolism in humans.
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PMID:Influence of obesity and malnutrition on the metabolism of some cancer-related hormones. 726 Sep 51

Studies of diagnostic subtypes within the anorexia nervosa syndrome has given rise to the differentiation of a bulimic subgroup as distinct from the restrictive type of anorexia nervosa. The bulimic subtype is characterized by the use of vomiting and laxatives to induce weight loss; a display of impulse-related behaviours; extraversion and sexual activity in contrast to the isolation of the restrictive group; and a family history of obesity in the mother, all suggesting a subcategory within the primary anorexia nervosa syndrome. Investigation of behaviours and attitudes related to anorexia nervosa in a group of dancers disclosed a significantly elevated attitude toward food and body image characteristic of anorexia nervosa in this group and ten times the expected prevalence of the disorder itself. This is suggestive of the relative importance of cultural pressures towards thinness and anorexia nervosa in certain populations as one factor amongst others in the multi-determined origin of this condition. This cultural pressure is consistent with a disturbance of body image perception in anorexia nervosa. This disturbance seems to be stable in the same individual over a period of one year, is related to a poor prognosis and is correlated with measures of psychopathology including helplessness, depression and anhedonia. It is also correlated with a satiety defect as reflected in a failure to develop an aversion to sucrose when directly tested.
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PMID:Some recent observations on the pathogenesis of anorexia nervosa. 729 32

Disgust with "fatness" and a consequent preoccupation with body weight, coupled with an inability to reduce it to or sustain it at the desired low level, characterizes the abnormal normal weight control syndrome. Individuals remain sexually active in a biological sense and often also socially. Indeed their sexual behaviour may be as impulse ridden as is their eating behaviour, which often comprises phases of massive bingeing coupled with vomiting and/or purgation. The syndrome is unlike frank anorexia nervosa in that the latter involves a regression to a position of phobic avoidance of normal body weight and consequent low body weight control with inhibition of both biological and social sexual activity. In abnormal normal weight control there is a strong and sometimes desperate hedonistic and extrovert element that will often not be denied so long as body weight does not get too low. Individuals nevertheless feel desperately "out of control" and insecure beneath their bravura. The syndrome is much more common in females than in males. There is a clinical overlap with anorexia nervosa and obesity in many cases as the disorder evolves. Depression, stealing, drug dependence (including alcohol) and acute self-poisoning and self-mutilation are common complications. Clinic cases probably only represent the tip of the iceberg of the much more widespread morbidity within the general population. Like anorexia nervosa and for the same reasons the disorder is probably more common than it used to be.
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PMID:Anorexia nervosa at normal body weight!--The abnormal normal weight control syndrome. 730 91

This study examined racial differences in drive for thinness, a motivational variable implicated in the etiology of eating disorders. Subjects included 613 black and white preadolescent girls from one of three National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study centers. Instruments included the Drive for Thinness Scale, a Criticism about Weight scale, the Self-Perception Profile for Children, a Sexual Maturation index, and 3-day food diaries. Black girls reported significantly greater drive for thinness than white girls. Drive for thinness was significantly associated with adiposity in both groups; additional predictors included criticism about weight for black girls and dissatisfaction with physical appearance for white girls. Correlations between drive for thinness and nutrient intakes were not significant. The finding of a greater drive for thinness among young black girls is provocative, given the higher prevalence of obesity and the lower prevalence of anorexia nervosa among black women. Longitudinal follow-up will examine the significance of drive for thinness in the development of weight and eating disorders in this cohort.
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PMID:Drive for thinness in black and white preadolescent girls. 767 Apr 44

In the stress concept, fight and flight situations as well as other CNS-controlled reaction patterns for alertness to danger have to be followed by or integrated with a restorative "build-up" process in order to maintain homeostasis. The "build-up" process can be studied physiologically for example after regular exercise or training. Under these conditions there is a decrease in resting sympathetic adrenergic activity and an increase in the parasympathetic vagal activity. A theoretical model for the "build-up" process in psychosomatic gastroenterology has previously been presented. The present paper deals with the "build-up" process in cardiovascular and respiratory tract diseases seen in athletes. Anorexia nervosa related to excess physical training is also discussed as well as the "build-up" process in severe obesity and psychosomatic gastroenterological disorders.
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PMID:Involvement of cardiac, respiratory and gastrointestinal functions in neural responses to stressful events. 769 34

The main forms of eating disorders are anorexia and bulimia nervosa and obesity. The clinical features, aetiology, treatment and prognosis of anorexia and bulimia nervosa are described to highlight the similarities and differences between these two conditions. Both conditions affect predominantly the young female population with body image disturbance as one of the core symptoms. Whilst the body weight of anorexics are by definition low, most bulimics have normal or near normal body weight. Sufferers of anorexia nervosa tend to deny their illness while those with bulimia are often miserable and acutely aware of their eating difficulties. The aetiological factors in both conditions overlap to a large extent. The outcome of treatment for bulimia is reportedly better than that of anorexia nervosa. Obese people often become depressed and anxious as a result of low self-esteem causing them to seek psychiatric treatment. The severely obese who are placed on very low calorie diets may develop adverse emotional disturbances whilst weight gain may follow a major depressive illness or develop as a side effect of psychotropic medications. A subgroup of the obese population engage in frequent binge eating and preliminary criteria are being developed for this condition called "binge eating disorder". Behaviour therapy is the treatment of choice for obesity. Other forms of treatment include individual and group psychotherapy, use of appetite suppressants and in the severely obese, surgical methods.
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PMID:Eating disorders. 776 92


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