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

As part of a larger prognostic study of anorexia nervosa, clinical features at presentation of 24 males with anorexia are described, and compared with a female group matched for date of admission. Data were extracted from the original case records and follow-up interview. The study confirms the view that males display the classical syndrome of anorexia nervosa, but differs from previous studies in several respects. Age at onset (mean 18.6 years) and at presentation (mean 20.2 years) is later, with a mean duration of illness at presentation of only 1.6 years. A premorbid tendency to obesity is confirmed; maximum weight loss during the illness amounted to 42% matched population mean weight (MPMW), and weight at presentation was 78.5% MPMW, somewhat higher than the female group. In keeping with earlier studies, binging and vomiting were noted commonly, in around half of sufferers, but laxative abuse was less frequent and excessive exercising more frequent in males. Depressive and obsessional symptoms are common in both groups, and a strong family history of affective disorders and alcohol abuse was noted in over one third.
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PMID:Clinical presentation of anorexia nervosa in males: 24 new cases. 817 58

Discrepancies between GH measurements and growth rate of children have complicated diagnosis in a variety of clinical conditions. The competition of GH-BP with the GH-receptor towards GH-receptor binding can have a role in these discrepancies. A mathematical model was developed for appraising the availability of GH for receptor binding from measurements of serum GH by RIA and serum GH binding protein (BP) by a binding assay. Eighteen patients with high GH-BP (obesity), normal GH-BP (normal control) or low GH-BP (children, anorexia nervosa or cirrhosis of the liver) were the subjects of this study. Sera of patients with high, normal or low GH-BP levels were analyzed for their competition with [125I]hGH binding to rabbit liver membranes. Serum GH was measured by a commercial polyclonal RIA. Serum GH-BP was measured by a binding assay with dextran-coated charcoal separation. Receptor availability for GH was assessed by displacing of [125I]hGH from rabbit liver membranes. The decline in receptor availability for each hGH value, caused by GH-BP competition with the receptor, was calculated by subtraction of the percent displacement in the absence of GH-BP from the percent displacement in the presence of a given GH-BP value. The results were analyzed statistically to give a series of polynomes. These enabled the calculation of an activity factor for serum RIA GH levels, that should predict the receptor availability of each GH level, according to the concomitant GH-BP level.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A mathematical model for appraisal of the impact of GH binding protein on GH receptor binding. 819 83

As the hypothalamic gonadotropin-releasing hormone (GnRH) pulse generator is an integrator of hormonal, metabolic, and neural signals, it is not surprising that the function of the hypothalamogonadal axis is subject to the influence of a large array of environmental factors. Before puberty, the central nervous system (CNS) restrains the GnRH pulse generator. Undernutrition, low socioeconomic status, stress, and emotional deprivation, all delay puberty. During reproductive life, among peripheral factors that effect the reproductive system, stress plays an important role. Stress, via the release of corticotropin-releasing factor (CRF), eventually triggered by interleukin 1, inhibits GnRH release, resulting in hypogonadism. Effects of CRF are probably mediated by the opioid system. Food restriction and underweight (anorexia nervosa), obesity, smoking, and alcohol all have negative effects on the GnRH pulse generator and gonadal function. Age and diet are important determinants of fertility in both men and women. The age-associated decrease in fertility in women has as a major determinant chromosomal abnormalities of the oocyte, with uterine factors playing a subsidiary role. Age at menopause, determined by ovarian oocyte depletion, is influenced by occupation, age at menarche, parity, age at last pregnancy, altitude, smoking, and use of oral contraceptives. Smoking, however, appears to be the major determinant. Premature menopause is most frequently attributable to mosaicism for Turner Syndrome, mumps ovaritis, and, above all, total hysterectomy, which has a prevalence of about 12-15% in women 50 years old. Premature ovarian failure with presence of immature follicles is most frequently caused by autoimmune diseases or is the consequence of irradiation or chemotherapy with alkylating cytostatics. Plasma estrogens have a physiological role in the prevention of osteoporosis. Obese women have osteoporosis less frequently than women who are not overweight. Early menopause, suppression of adrenal function (corticoids), and thyroid hormone treatment all increase the frequency of osteoporosis. Aging in men is accompanied by decreased Leydig cell and Sertoli cell function, which has a predominantly primary testicular origin, although changes also occur at the hypothalamopituitary level. Plasma testosterone levels, sperm production, and sperm quality decrease, but fertility, although declining, is preserved until senescence. Stress and disease states accelerate the decline on Leydig cell function. Many occupational noxious agents have a negative effect on fertility.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Environment, human reproduction, menopause, and andropause. 824 11

Secondary causes of hyperlipidemia are important to recognize. In fact, hyperlipidemia may be a clue to the presence of an underlying systemic disorder. It may greatly heighten the risk of atherosclerosis with a raised LDL-c, triglyceride-rich lipoprotein excess, and increased lipoprotein(a) as well as lowered HDL-c. The search for secondary causes may provide a clue as to why patients with primary lipid disorders suddenly develop worsening lipid profiles. The point is a crucial one because some acquired causes of hyperlipidemia, such as alcohol, estrogens, steroids, or pregnancy, when superimposed on a primary familial form of hypertriglyceridemia can result in a saturated removal system and a buildup of chylomicrons, which can lead to life-threatening pancreatitis. A convenient way to remember secondary causes is to think of the four D's of diet, drugs, disorders of metabolism, and diseases. Although diets rich in saturated fats and cholesterol are a common cause of the mild hypercholesterolemia seen in our society, alcohol excess and weight gain can explain much of the tendency toward hypertriglyceridemia. Interestingly anorexia nervosa has long been associated with severe but reversible hypercholesterolemia. Several classes of drugs need to be considered as common causes of altered lipid profiles. Glucocorticoids and estrogens elevate triglycerides and raise levels of HDL-c. Anabolic steroids taken orally markedly reduce levels of HDL-c in contrast to injectable testosterone, which does not adversely affect the LDL-to-HDL ratio. Oral contraceptives affect atherosclerotic risk depending on the kind and doses of progestin/estrogen. In those with an underlying primary hypertriglyceridemia and associated obesity, estrogenic medications can depress triglyceride removal mechanisms, leading to the chylomicronemia syndrome and pancreatitis. Antihypertensives have variable effects on lipids and lipoproteins. Although short-term thiazide usage raises cholesterol, triglycerides, and LDL-c, long-term usage is not necessarily associated with significant alterations in lipid levels. Alpha blockers may cause an increase in HDL-c, whereas beta blockers raise triglycerides and lower HDL-c. Sympatholytics, angiotensin converting enzyme inhibitors, and calcium channel blockers are essentially lipid neutral. Retinoids can be associated with increased LDL-to-HDL ratios and occasionally striking elevations in triglycerides. Cyclosporine raises LDL-c and lipoprotein(a). Classes of drugs that may raise HDL-c include cimetidine, antiepileptic drugs, and tamoxifen, but the effect may be seen primarily in women. Hypothyroidism is the most common secondary cause of hyperlipidemia after dietary causes are considered. A thyroxine and TSH level should be obtained on all new cases of clinically important hyperlipidemia.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Secondary causes of hyperlipidemia. 828 27

Anorexia nervosa (AN) rarely develops after the age of 30 years, and rarely occurs in men. We report a case of chronic AN in a 72-year-old man, who reported a 20-year history of extreme low body weight, persistent fears of obesity, and feelings of being fat even at 93 lb. Also reported were episodes of self-induced vomiting, laxative abuse, and excessive exercising. Patient's scores on a battery of questionnaires were also consistent with a diagnosis of AN.
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PMID:Anorexia nervosa in an elderly man. 829 33

The goal of the study was to contribute empirical data to the discussion of appropriate diagnostic classification of obese and nonobese, binging, and nonbinging eating disordered patients. The study consists of two parts: (1) patients with binge eating disorder (BED) (N = 22) are compared to a matched sample of patients with bulimia nervosa (BN) and to 16 patients with obesity (body mass index [BMI] > 30). These patient groups were cross-sectionally assessed using expert ratings (interview) and self-ratings. (2) A sample of 68 patients with BED were assessed longitudinally on admission and discharge of inpatient treatment and at a 3-year follow-up using the same instruments as in the first study. The study is the first to report longitudinal data on patients with BED. The general pattern of the cross-sectional data was that patients with BN not only had higher scores concerning disturbances of eating behavior and attitude but also for general psychopathology when compared to patients with obesity without marked binges. The scores of patients with BED had an intermediate position between BN and obesity but were closer to BN than to obesity. The BED group (and the obesity group) showed a high degree of body dissatisfaction, which, however, was accounted for by their high body weight. Concerning general psychopathology BED as well as BN had significantly higher scores than the obesity group in the Hopkin's Symptom Checklist (SCL) subscale anger and hostility, in the Complaint List, the PERI Demoralization Scale, and the Beck Depression Inventory. Results of the longitudinal study with BED showed marked improvement in specific and general psychopathology over time. Except for body weight this improvement largely persisted over the 3-year follow-up period. Severity of depression did not predict the course of body weight over time. Data are presented concerning the design of diagnostic criteria for eating disturbed patients not fitting criteria for BN or anorexia nervosa (AN). Arguments pro and contra the introduction of a new BED category in psychiatric diagnostic criteria are discussed. Although there is generally a need for developing or revising the diagnostic criteria for recurrent bingers, our data do not support inclusion of BED (as presently defined) as a separate diagnostic category in DSM-IV.
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PMID:Recurrent overeating: an empirical comparison of binge eating disorder, bulimia nervosa, and obesity. 833 91

Dietary intakes were compared in two groups of patients with anorexia nervosa, those who had earlier been "heavy" (n = 27, peak body mass = 65.0 +/- 7.5 kg) and those who had always been "light" (n = 25, peak body mass = 51.5 +/- 7.3 kg). Both groups were initially given a food intake of 7.5 MJ per day, and this was increased as needed to yield a controlled 1-2 kg per week increase of body mass. Body mass was restored most rapidly in the patients who reached the lowest weights, whether the classification was based upon the lowest body mass observed during the illness (gain in weeks 0-7, p < .002) or the body mass on admission to hospital (gain in weeks 0-14, p < .02, weeks 7-14, p < .01). Classifying patients in terms of their peak premorbid mass, the light group consumed food energy at a faster rate than the heavy group over the first 7 weeks of hospital treatment (p < .008), but nevertheless they did not gain more weight. Food intake reached a plateau in both groups between weeks 7 and 14 of treatment, although the light group was still consuming more energy than the heavy subjects (p < .005). Prospective observations on two light and two heavy patients confirmed both the time course of weight gain and the greater energy needed for a given increase of body mass in light patients. It is suggested that during the early stages of recovery from anorexia nervosa, energy utilization is more efficient in the heavier patients. However, it seems more difficult to sustain a high food intake in such patients, possibly because they fear a return to obesity.
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PMID:Relationship of premorbid mass and energy intake to increase of body mass during the treatment of anorexia nervosa. 833 1

To study the effects of nutrition on growth hormone (GH) receptor status, the plasma GH-binding protein was evaluated under conditions of poor nutrition, anorexia nervosa, celiac disease, and obesity. Nine patients, aged 12-30 years, presented anorexia nervosa and had a mean weight loss of -19% of their initial weight at the time of the study. Ten patients with celiac disease, aged 3-14 years, had a mean height at -4.2 SD, and normal body weight for height. Fourteen severely obese children, aged 3-10 years, had a mean body mass index (BMI) of 25.7 +/- 0.9. GH-binding protein was low in patients with anorexia nervosa (16.8 +/- 1.9% of radioactivity) and in patients with celiac disease (16.1 +/- 2.2%) whereas it was very high in obese children (57.2 +/- 3.3%). A strong correlation was found between GH-binding protein and BMI. GH-binding protein was also correlated with insulin-like growth factor-1 plasma levels. Nutrition is an important regulator of the GH receptor/binding protein. The growth failure presented by undernourished children is associated with partial GH resistance and low GH receptor level. On the contrary, children with obesity and normal growth have a high GH receptor level.
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PMID:Nutritional status and growth hormone-binding protein. 852 80

The first stage in the development of anorexia nervosa involves voluntary restriction of food intake, that is, diet. Marked weight loss, impairment in body image, and deterioration of health ensue. Anorexia nervosa is much more prevalent among women than men. Its etiology and presentation are mostly similar for both sexes. Certain features, such as greater premorbid obesity and sexual identity concerns, are thought to be more prevalent in male patients. We present 2 male patients who had undergone gastroplasty for morbid obesity and subsequently developed anorexia nervosa. Both evinced signs of identity confusion. Neither one of the patients underwent psychiatric evaluation before surgery. The cases described illustrate that anorexia nervosa may succeed acute and marked weight loss following gastroplasty. This emphasizes the need for a psychiatric assessment before bariatric surgery, and should alert clinicians to search for elements that may predispose vulnerable individuals to a risk of developing anorexia nervosa.
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PMID:Anorexia nervosa following gastroplasty in the male: two cases. 864 Jan 97

Incidental findings from animal experiments involving administration of exogenous opioid agonists indicate that there are close links between the endogenous opioid system and feeding behaviour. Subsequent investigations aimed at elucidating the nature of the opioid-feeding relationship led to a wide variety of findings, some of them apparently contradictory. This paper examines the effects of opioid agonists and antagonists on feeding behaviour, and considers the evidence relating levels of endogenous opioids to feeding states, with particular reference to certain eating disorders, including anorexia nervosa, bulimia nervosa, Prader-Willi syndrome, and eating-induced obesity. The receptors which may be involved in opioid-feeding relationships are discussed. Relationships between the endogenous opioid system and other systems, such as the dopaminergic, noradrenergic and hormonal systems, are considered insofar as they may have bearing on the modulation of feeding behaviour. Finally, three theories are briefly outlined which attempt to link the endogenous opioid system with feeding modulation and the pathogenesis of certain eating disorders. The suggestion is put forward that anorexia nervosa may represent a pathological consequence of the triggering of a primitive mechanism for coping with unforeseen food shortages which may have short-term advantages, e.g., for masking or temporarily alleviating a depressed state.
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PMID:Opioid involvement in feeding behaviour and the pathogenesis of certain eating disorders. 874 94


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