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

This paper describes a framework for involving schools in primary and secondary prevention of eating disturbances. The issues of why, what, who, and how are considered. Research on the prevalence and consequences of obesity, anorexia and bulimia nervosa, unhealthy dieting, and behaviors such as binge eating and purging indicates why prevention is necessary. Research on the etiology of eating disturbances also provided a basis for determining what factors need to be addressed. However, research has not adequately addressed the question of who should be targeted for prevention and how the topic of prevention should be approached. While different approaches to school-based prevention programs are possible, a comprehensive school-based program is recommended. Important components of a comprehensive program include staff training, classroom interventions, integration of relevant material into existing curriculum, individual counseling and small group work with high risk students, referral systems, opportunities for healthy eating, modifications within the physical education program, and outreach activities. This type of comprehensive program is based on an ecological model for health promotion and aims at the modification of both individual and environmental determinants of behavior.
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PMID:School-based programs for preventing eating disturbances. 893 12

This study examined two groups of people who were pursuing treatment for obesity: either medical intervention (a hospital group; N = 20) or support for dietary restriction (a community group; N = 18). This study addressed four questions: (1) Were there differences between the two groups in terms of their psychological distress (as measured by the Symptom Checklist)? (2) Does binge eating moderate psychological distress? (3) Do feelings of ineffectiveness moderate psychological distress? and (4) Which variables best accounted for group membership (i.e., type of treatment sought)? Results suggested that the hospital group was significantly more distressed than the community group. However, there were no differences between the two groups with respect to binge eating or feelings of ineffectiveness. These findings suggest that it is the effects of morbid obesity that are most likely to moderate psychological distress.
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PMID:Differences between treatment seekers in an obese population: medical intervention vs. dietary restriction. 929 37

Practitioners and psychotherapists see themselves more and more confronted to patients, specially women, with eating disorders. According to recent studies it can be estimated that the incidence of bulimia lies between 2% and 5%, of anorexia between 0.2% an 1%. The percentage of separate elements of the disorder is considered to be much higher, e.g. for binge eating at least 25%. At present around 3 to 6 years go by until patients contact a therapeutic setting for the first time. But the shorter the time between first appearance of the disorder and beginning of its treatment is, the better the prognosis. In order to improve treatment an interdisciplinary approach of practitioners, psychotherapists, dieticians and if needed other specialists should be strived for. Although obesity must be seen in a psychopathologic context in many cases, here we concentrate on the discussion of anorexia and bulimia.
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PMID:[Eating disorders]. 933 93

Serotonin reuptake inhibitors, such as fluoxetine, fenfluramine, and dexfenfluramine, are frequently used to treat obesity, depression, and bulimia. A common side effect of these medications is xerostomia, or dry mouth. A case study demonstrating the impact of drug-induced xerostomia on oral health and subsequent nutrition implications is presented. Rampant caries can result from a combination of xerostomia and inappropriate dietary and oral hygiene habits. Preventive dietary and dental guidelines are presented to assist nutrition and dental professionals in treating and counseling patients with xerostomia.
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PMID:Nutritional implications of xerostomia and rampant caries caused by serotonin reuptake inhibitors: a case study. 935 80

The pharmacology, pharmacokinetics, efficacy, and adverse effects of dexfenfluramine hydrochloride are reviewed. Dexfenfluramine, the dextrorotatory isomer of fenfluramine, is indicated for use in the management of obesity in patients with a body mass index of > or = 30 kg/m2, or > or = 27 kg/m2 in the presence of other risk factors. Unlike fenfluramine, dexfenfluramine is a pure serotonin agonist. Dexfenfluramine may mimic the effect of carbohydrate intake. Systemic bioavailability is about 68%, and the drug is metabolized in the liver. In randomized, placebo-controlled trials, dexfenfluramine was effective in reducing weight in obese patients given the drug for three or six months. In trials lasting one year, the statistically significant weight loss occurred during months 4 to 6. Dexfenfluramine reduces blood pressure, percent glycosylated hemoglobin, and concentrations of blood glucose and blood lipids, but these benefits may be indirect. Dexfenfluramine may also be of some value in controlling eating habits in diabetic patients, preventing weight gain after smoking cessation, and treating bulimia, seasonal affective disorder, neuroleptic-induced obesity, and premenstrual syndrome. Dexfenfluramine's most frequent adverse effects are insomnia, diarrhea, and headache; it has also been associated with primary pulmonary hypertension. The drug should not be combined with other serotonergic agonists because of the risk of serotonin syndrome. The recommended dosage is 15 mg twice daily. Dexfenfluramine is effective in the treatment of obesity in selected patients. Because its efficacy is lost after six months of continuous treatment, it should be viewed primarily as an adjunct to diet and exercise.
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PMID:Dexfenfluramine hydrochloride: an anorexigenic agent. 937 5

The field of eating disorders has grown rapidly, amassing an impressive body of treatment research in the past 20 years. In particular, researchers have focused on binge eating problems, which include bulimia nervosa (BN) and the more recently recognized binge eating disorder (BED). Numerous controlled treatment trials have shown cognitive-behavioral therapy (CBT) to be equally or more efficacious than any other BN treatment to which it has been compared. Although CBT also seems to be effective for BED, research is in a preliminary stage. Further combinations and adaptations of treatments for BED are needed to address the additional problem of obesity in this population. Preliminary data suggest that behavioral weight control treatment for BED is effective in reducing binge eating, and it may have the added benefit of weight loss. Interpersonal psychotherapy (IPT), the combination of CBT and medication, and self-help manuals are promising treatment alternatives for both BN and BED. Future treatment trials should include longer-term followup periods and more consistent definitions of successful treatment outcome. In addition, further study is needed in the areas of treatment nonresponders, pre-treatment predictors, a stepped-care treatment model, and methods for a wider dissemination of validated treatments.
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PMID:Psychological treatment of bulimia nervosa and binge eating disorder. 955 Aug 90

The discovery of leptin, the product of the obese (ob)-gene, has broadened the horizons of research on energy balance. This hormone, produced and secreted by adipose tissue and some placental cells, finds its way to the hypothalamus, where it binds to the leptin receptors and signals satiety through the neuroendocrine axis. The fact that adipose tissue is not merely a storage depot, but also an important endocrine tissue, has revived the interest in the "lipostatic" theory of body fat regulation and has initiated many research efforts in the field of obesity, anorexia nervosa, bulimia, reproduction and haematology.
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PMID:[Leptin--an interim evaluation]. 958 46

Anorexia nervosa ranks third among common chronic disorders in adolescents, surpassed only by asthma and obesity. Unfortunately, recent changes in health care and insurance have resulted in fewer resources for these vulnerable clients Anorexia and bulimia are best managed by a treatment team, but frequently it is the nurse who manages much of the eating-disordered client's care, especially when there is no available team, or when the nurse is the primary care provider or therapist. Nurses can and do care for adolescents with anorexia and bulimia. All it takes is commitment, knowledge, and networking.
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PMID:Thin line: managing care for adolescents with anorexia and bulimia. 959 9

Obesity is characterised by an imbalance of caloric intake and energy expenditure. Increased caloric uptake and reduced physical activity are important. No specific psychopathology exists in obesity. Obese people view their body weight and form significantly more negative than lean controls and often experience depression and anxiety. Quality of life is often impaired. Obesity causes many disadvantages in interpersonal and social aspects. 30% of the obese subjects report binge eating. Whether binge eating should be considered as an independent syndrome is currently under discussion. The treatment of obesity is not satisfactory. Pharmacological approaches have so far failed. Behavioral therapy including dieting of different forms is not successful in long terms. 95% of the patients regain body weight within five years. Surgical therapy are very successful but should be only applied in severe obesity.
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PMID:[Psychosomatic aspects of obesity]. 962 34

Obesity is of great importance for health and health economy. It often goes along with immense subjective and objective suffering. It has traditionally been a topic of general and internal medicine. This article summarizes results derived from recent psychiatric and psychotherapeutic approaches, that may also be of interest for the somatic physician as they contribute to the understanding and therapeutic management of the disease. Common definitions of obesity and epidemiologic data are presented. Traditional therapeutic approaches such as reducing diets often turned out to be insufficient. New knowledge, especially on ponderal and nutritional physiology (set point theory of body weight, investigations of dietary effects), studies about comorbidity with disturbed eating habits (particularly binge eating and bulimia) and about psychodynamics and life quality are expected to contribute to a better understanding of this phenomenon.
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PMID:[Overweight (obesity) from the psychiatric viewpoint and its relevance for general practice]. 965 90


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