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

Children who have been sexually abused develop a variety of emotional and physical complaints, often unrelated to the genital area. Emergency department records of children diagnosed as being sexually abused were reviewed for the period covering January 1984 through June 1985. Of 26,000 patients seen, 300 cases of sexual abuse were identified. Of these, 57 were patients who presented with initial complaints other than sexual abuse. The data were analyzed for age, sex, chief complaint, time of presentation, physical findings, and person accompanying the child. The most common presenting complaints of these 57 patients were abdominal pain (26%) and vaginal symptoms (26%) The latter included pruritus, discharge, and bleeding. Other complaints included rectal bleeding or constipation (9%), chronic urinary tract infection (5%), straddle injury (4%), and suicide attempt (2%). The remaining 26% included fever, respiratory infections, sore throat, asthma, bronchitis, obesity, mastoiditis, and weight loss. Because resident physicians are instructed to conduct complete anal and genital examinations on all patients, sexual misuse was often diagnosed with seemingly unrelated complaints. A protocol developed for use in the emergency department is described.
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PMID:Presentation and evaluation of sexual misuse in the emergency department. 378 20

The following study tested the hypothesis that women with post-traumatic stress disorder (PTSD) related to childhood sexual abuse would display elevated norepinephrine-to-cortisol ratios similar to that found in male combat veterans diagnosed with PTSD. Twenty-four-hour urine samples were collected from 28 women: 11 women with PTSD who experienced childhood sexual abuse (PTSD+), 8 women who experienced childhood sexual abuse without PTSD (PTSD-), and 9 nonabused controls. All urine samples were tested for creatinine, total catecholamines, free-cortisol, and 17-ketosteroid levels. Psychological testing validated that the PTSD+ group was significantly elevated on all three subscales of the Impact of Events Scale. Both abused groups (PTSD+ and PTSD-) showed a tendency for polyuria, and the PTSD+ group showed a tendency towards obesity. Thus, neuroendocrine values (micrograms/day) were adjusted by creatinine clearance rates (creatinine mg/day/kg body weight). The corrected values indicated that the PTSD+ group had significantly elevated daily levels of norepinephrine, epinephrine, dopamine, and cortisol. However, because of the parallel elevation in cortisol, the norepinephrine-to-cortisol ratio was not significantly elevated in the PTSD+ diagnosed women in contrast to the findings reported for male PTSD patients. This discrepancy may reflect an important gender difference, an interaction between gender and age at onset of the traumatic experience (childhood abuse in females vs. combat experience in young adult males), or physiological variation related to phase of the disorder.
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PMID:Abuse-related posttraumatic stress disorder: evidence for chronic neuroendocrine activation in women. 779 68

The literature is contradictory concerning a possible connection between sexual abuse and the development of eating disorders. In the present study, the medical records and psychotherapeutic courses of all female patients (n = 127) were reviewed for the years 1987-1989 in the Department of Psychosomatics and Psychotherapy at Steglitz Medical Center in Berlin in order to record any reported incidences of pre-onset sexual abuse as well as the age at the time of abuse. The women were subdivided into four diagnostic groups: obesity (n = 14), bulimia (n = 18), anorexia (n = 22) and others without eating disorders (n = 73). Altogether, sexual abuse was reported in 19% with and 10% without eating disorders (difference not statistically significant). Comparison of the individual diagnostic groups unexpectedly revealed a significantly higher frequency of sexual abuse among obese patients than among those without eating disorders (36% vs. 10%, p = 0.028).
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PMID:[The incidence of sexual abuse in women with eating disorders]. 802 80

One hundred significantly overweight patients sequentially applying to a very low calorie diet (VLCD) program were interviewed to learn how the onset of obesity correlated with other life events. By comparison with a control group of 100 always-slender adults, the obese applicants were found to be different at a highly significant level in the prevalence of childhood sexual abuse, nonsexual childhood abuse, early parental loss, parental alcoholism, chronic depression, and marital family dysfunction in their own adult lives. The obese patients commonly reported using obesity as a sexually protective device; many reported overeating to cope with emotional distress. Inquiry into depression, past sexual abuse, and past or present dysfunctional family life should be added to the current medical evaluation of all obese patients. The resultant findings are likely to be relevant to their treatment, whether for obesity or for other medical conditions.
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PMID:Childhood sexual abuse, depression, and family dysfunction in adult obese patients: a case control study. 820 85

Researchers have increasingly demonstrated that 15% to 30% of all women have been sexually abused as children. Information on the emotional, behavioral, and cognitive sequelae of this abuse has been available. Most recently, a literature on the somatic and medical sequelae has developed. This article reviews this literature and discusses its implications for primary care providers. Survivors are likely to suffer from insomnia, gastrointestinal problems, obesity, chronic pain, headache, and somatization, and they are frequent utilizers of primary care services. Specific suggestions about history taking, physical examination, and referrals are given to ensure that survivors receive care that is sensitive, supportive, and competent. The article also discusses the dynamics of abuse and how they relate to the ongoing relationship between the primary care provider and the survivor of sexual abuse.
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PMID:The sequelae of childhood sexual abuse: a primary care focus for adult female survivors. 923 50

Psychosocial distress and psychological abnormality occurs frequently in fibromyalgia patients. Patterns of decreased levels of education, and increased rates of divorce, obesity, and smoking have been noted in clinical and epidemiological studies. Links to physical and sexual abuse have been noted as well. Major depression as well as increased rates of depression, anxiety, and somatization are also commonly found in fibromyalgia.
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PMID:Psychosocial factors and the fibromyalgia syndrome. 1002 91

In an attempt to explore the possibly adaptive function obesity may serve for some women with histories of sexual trauma, we examined relationships among sexual abuse history, body dissatisfaction, and maximum weight fluctuation among obese (n = 38; Body Mass Index > or = 27.3) and nonobese (n = 112; Body Mass Index < 27.3) women sampled from a primary care medical setting. History of sexual abuse was unrelated to current body weight within the entire sample, as well as the nonobese and the obese subsamples. However, the interaction between obesity and sexual abuse was statistically significant in the prediction of both current/ideal body-weight discrepancy (i.e., body dissatisfaction) and maximum weight fluctuation during adulthood. Among nonobese women, history of sexual abuse was unrelated to current body dissatisfaction but was related to greater maximal weight fluctuation during adulthood. Among obese women, those with a history of sexual abuse reported relatively less current body dissatisfaction and less weight fluctuation during adulthood compared to nonsexually-abused obese women. Results are discussed with regard to the potential adaptive function obesity may play for some sexually abused women and the need for additional research using larger, more diverse samples and more elaborate measures.
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PMID:Obesity among sexually abused women: an adaptive function for some? 1042 43

Controversy concerning the most appropriate treatment guidelines for intersex children currently exists. This is due to a lack of long-term information regarding medical, surgical, and psychosexual outcome in affected adults. We have assessed by questionnaire and medical examination the physical and psychosexual status of 14 women with documented complete androgen insensitivity syndrome (CAIS). We have also determined participant knowledge of CAIS as well as opinion of medical and surgical treatment. As a whole, secondary sexual development of these women was satisfactory, as judged by both participants and physicians. In general, most women were satisfied with their psychosexual development and sexual function. Factors reported to contribute to dissatisfaction were sexual abuse in one case and marked obesity in another. All of the women who participated were satisfied with having been raised as females, and none desired a gender reassignment. Although not perfect, the medical, surgical, and psychosexual outcomes for women with CAIS were satisfactory; however, specific ways for improving long-term treatment of this population were identified.
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PMID:Complete androgen insensitivity syndrome: long-term medical, surgical, and psychosexual outcome. 1094 63

150 (80 females and 70 males) community college students were surveyed regarding their attitudes toward abortion, their sexual behavior, and their problems. The profile of the students was Caucasian (95%), young (18-24 years = 87%), single (87%), middle and lower middle class, and Catholic (70%). 82% supported abortion choice, 86% had engaged in premarital sex, 70% used contraception, and 26% had premarital pregnancies. The hard reasons for abortion (rape, the woman's life, is endangered, and the fetus is defective) received high support. The soft reasons (the family cannot afford more children or the woman does not want to marry the man) received lower support. The students were divided into 3 groups of 50 students based on the number of abortion reasons they supported out of 43 reasons. The low-group that accepted 0-10 reasons was called anti-abortion. 50% of them still believed a woman has a right to an abortion vs. 97% of the pro-abortion students. The students reported many problems in their families: alcoholic home (39%), loss of a parent through death, divorce, or separation (33%), victims of severe corporal punishment (31%), one or more family members physically abused (20%), and deprived of parental affection while growing up (20%). When the anti-abortion females (N=30) were compared with the pro-abortion females (N=50), they reported significantly (p.01) more hospitalization, a greater number of physical handicaps, and more shyness (p.1). When the anti-abortion males (N=20) were compared with the pro-abortion males (N=50), they reported significantly more obesity and agoraphobia (p.05) and more convictions for a crime (p.1). Comparison of women who had abortion (N=13) with the women who had their baby (N=8) indicated that the latter reported significantly (p.01) more battering by their boyfriend or husband, significantly (p.05) more battering in their family of origin and childhood sexual abuse, and a greater tendency (p.1) to have been raped.
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PMID:Abortion research: attitudes, sexual behavior, and problems in a community college population. 1234 19

Stress activates the central and peripheral components of the stress system, i.e., the hypothalamic-pituitary-adrenal (HPA) axis and the arousal/sympathetic system. The principal effectors of the stress system are corticotropin-releasing hormone (CRH), arginine vasopressin, the proopiomelanocortin-derived peptides alpha-melanocyte-stimulating hormone and beta-endorphin, the glucocorticoids, and the catecholamines norepinephrine and epinephrine. Appropriate responsiveness of the stress system to stressors is a crucial prerequisite for a sense of well-being, adequate performance of tasks and positive social interactions. By contrast, inappropriate responsiveness of the stress system may impair growth and development, and may account for a number of endocrine, metabolic, autoimmune and psychiatric disorders. The development and severity of these conditions primarily depend on the genetic vulnerability of the individual, the exposure to adverse environmental factors and the timing of the stressful event(s), given that prenatal life, infancy, childhood and adolescence are critical periods characterized by increased vulnerability to stressors. The developing brain undergoes rapid growth and is characterized by high turnover of neuronal connections during the prenatal and early postnatal life. These processes and, hence, brain plasticity, slow down during childhood and puberty, and plateau in young adulthood. Hormonal actions in early life, and to a much lesser extent later, can be organizational, i.e., can have effects that last for long periods of time, often for the entire life of the individual. Hormones of the stress system and sex steroids have such effects, which influence the behavior and certain physiologic functions of individuals for life. Exposure of the developing brain to severe and/or prolonged stress may result in hyperactivity/hyperreactivity of the stress system, with resultant amygdala hyperfunction (fear reaction), decreased activity of the hippocampus (defective glucocorticoid-negative feedback, cognition), and the mesocorticolimbic dopaminergic system (dysthymia, novelty-seeking, addictive behaviors), hyperactivation of the HPA axis (hypercortisolism), suppression of reproductive, growth, thyroid and immune functions, and changes in pain perception. These changes may be accompanied by abnormal childhood, adolescent and adult behaviors, including excessive fear ('inhibited child syndrome') and addictive behaviors, dysthymia and/or depression, and gradual development of components of the metabolic syndrome X, including visceral obesity and essential hypertension. Prenatal stress exerted during the period of sexual differentiation may be accompanied by impairment of this process with behavioral and/or somatic sequelae. The vulnerability of individuals to develop varying degrees and/or components of the above life-long syndrome is defined by as yet unidentified genetic factors, which account for up to 60% of the variance. CRH has marked kindling and glucocorticoids have strong consolidating properties, hence both of these hormones are crucial in development and can alone produce the above syndrome. CRH and glucocorticoids may act in synergy, as in acoustic startle, while glucocorticoids may suppress or stimulate CRH, as in the hypothalamus and amygdala, respectively. A CRH type 1 receptor antagonist, antalarmin, inhibits both the development and expression of conditioned fear in rats, and has anxiolytic properties in monkeys. Profound stressors, such as those from sexual abuse, may elicit the syndrome in older children, adolescents and adults. Most frequently, chronic dysthymia and/or depression may develop in association with gastrointestinal complaints and/or the premenstrual tension syndrome. A lesser proportion of individuals may develop the classic posttraumatic stress disorder, which is characterized by hypocortisolism and intrusive and avoidance symptoms; in younger individuals it may present as dissociative personality disorder.
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PMID:Pediatric stress: hormonal mediators and human development. 1264 70


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