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

Animal studies have demonstrated a robust role for the endogenous opioid system in the control of food intake. In humans, selective opioid antagonists such as naloxone, naltrexone, and nalmefene have been shown in some studies to reduce total food intake by up to 30% and to alter food preferences in short-term experimental trials in normal-weight subjects, as well as in obese and bulimic patients. The value of naloxone and naltrexone in the long-term treatment of eating disordered patients, however, must be considered very limited. The published treatment studies do not justify the routine use of naloxone and naltrexone in patients with Prader-Willi syndrome, obesity, bulimia nervosa, or anorexia nervosa because of their unprofitable risk/benefit ratios, although further work, particularly focused on some of the newer antagonists, should be undertaken.
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PMID:Opiate antagonists and eating behavior in humans: a review. 148 43

Although pre-pubertal anorexia nervosa has been well described, pre-pubertal bulimic behaviour in the context of this disorder appears to be uncommon. There have been no published reports of pre-pubertal bulimia nervosa occurring independently. Of 323 patients with bulimia nervosa attending an eating disorders research clinic between 1980 and 1989, the authors identified six patients who described pre-menarchal binge eating in the absence of a concurrent history of anorexia nervosa or massive obesity. Three (0.93%) of these patients described a pre-menarchal onset of bulimia nervosa, but there was no evidence that they were pre-pubertal. The implications of these findings are discussed.
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PMID:Pre-menarchal bulimia nervosa. 156 72

Data on the prevalence and characteristics of binge eating in a series of 64 obese women participating in a controlled weight-reduction program are presented. Twenty-two (34.4%) reported recurrent binge eating episodes defined as overeating plus loss of control as assessed by patients' self-report and confirmed by a clinical interview. Six of those indicated that they engaged in either self-induced vomiting or laxative use to control their weight, but only two met full criteria for current bulimia nervosa according to DSM-III-R. A detailed description of the binge eating behavior revealed similarities to the eating pattern described in patients with bulimia nervosa: obese binge eaters tended to overeat in the evening, when they were alone and at home. Compared with their non-binge eating counterparts, binge eaters were significantly younger when they presented for treatment. The prevalence of childhood obesity was higher, and they were significantly younger when they first started on a diet than the non-binge eaters. Binge eaters reported more psychological problems such as body image distortion, and there was a slight tendency for binge eaters to exhibit more depressive symptomatology at baseline. No association between binge eating and weight at baseline, or weight loss during therapy or at follow-up could be found. Fluvoxamine (100 mg) did not seem to be of specific benefit in this subgroup of the obese with regard to weight loss.
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PMID:Binge eating in overweight women. 164 67

In the treatment of obesity, anorexiant medication appears to enhance restraint, presumably through altering internal cues, and facilitates weight loss with behavioral treatment. However, relapse occurs once medication is withdrawn. Antidepressants appear to work similarly, and initial evidence suggests the same limitations. Long-term combined pharmacologic and behavioral treatment, however, may be useful for some individuals not responding positively to behavioral treatment alone. In the treatment of bulimia nervosa, antidepressants appear to enhance restraint, whereas cognitive behavioral treatment decreases restraint. Thus, these modalities appear to be incompatible, and highly restrictive eating is not desirable for those of normal weight. However, for individuals not responding to cognitive-behavioral treatment, long-term pharmacologic treatment may be an alternative, perhaps combined with a more compatible psychological treatment.
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PMID:Mechanisms of action in cognitive-behavioral and pharmacological interventions for obesity and bulimia nervosa. 200 26

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

In the course of this discussion of body image disorders there has been little opportunity to discuss culture bound disorders although of course it should not be overlooked that obesity, anorexia and bulimia nervosa are to some extent culture bound, but prevalent within our own society. There are many different specific syndromes presenting with physical symptoms, often based upon hypochondriacal concern about the body. For example, koro which occurs in South East Asia presents with an overwhelming preoccupation that the penis will retract into the abdomen and hence cause death; there is thus both a fear for virility and a fear for life. Can there be unification of these very different concepts? Although the answer is probably negative, classification becomes more meaningful if epistemological unity is achieved, and phenomenological psychopathology is the most likely root to achieve this. There is therefore a need to concentrate upon the precise description of the patients' own internal experience, using this for categorisation of the symptoms. Objectivity has been held up in medicine as the ideal; however, in order to make progress in this area there is a need to structure subjectivity. Body image, as the concept of the body, is a part of self image; ultimately the only way to explore the self is to study self description using empathy as a diagnostic instrument.
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PMID:Towards the unification of body image disorders. 307 55

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

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

The feeding responses induced by systemic administration of 2-deoxy-D-glucose (2-DG) and paraventricular hypothalamic injection of norepinephrine were assessed in Brattleboro rats deficient in vasopressin (VP). Controlling for the non-specific complications of diabetes insipidus, it was found that Brattleboro rats have a deficient 2-DG-feeding response, but an essentially normal noradrenergic-feeding response. Specific carbohydrate appetite abnormalities were also demonstrated. It is argued that VP influences 2-DG feeding by mobilizing endogenous energy stores following its acute release from the hypothalamoneurohypophysial system. A new function is thus ascribed for VP and the neural lobe of the pituitary. It is suggested that VP plays a role in stress-induced feeding and in specific aspects of carbohydrate appetite. The potential relevancy of vasopressin perturbations to bulimia nervosa and to the Prader-Willi obesity syndrome is also discussed.
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PMID:Vasopressin and glucoprivic-feeding behavior: a new perspective on an 'old' peptide. 377 90


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