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

Eating disorders are one of the rare psychiatric disorders with a large preponderance of female patients. The other articles in this issue review eating disorders in children and adolescents and focus primarily on female patients. This article reviews the eating disorders that occur in male children and teenagers, including anorexia nervosa, bulimia nervosa, binge eating disorder, a subtype of body dysmorphic disorder named muscle dysmorphobia, and obesity. This article reviews subgroups of boys who are at higher risk for developing eating disorders. The article commences with the difference in male perceptions of body image and dieting behaviors.
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PMID:Eating disorders in males. 1210 28

Obesity has been identified as a risk factor for the development of bulimia nervosa (BN). Accordingly, we hypothesize that genotypes predisposing to obesity can be detected in patients with this eating disorder. In order to investigate this hypothesis we screened the melanocortin-4 receptor gene (MC4R) for mutations using single strand conformation analysis in 81 female inpatients treated for BN. A single patient with both extreme obesity and BN had a haplo-insufficiency mutation in the MC4R. Comparison of current and maximal body mass index (BMI) of all patients with cross-sectionally obtained BMI in the general population revealed an age appropriate distribution for current BMI and a substantially increased frequency for overweight at time of maximal BMI. Our findings suggest that overweight is a risk factor for BN in clinically ascertained patients. For the first time a genotype predisposing to obesity has been detected in an extremely obese patient with BN.
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PMID:Genetic predisposition to obesity in bulimia nervosa: a mutation screen of the melanocortin-4 receptor gene. 1214 Jul 89

Obesity is a serious disorder and its treatment involves dietitians, psychologists, and psychiatrists, often with a poor outcome. The role of psychiatric issues in obesity is equivocal, and so is the fact whether emotional and behavioral disturbances are causes or consequences of an individual's overweight condition. We performed a study that included 120 obese women (59 with binge eating disorder [BED] and 61 with non-BED) according to specific selection criteria, and compared to 80 healthy controls. Body mass index (BMI) was calculated for all patients and they were assessed with the Temperament and Character Inventory (TCI). Despite the fact that obese patients with BED and without BED display a similar personality profile, those with BED show lower scores in Self-Directedness (SD). Both groups of obese patients differ from nonobese controls in Novelty Seeking (NS), Harm Avoidance (HA), Cooperativeness (C), and SD. SD seems to be the strongest predictor for the development of BED. The idea that two distinct groups of obese patients exist is supported. Moreover, as regards personality, a lower SD and a higher risk of Personality Disorders were found in obese BED patients. Different severities of overweight do not seem to relate to a specific personality susceptibility.
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PMID:Temperament and character in obese women with and without binge eating disorder. 1243 29

Indirect calorimetry is a noninvasive, inexpensive technique used to determine resting energy expenditure. Its use provides the clinician with objective information that can be used to design, implement, and evaluate efficacy of treatment in the nutritional management of adolescents with anorexia nervosa, bulimia nervosa, chronic dieting behavior, and obesity. This chapter outlines the theoretical framework, interpretation of data, and clinical applications of indirect calorimetry and presents case examples to underscore its utility in adolescents with eating disorders.
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PMID:The use of indirect calorimetry in the clinical management of adolescents with nutritional disorders. 1252 92

Bulimia nervosa (BN) and binge-eating disorder (BED) are separate entities with the common denominator of binge eating. In this chapter, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for BN are reviewed, including both recurrent episodes of binge eating and inappropriate compensatory behaviors to prevent weight gain in one whose self-evaluation is unduly influenced by body weight and shape. Two percent of adolescent females and 0.3% of adolescent males fulfill criteria for BN. Risk factors, medical complications of binge eating (vomiting, use of ipecac, diet pills, diuretics, and laxatives), physical and laboratory findings, and treatment options and outcome are discussed. BED is seen in 1-2% of adolescents. The DSM-IV lists BED under Eating Disorder Not Otherwise Specified. DSM-IV research criteria for BED is reviewed, including binge eating, distress over binge eating, and absence of regular extreme compensatory behaviors. The mean age of onset is 17.2 years. Up to 30% of obese patients have BED. Risk factors are discussed. Because most patients with BED are obese, medical evaluation is similar to that for obesity. Treatment goals must be geared not only toward decreased binge eating but toward weight loss. Outcome is discussed.
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PMID:Bulimia nervosa and binge-eating disorder in adolescents. 1252 96

Bulimia nervosa shows a marked tendency to persist, suggesting that powerful maintaining mechanisms operate. Using data from a prospective, 5-year, study of the natural course of 102 people with bulimia nervosa, the authors sought to identify predictors of persistence and to test specific hypotheses derived from the cognitive-behavioral theory of the persistence of bulimia nervosa. The results of both sets of analyses were consistent with the theory, with the degree of overevaluation of shape and weight and a history of childhood obesity predicting a persistent course. There was also support for the central prediction of the cognitive-behavioral theory. These findings suggest that the mechanisms specified by the theory influence its longer term natural course.
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PMID:Understanding persistence in bulimia nervosa: a 5-year naturalistic study. 1260 30

The focus of this meeting was the interface between eating disorders and obesity. A symposium at this meeting dealt with advances in treatment for bulimia nervosa (BN) and binge eating disorder. There were two presentations in this symposium that addressed pharmacological treatments. One reviewed drug treatments for BN, which included reviewing the evidence for the efficacy of tricyclic antidepressants, monoamine oxidase inhibitors and selective serotonin inhibitors in the treatment of BN. All drug studies demonstrated greater reduction in binge eating and purging than with placebo. Other medications studied without evidence of efficacy for BN include opiate antagonists, lithium and anticonvulsants. Two promising agents for BN that require further study are odansitron and topiramate. For binge eating disorder, studies have examined the efficacy of antidepressants (tricyclic antidepressants, selective serotonin re-uptake inhibitors and serotonin/noradrenaline re-uptake inhibitors), antiobesity agents (sibutramine) and antiepileptics associated with weight loss (topiramate), with some evidence of efficacy for these agents.
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PMID:Academy for Eating Disorders International Conference on Eating Disorders. Denver, CO, USA, May 29-31, 2003. 1288 30

The diagnostic concept of binge eating disorder (BED) was introduced in response to the clinical observation of Stunkard (1959) that some people with obesity have recurrent episodes of binge eating. We suggest that the DSM-IV concept of BED has resulted in the recruitment of heterogeneous research samples, amongst which are some people with BED, as described by Stunkard, some with bulimia nervosa, some with other types of eating disorder, and some with no eating disorder. We consider the difficulties distinguishing BED from other forms of overeating, especially in patients with obesity, and from nonpurging bulimia nervosa. We propose revised diagnostic criteria for BED and bulimia nervosa that are designed to minimize these problems.
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PMID:Refining the definition of binge eating disorder and nonpurging bulimia nervosa. 1290 Sep 89

Undernutrition due to insufficient intake of energy and macronutrients and/or due to deficiencies in specific micronutrients impairs the immune system, suppressing immune functions that are fundamental to host protection. The most consistent abnormalities are seen in cell-mediated immunity, complement system, phagocyte function, cytokine production, mucosal secretory antibody response, and antibody affinity. There is a number of physiological situations such as ageing and performance of intense physical exercise associated with an impairment of some immune parameters' response. Nutrition can influence the extent of immune alteration in both of them. There are also numerous pathological situations in which nutrition plays a role as a primary or secondary determinant of some underlying immunological impairments. This includes obesity, eating disorders (anorexia nervosa and bulimia nervosa), food hypersensitivity and gastrointestinal disorders as some examples. The implications of nutrition on immune function in these disorders are briefly reviewed.
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PMID:Changes in the immune system are conditioned by nutrition. 1294 57

This study compared patients with bulimia nervosa (BN), obese patients with binge eating disorder (BED), and nonobese patients with BED. One hundred sixty-two adult women consecutively evaluated for outpatient clinical trials who met DSM-IV criteria for BN, purging type (N = 46) or for BED (N = 79 obese and N = 37 nonobese) were compared using the Eating Disorder Inventory (EDI). The three groups differed significantly on two (drive for thinness and body dissatisfaction) of the three eating-related scales and on all five of the general personality scales of the EDI. When age and depression level were controlled, findings for the eating-related scales did not change, whereas four of the five general personality scales were no longer significant. Post hoc analyses revealed that the BN group and the nonobese BED group had significantly higher drive for thinness than the obese BED group. The nonobese and the obese BED groups did not differ from each other in any area (other than drive for thinness), including body dissatisfaction. The nonobese and the obese BED groups had significantly lower maturity features than the BN group. Our findings suggest that when the effects of age and depression levels are controlled, treatment-seeking women with BN and BED are generally similar. Certain differences that do exist between women with BN and BED are associated with obesity status (drive for thinness), whereas others are associated with diagnosis (body dissatisfaction, maturity fears).
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PMID:Comparison of patients with bulimia nervosa, obese patients with binge eating disorder, and nonobese patients with binge eating disorder. 1450 68


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