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

The prevalence of binge eating disorder (BED) was assessed in a sample of 110 morbidly obese presurgery patients by means of self-report (Questionnaire on Eating and Weight Patterns [QEWP]). Subsequently, patients with (n = 19, 17.3%) and without BED (n = 91, 82.7%) were compared on several eating-related and general psychopathological instruments, as well as an obesity-specific health-related quality-of-life measure. Patients with BED exhibited higher scores than non-BED patients on most of the subscales of two questionnaires measuring eating behavior and attitudes towards eating, shape, and weight (Three Factor Eating Questionnaire [TFEQ], Eating Disorders Examination-questionnaire version [EDE-Q4]) with the exception of the respective restraint subscales. The two groups also differed significantly on the disease-specific quality-of-life measure (Impact of Quality of Life Questionnaire-Lite [IWQOL-Lite]). No differences were found for measures of severity of depressive symptoms (Inventory of Depressive Symptoms [IDS]) and impairment of self-esteem (Rosenberg Self-Esteem Questionnaire [RSE]). Our findings replicate the results of other studies comparing patients with and without BED in samples with different degrees of obesity and extend the results to an obesity-specific quality-of-life measure. Further research needs to investigate the short- and long-term impact of presurgery BED on surgery outcome, as well as the impact of surgery on binge eating and eating-related psychopathology.
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PMID:Characteristics of morbidly obese patients before gastric bypass surgery. 1450 5

Cognitive behavioural therapy (CBT) is the most comprehensive means of medically treating obesity, but only few data have so far been published concerning its long-term effectiveness. We here report our experience of 1068 consecutive patients (868 females) treated with CBT at a university-based obesity centre. The patients were enrolled into three different programmes: a 14-week LEARN programme (672 patients), a 16-week MOB programme for the morbidly obese (259 patients), or a 20-week BINGE programme for subjects affected by binge eating (137 patients). Eighty-five percent of the subjects completed the weekly programmes. The percentage of patients attending the scheduled control visits during the 1-year follow-up gradually decreased, being very low in the BINGE group (10%). The percentage weight loss was an average of 6% during the weekly courses, being higher in the MOB programme; by the end of the weekly sessions, it exceeded 10% of initial body weight in 22% of cases and increased to 36% during the follow-up. The cumulative probability of follow-up was higher among the patients undergoing the MOB and LEARN programmes than among the BINGE patients (p < 0.0001), and decreased with the increasing severity of obesity. Female gender and a weight loss of > 10% i.b.w. increased compliance to follow-up. The study further demonstrates the difficulty of achieving compliance to chronic management of obesity and the critical role of binge eating disorder in the medium-term treatment of obesity. Strategies are needed to improve adherence to a follow-up protocol.
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PMID:Cognitive behavioural therapy for obesity: one-year follow-up in a clinical setting. 1464 81

Eating behavior is a complex function determined by regulatory mechanisms characterized by bioperiodic fluctuations. It involves the hypothalamus as well as the related higher centers in the central nervous system (CNS). Many hormones, neurotransmitters and neuropeptides play an important role in the synchronization of food intake. Our study therefore sets out to evaluate the circadian rhythms of several endocrine functions in women with eating disorders, to clarify the pathophysiology of the limbic-hypothalamic system. We measured the circadian rhythms of plasma melatonin, serum cortisol, growth hormone (GH) and prolactin (PRL) in 26 patients with anorexia nervosa (AN), 27 with primary obesity (OB) and 7 with bulimia nervosa (BN). Simultaneous evaluation of different neuroendocrine rhythms in these three groups revealed similar circadian abnormalities, (namely daytime persistence of melatonin secretion in AN and OB, and similar cortisol profile changes in AN and BN), together with evidence of internal desynchronization among the different bioperiodic functions. These findings suggest that some changes of the central pathways involved in the control of eating, mood and endocrine functions are common to dissimilar kinds of eating disorders.
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PMID:Circadian neuroendocrine functions in disorders of eating behavior. 1465 27

The aim of the present study is to assess the psychometric properties of the Eating Disorder Examination (EDE) 12.0D in obese adult patients without Binge Eating Disorder (BED). A consecutive series of 115 obese patients without BED (23 M; 92 F), seeking treatment for obesity at the Outpatient Clinic of the Section of Metabolic Diseases and Diabetology of the University of Florence was studied using the EDE 12.0D. Patients had a mean (+/- SD) age of 40.8 +/- 15.1 years, and a Body Mass Index (BMI) of 36.3 +/- 5.9 Kg/m2. Internal consistency of EDE and its scales was evaluated through Cronbach's alpha; factor structure of EDE 12.0D was studied with factor analysis. EDE total and Shape Concern (SC) scores were found to be higher in females than in males. EDE total, SC and Eating Concern (EC) scores were inversely correlated to age, but not BMI. Factor analysis suggested the grouping of items in two subscales. The first scale includes all the items from EC, Weight Concern (WC) and SC except reaction to prescribed weighing; the second scale consists of all the items from Restraint. Data obtained show that items from EC, WC and SC all converge into the same factor analysis derived scale in obese patients without BED. EDE 12.0D provides relevant information about psychopathological features of obese patients, but a grouping of items into subscales different from those originally described could be indicated.
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PMID:Psychometric properties of EDE 12.0D in obese adult patients without binge eating disorder. 1465 38

The past thirty years have seen dramatic changes in our approach to the eating disorders. These include marked improvements in the recognition and understanding of the disorders, and the reduction of the morbidity and mortality of anorexia and bulimia nervosa. Bulimia nervosa itself, now the focus of so much attention, was described less than twenty years ago. While these gains, including those in the level of knowledge and appreciation by the public, have been transmitted to the benefit of patients, there remain significant difficulties in treating people with eating disorders. Critical research may address gaps in knowledge and lead to more efficacious treatments. At the same time, however, changes in the health care system are occurring rapidly and these will have an effect on both research and treatment. The purpose of the present article is to highlight scientific and systemic factors that the authors feel will play an important role in how people with eating disorders are responded to in the coming years. In addressing the eating disorders we are confining our remarks to anorexia and bulimia nervosa, and not to obesity; the latter would require consideration of many other issues, beyond the scope of this review.
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PMID:Factors that may influence future approaches to the eating disorders. 1465 51

Binge eating disorder (BED) is a frequent and significant psychiatric comorbidity among individuals seeking treatment for obesity. Cognitive-behavioral therapy (CBT) is frequently recommended for the treatment of obese individuals with BED. However, there is limited investigation into the effectiveness of the specific components of CBT. In this study, we examine the impact of CBT for BED in obese women on self-efficacy for eating behavior and body image issues. Participants were 12 obese women who participated in a 15-week CBT group program. As predicted, results indicated a reduction in binge episode frequency and significant improvements in self-efficacy and body image pre- and posttreatment. These findings support the premise that a structured cognitive-behavioral group treatment program for obese individuals with BED will promote changes in self-efficacy and body image.
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PMID:Changes in eating self-efficacy and body image following cognitive-behavioral group therapy for binge eating disorder: a clinical study. 1500 Oct 39

Binge eating disorder (BED) is a newly defined diagnostic category characterized by recurrent episodes of binge eating not followed by the inappropriate compensatory weight loss behaviors characteristic of bulimia nervosa. BED is usually associated with overweight or obesity and psychopathology. Pharmacotherapy may be a useful component of a multidimensional treatment approach. Although pharmacotherapy research in BED is still in its preliminary stages. some drugs have been shown to be promising agents. This paper reviews available pharmacological treatment studies of BED and related conditions. Currently, three main classes of drugs have been studied in double-blind, placebo controlled trials in BED: antidepressants, anti-obesity agents, and anticonvulsants. Serotonin selective reuptake inhibitors (SSRIs) are the best studied medications. Thus, fluoxetine, fluvoxamine, sertraline and citalopram have been shown to modestly but significantly reduce binge eating frequency and body weight in BED over the short term. More recently, the anti-obesity agent sibutramine and the anticonvulsant topiramate have been shown to significantly reduce binge eating behavior and body weight in BED associated with obesity. Special issues concerning current pharmacological trials and future research directions in this area are also discussed.
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PMID:Pharmacological approaches in the treatment of binge eating disorder. 1505 14

Concern has been expressed that African American and Hispanic girls, because of their greater prevalence and degree of overweight, may be at greater risk than Caucasian girls for the development of bulimia nervosa and binge eating disorder. A cross-sectional study was undertaken to document the prevalence of overweight and obesity and to compare overweight and obese girls to average-weight girls with regard to early warning signs of eating disorder development. Participants included 139 predominantly African American and Hispanic girls who were classified as average weight, overweight, or obese in Grades 4 and 5. Overall, 18% of the girls were overweight and an additional 30.9% were obese. Overweight and obese girls had lower body esteem and greater concerns about peer influence than did their average-weight peers. They did not have greater fears of negative evaluation or more disturbed eating attitudes and behaviors. Future research should incorporate instruments more sensitive to disorders of overeating and investigate how eating disorder development differs among girls from various racial and ethnic backgrounds.
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PMID:Eating and body image concerns among average-weight and obese African American and Hispanic girls. 1509 87

The past decade has witnessed a dramatic acceleration in research on the role of the neuropeptides in the regulation of eating behavior and body weight homeostasis. This expanding research focus has been driven in part by increasing public health concerns related to obesity and the eating disorders anorexia nervosa (AN) and bulimia nervosa (BN). Preclinical advances have been facilitated by the development of new molecular and behavioral research methodologies. With a focus on clinical investigations in AN and BN, this article reviews research on selected hypothalamic and gut-related peptide systems with prominent effects on eating behavior. Studies of the orexigenic peptides neuropeptide Y and the opioid peptides have shown state-related abnormalities in patients with eating disorders. With respect to gut-related peptides, there appears to be substantial evidence for blunting in the meal-related release of the satiety promoting peptide cholecystokinin in BN. Fasting plasma levels of the orexigenic peptide ghrelin have been found to be elevated in patients with AN. As discussed in this review, additional studies will be needed to assess the role of nutritional and body weight changes in neuropeptide alterations observed in symptomatic eating disorder patients, and to identify stable trait-related abnormalities in neuropeptide regulation that persist in individuals who have recovered from an eating disorder.
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PMID:Neuropeptides in eating disorders. 1520 11

Binge eating disorder (BED), characterized by ingestion of very large meals without purging afterwards, is found in a subset of obese individuals. We showed previously that stomach capacity is greater in obese than in lean subjects, and in this study, we investigated capacity in obese individuals with BED. We also determined ad-libitum intake of a test meal until extremely full. Furthermore, we measured various appetitive hormones (insulin, leptin, glucagon, CCK, ghrelin) and glucose before a fixed meal and for 120 min afterwards. An acetaminophen tracer was used to assess gastric emptying rate. We compared three groups of overweight women: 11 BED, 13 BE (subthreshold BED), and 13 non-binge-eating normals. The BED individuals had the largest stomach capacity as assessed by either maximum volume tolerated (P=.05) or by gastric compliance to pressure (P=.02) using an intragastric balloon. Although test meal intake did not differ between groups, it correlated (P=.03) with gastric capacity. The BED group showed a tendency (P=.06) to have greater area under the curve (AUC) and had higher values at 5 and 60 min (P<.05) for insulin compared to normals. Moreover, the BED subjects had lower ghrelin baselines premeal, and lower AUC for ghrelin, which then declined less postmeal than for the normals (P<.05). None of the other blood values differed, including glucose, leptin glucagon, and CCK, as well as acetaminophen, reflecting gastric emptying. The lower ghrelin in BED, although contrary to what was expected, is consistent with lower ghrelin in obesity, and suggests down-regulation of ghrelin by overeating. The lack of differences in CCK is consistent with the lack of differences in gastric emptying rate, given that CCK is released when nutrients reach the intestine. The results show that BED subjects have a large gastric capacity as well as abnormalities in meal-related ghrelin and insulin patterns that may be factors in binge eating.
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PMID:Gastric capacity, test meal intake, and appetitive hormones in binge eating disorder. 1523 78


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