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

Obesity and substance abuse during adolescence have reached epidemic proportions, and both are among the leading major public health problems in the United States. There is a significant amount of weight and Body Mass Index (BMI) gain in adolescent ex-addicts during supervised and confirmed abstinence from drugs and alcohol. The primary purpose of this secondary data analysis was to examine the effectiveness of two interventions implemented to address weight management in residential facilities treating adolescent substance use disorders. The secondary purpose was to establish if the outcome was a function of mandated smoking cessation and prescribed psychotropic medications. The results of the study suggest adolescents experienced weight gain in all groups, however there was no interaction effect for smokers and those adolescents on psychotropic medication for either outcome variable.
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PMID:Weight gain during substance abuse treatment: the dual problem of addiction and overeating in an adolescent population. 1928 73

Motivational interviewing (MI) is a client-centered approach aimed to enhance a client's motivation to change behaviors and to move him or her to action. MI focuses on client desires, thoughts and feelings as a way to encourage clients to express their own barriers to change and to explore and resolve ambivalence to behavioral change. Motivational interviewing has been applied in a variety of conditions, including substance abuse cessation, obesity treatment, treatment adherence, enhance of diet and exercise behaviors and the prevention and management of chronic diseases. Evidence from research has demonstrated that motivational interviewing is effective in improving client lifestyle and health outcomes. There are four guiding principles in conducting motivational interviews include expressing empathy, developing discrepancies, backing off when encountering resistance, and supporting self-efficacy. In addition, five basic therapeutic skills are often used in the interview process, including reflective listening, asking open questions, affirming, weight of cons and pros, summarizing. The principles and skills discussed in this paper will help nurses better understand the "spirit" of motivational interviewing and facilitate their further application them in clinical practice to promote client self-awareness and instill a motivation to change health behaviors.
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PMID:[The application of motivational interviewing in nursing practice]. 1931 9

Several prescription medications are approved to treat obesity, yet little is known about their use in the United States. Our objective was to describe recent trends and patterns of obesity reduction medication use in an insured US population. From among ~4.2 million persons enrolled in two Blue Cross and Blue Shield plans, we obtained all medical and pharmacy claims for 86,804 persons who took an obesity reduction medication anytime during 2002-2005. Overall, obesity reduction medication use decreased significantly over time from 1% in 2002 to 0.7% in 2005 (P for trend <0.001), which was most notable for the newer medications (orlistat and sibutramine). Few (range: 11-18%) used these medications longer than 3 months regardless of whether they were Federal Drug Administration (FDA)-approved for long-term use or not. More than half (57%) of obesity reduction medication users also took narcotics and 38% took antidepressants. Few sympathomimetic users had potential serious contraindications prior to medication initiation, including cardiovascular diseases (2.4%), schizophrenia (2.5%), and age >65 (1.2%). Despite the high prevalence of obesity, obesity reduction medication use was low and decreased significantly from 2002 through 2005. Prescribers of these agents should be aware of approved durations, potential contraindications, and consider screening for depression and substance abuse.
Obesity (Silver Spring) 2010 Jan
PMID:Trends in and patterns of obesity reduction medication use in an insured cohort. 1949 47

In North American society, it is all too common for the intake of calories to outweigh an individual's energy demands. Such over-consumption where high-energy foods are readily available undoubtedly contributes to the growing problem of obesity. Palatable food stimulates brain circuits similar to those that mediate behavioral responses to drugs of abuse, which may underlie the continuation of food intake long after energy requirements are met. Among the brain areas implicated in reward and food intake, the lateral hypothalamus (LH) has long been recognized as a common region involved in both. It has been suggested that orexin neurons that are expressed exclusively within and adjacent to the LH comprise a major cellular substrate for the functioning of the LH. Here, we review the idea that the orexin neuropeptides play a key role in the rewarding aspects of food intake through interactions with both peripheral and central signals reflecting current energy stores as well as the classic reward pathway--the mesolimbic dopamine system. Furthermore, a possible heterogeneity of orexin neurons is discussed. Uncovering orexin's role in food reinforcement may provide insight into hyperphagia and obesity. In addition, the idea that food intake and substance abuse involve similar brain circuitry suggests potential for a single treatment aiding both obesity and addiction.
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PMID:Interaction between orexins and the mesolimbic system for overriding satiety. 1954 24

Stress can be a primary or secondary contributor to ill health via excessive and sustained sympathetic arousal leading to ischemic heart disease, hypertension, stroke, obesity, and mental ill health, or through related behaviors such as smoking, substance abuse, and over or inappropriate eating; or as a contextual variable in terms of risk factor and lifestyle outcome. In addition, psychosocial stress can impair recovery from any pathological insult or injury. Most assessments of stress relate to life events, and both past and current life stressors, acute and chronic, play a major role. However, beyond the impact of stressors, it is the reported state of feeling stressed that is the critical predictor of ill health. This article describes stress and its correlates, discusses models of stress, and presents the nine-item Psychological Stress Measure (PSM-9). This tool is aimed directly at the state of feeling stressed, is suited for assessing stress clinically in the general population and serving as an outcome measure. The tool is valid and reliable and easy to administer in health care settings; it has a normal distribution, which makes it a very sensitive-to-change instrument in repeated measures to document progress.
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PMID:Psychological Stress Measure (PSM-9): integration of an evidence-based approach to assessment, monitoring, and evaluation of stress in physical therapy practice. 1984 68

It is now generally accepted that complex mental disorders are the results of interplay between genetic and environmental factors. This holds out the prospect that by studying G x E interplay we can explain individual variation in vulnerability and resilience to environmental hazards in the development of mental disorders. Furthermore studying G x E findings may give insights in neurobiological mechanisms of psychiatric disorder and so improve individualized treatment and potentially prevention. In this paper, we provide an overview of the state of field with regard to G x E in mental disorders. Strategies for G x E research are introduced. G x E findings from selected mental disorders with onset in childhood or adolescence are reviewed [such as depressive disorders, attention-deficit/hyperactivity disorder (ADHD), obesity, schizophrenia and substance use disorders]. Early seminal studies provided evidence for G x E in the pathogenesis of depression implicating 5-HTTLPR, and conduct problems implicating MAOA. Since then G x E effects have been seen across a wide range of mental disorders (e.g., ADHD, anxiety, schizophrenia, substance abuse disorder) implicating a wide range of measured genes and measured environments (e.g., pre-, peri- and postnatal influences of both a physical and a social nature). To date few of these G x E effects have been sufficiently replicated. Indeed meta-analyses have raised doubts about the robustness of even the most well studied findings. In future we need larger, sufficiently powered studies that include a detailed and sophisticated characterization of both phenotype and the environmental risk.
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PMID:From nature versus nurture, via nature and nurture, to gene x environment interaction in mental disorders. 2002 96

Study goals were to distinguish between maternal risk factors for fetal versus infant mortality, and to identify which maternal characteristics contributed the greatest risk of mortality overall. This case-control retrospective study abstracted data on more than forty maternal characteristics from 261 prenatal and delivery records: all 26 fetal deaths, all 40 infant deaths and 195 randomly selected surviving births in a high-mortality Healthy Start community. Bivariate and multivariate analyses were conducted. The fetal-mortality population was significantly more likely than the infant-mortality population to have no insurance (P = .047), inadequate prenatal care (P = .039) and previous fetal death (P = .021). Comparing the combined mortality population with the surviving sample, two tiers of risk emerged: Rare-but-lethal risks, including no prenatal care (P < .001) and Child-Protective-Service involvement (P = .001), and common-and-dangerous risks, including inadequate maternal weight gain (OR = 13.55), drug or alcohol abuse (OR = 8.67), obesity (OR = 2.77) and anemia (OR = 3.61). Both fetal and infant mortality groups must be considered when identifying maternal risks. Inadequate prenatal weight gain, obesity and anemia contribute as much to feto-infant mortality as substance abuse. Public health efforts to improve maternal nutrition and healthy weight should be redoubled.
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PMID:Assessing maternal risk for fetal-infant mortality: a population-based study to prioritize risk reduction in a healthy start community. 2008 28

The current study explored the predictive value of cognitive biases to food cues (assessed by emotional Stroop and dot probe tasks) on weight change over a 1-year period. This was a longitudinal study with undergraduate students (N = 102) living in shared student accommodation. After controlling for the effects of variables associated with weight (e.g., physical activity, stress, restrained eating, external eating, and emotional eating), no effects of cognitive bias were found with the dot probe. However, for the emotional Stroop, cognitive bias to unhealthy foods predicted an increase in BMI whereas cognitive bias to healthy foods was associated with a decrease in BMI. Results parallel findings in substance abuse research; cognitive biases appear to predict behavior change. Accordingly, future research should consider strategies for attentional retraining, encouraging individuals to reorient attention away from unhealthy eating cues.
Obesity (Silver Spring) 2010 Dec
PMID:Cognitive biases to healthy and unhealthy food words predict change in BMI. 2037 49

The main pharmacological effects of marijuana, as well as synthetic and endogenous cannabinoids, are mediated through G-protein-coupled receptors (GPCRs), including CB(1) and CB(2) receptors. The CB(1) receptor is the major cannabinoid receptor in the central nervous system and has gained increasing interest as a target for drug discovery for treatment of nausea, cachexia, obesity, pain, spasticity, neurodegenerative diseases and mood and substance abuse disorders. Evidence has accumulated to suggest that CB(1) receptors, like other GPCRs, interact with and are regulated by several other proteins beyond the established role of heterotrimeric G-proteins. These proteins, which include the GPCR kinases, beta-arrestins, GPCR-associated sorting proteins, factor associated with neutral sphingomyelinase, other GPCRs (heterodimerization) and the novel cannabinoid receptor-interacting proteins: CRIP(1a/b), are thought to play important roles in the regulation of intracellular trafficking, desensitization, down-regulation, signal transduction and constitutive activity of CB(1) receptors. This review examines CB(1) receptor-interacting proteins, including heterotrimeric G-proteins, but with particular emphasis on non-G-protein entities, that might comprise the CB(1) receptosomal complex. The evidence for direct interaction with CB(1) receptors and potential functional roles of these interacting proteins is discussed, as are future directions and challenges in this field with an emphasis on the possibility of eventually targeting these proteins for drug discovery.
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PMID:Cannabinoid CB1 receptor-interacting proteins: novel targets for central nervous system drug discovery? 2059 May 57

This international meeting discussed the management of physical health in patients with schizophrenia in several countries including France, Spain, Germany, the UK and Italy. Physical health parameters, including weight, blood pressure, blood glucose, lipids and standard biochemical assessments are measured in many patients at the first hospital consultation. These reveal physical disorders such as obesity, hypertension, dyslipidaemia, the metabolic syndrome, substance abuse, cardiovascular disease, extrapyramidal symptoms, sexual dysfunction and diabetes in substantial proportions of patients. Psychiatrists consider switching antipsychotic therapy if excessive sedation, extrapyramidal symptoms, unacceptable weight gain, hyperglycaemia or dyslipidaemia occur. In general, switching is more likely to be considered for symptomatic adverse events than for laboratory abnormalities. Switching is discouraged by limited knowledge of protocols, the absence of guidelines and fears of relapse or reduced treatment adherence. The physical health of patients with schizophrenia receives much less attention in the community setting than in the hospital setting. Improved guidelines, protocols, resources and support are needed to improve the physical health of patients in the community.
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PMID:Management of physical health in patients with schizophrenia: international insights. 2062 Aug 86


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