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

Athletes have traditionally been considered greater risk takers than their peers. Some research suggests that athletic participation is associated with increased risk behaviors in males but may be protective in females. Still there is significant intersport variability, and some "nonathlete" risk behaviors exceed those of athletes. Motor vehicle accidents, sensation-seeking behaviors that contribute to unintentional injury and violence, alcohol, illicit drug and tobacco use, sexual misadventure, unhealthy dietary habits, and physical inactivity and obesity are major health risk considerations. There is new focus upon the negative health-related consequences of other risk behaviors such as gambling, sleep apnea and obesity, inappropriate medication, energy drink or contaminated supplement use, and depression/suicide. While it is important to look at the prevalence of "risk behaviors in sport," our cautions regarding these behaviors need to be shared with all youth regardless of athletic disposition.
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PMID:Risk behaviors in high school and college sport. 1900 60

There is clearly a connection between depression and cardiovascular disease, and suicide, obesity, and diabetes. Maternal depression has a considerable impact on both the mother and the child. A brief review of scientific findings in this regard leads to two conclusions. First, the high incidence of depression in Oklahoma contributes to its poor health status. Second, our physicians can make a difference by increased attention to the possibility of depression in their patients regardless of specialty.
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PMID:Depression and Oklahoma's poor health status: a connection? 1917 91

The state of child and adolescent overall health in the United States evidences the need for both prevention and treatment. Although much time and energy has been spent in recent years discussing and improving health benefit coverage and affordability for children, physical access to services has not kept pace with these changes. This article will introduce four major physical health issues (obesity, diabetes, asthma, and teen pregnancy/STD) and five key mental health issues (suicide, depression, ADHD, aggression, and violence) facing young people today. In an effort to answer the question, "What can be done?" school-based health clinics and their impact on health and educational outcomes are examined.
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PMID:Bridging the gap from availability to accessibility: providing health and mental health services in schools. 1919 36

It has been long known that the frequency of overweight and obese people is higher among depressed and bipolar patients than in the general population. The marked alteration of body weight (and appetite) is one of the most frequent of the 9 symptoms of major depressive episode, and these symptoms occur during recurrent episodes of depression with a remarkably high consequence. According to studies with representative adult population samples, in case of obesity (BMI over 30) unipolar or bipolar depression is significantly more frequently (20-45%) observable. Since in case of depressed patients appetite and body weight reduction is observable during the acute phase, the more frequent obesity in case of depressed patients is related (primarily) not only to depressive episodes, but rather to lifestyle factors, to diabetes mellitus also more frequently occurring in depressed patients, to comorbid bulimia, and probably to genetic-biological factors (as well as to pharmacotherapy in case of medicated patients). At the same time, according to certain studies, circadian symptoms of depression give rise to such metabolic processes in the body which eventually lead to obesity and insulin resistance. According to studies in unipolar and bipolar patients, 57-68% of patients is overweight or obese, and the rate of metabolic syndrome was found to be between 25-49% in bipolar patients. The rate of metabolic syndrome is further increased by pharmacotherapy. Low total and HDL cholesterol level increases the risk for depression and suicide and recent studies suggest that omega-3-fatty acids possess antidepressive efficacy. Certain lifestyle factors relevant to healthy metabolism (calorie reduction in food intake, regular exercise) may be protective factors related to depression as well. The depression- and possibly suicide-provoking effect of sibutramine and rimonabant used in the pharmacotherapy of obesity is one of the greatest recent challenges for professionals and patients alike.
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PMID:[Association of obesity and depression]. 1921 97

Higher BMI has been associated with a lower risk of suicide in large prospective studies, but the mechanisms for this link require elucidation. In the 2002 and 2004 iterations of the Behavioral Risk Factor Surveillance System (BRFSS), a large, population-based telephone survey of US adults conducted by the Centers for Disease Control and Prevention, participants reported their height, weight, and several potential risk factors for suicide, including alcohol use, mental health, marital status, firearm ownership, and risk-taking behaviors. We assessed whether BMI was associated with these risk factors among 224,247 eligible respondents in 2002 and 275,194 in 2004 after sample-weighted adjustment for age, race, region, smoking, and education. Alcohol-related risk factors tended to be lower with heavier BMI among women, while firearm-related risk factors tended to be higher with heavier BMI among men. Heavier BMI also tended to be associated with unmarried status and poor mental health, especially among women, and with infrequent seat belt use in men and women. No potential risk factors were consistently inversely associated with BMI in both sexes and years. In summary, in these samples of the US population, conventional risk factors for suicide were inconsistently associated with BMI, making them unlikely mediators for the observed relationship of BMI with lower risk of suicide. In some cases, risk factors were actually greater with heavier BMI. Further study of the relationship of BMI and suicide may yield novel modifiable risk factors that could cause or prevent this important cause of death.
Obesity (Silver Spring) 2009 Mar
PMID:BMI and risk factors for suicide: why is BMI inversely related to suicide? 1921 65

Numerous studies document disproportionate physical morbidity and premature death among people with serious mental illness. Although suicide remains an important cause of mortality for this population, cardiovascular disease is the leading cause of death. Cardiovascular death among those with serious mental illness is 2 to 3 times that of the general population. This vulnerability is commonly attributed to underlying mental illness and behavior. Some excess disease and deaths result from poor access to and use of quality health care. Negative cardiometabolic effects of newer psychotropic medications augment these trends by increasing rates of obesity, diabetes, and hyperlipidemia among those treated. Researchers have developed innovative care models aimed at minimizing the disparate health outcomes of patients with serious mental illness. Most strive to enhance access to primary care, but publications on this topic appear almost exclusively in the psychiatric literature. A focus on primary care for the prevention of excess cardiometabolic morbidity and mortality in this population is appropriate, but depends on primary care physicians' understanding of the problem, involvement in the solutions, and collaboration with psychiatrists. We review health outcomes of the seriously mentally ill and models designed to improve these outcomes. We propose specific strategies for Family Medicine clinicians and researchers to address this problem.
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PMID:Health care for patients with serious mental illness: family medicine's role. 1926 42

BMI has been inversely associated with risk of completed suicide in several cohort studies, but putative mechanisms for this association and its generalizability throughout the United States are uncertain. We ascertained recent population-based, state-level data on rates of obesity, completed suicide (by method), firearm ownership, smoking, major depression, income, education, white race, and nonmetropolitan residence, compiled from federal agencies and surveys, and determined the adjusted population-weighted correlations of statewide obesity rates with measures of completed and attempted suicide. Statewide prevalence of obesity was strongly inversely correlated with age adjusted suicide rate (multivariable-adjusted r=-0.66; P<0.001). The correlation was somewhat stronger for rates of nonfirearm-related (r=-0.75; P<0.001) than firearm-related suicides (r=-0.53; P<0.001), and was of similar magnitude as the positive correlations of firearm prevalence with suicide rate (r=0.75; P<0.001) or of obesity with prevalence of diabetes (r=0.41; P=0.006). In analyses of fatal and nonfatal suicidal acts, obesity rates were inversely correlated with rates of suicidal acts using firearms (r=-0.53; P=0.02) and suffocation (r=-0.76; P<0.001) but not other methods. Obesity rates were also inversely correlated with the case-fatality ratios of acts using poisoning (r=-0.51; P=0.01). Thus, statewide rates of obesity are strongly inversely correlated with rates of completed suicide in multivariable analyses, a finding that appears to relate to fewer attempts by suffocation and a lower case-fatality ratio for poisonings, although the mechanism for the inverse correlation with firearm-related suicides requires further elucidation.
Obesity (Silver Spring) 2009 Oct
PMID:BMI and rates of suicide in the United States: an ecological analysis. 1939 May 24

Menopause is one of the triggers that induce obesity. Estradiol (E2), corticotropin-releasing hormone (CRH), and hypothalamic neuronal histamine are anorexigenic substances within the hypothalamus. This study examined the interactions among E2, CRH, and histamine during the regulation of feeding behavior and obesity in rodents. Food intake was measured in rats after the treatment of E2, alpha-fluoromethyl histidine, a specific suicide inhibitor of histidine decarboxylase that depletes hypothalamic neuronal histamine, or CRH antagonist. We measured food intake and body weight in wild-type mice or mice with targeted disruption of the histamine receptors (H1-R) knockout (H1KO mice). Furthermore, we investigated CRH content and histamine turnover in the hypothalamus after the E2 treatment or ovariectomy (OVX). We used immunohistochemical staining for estrogen receptors (ERs) in the histamine neurons. The E2-induced suppression of feeding was partially attenuated in rats pre-treated with alpha-fluoromethyl histidine or CRH antagonist and in H1KO mice. E2 treatment increased CRH content and histamine turnover in the hypothalamus. OVX increased food intake and body weight, and decreased CRH content and histamine turnover in the hypothalamus. In addition, E2 replacement reversed the OVX-induced changes in food intake and body weight in wild-type mice but not in H1KO mice. Immunohistochemical analysis revealed ERs were expressed on histamine neurons and western blotting analysis and pre-absorption study confirmed the specificity of ER antiserum we used. These results indicate that CRH and hypothalamic neuronal histamine mediate the suppressive effects of E2 on feeding behavior and body weight.
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PMID:Hypothalamic neuronal histamine signaling in the estrogen deficiency-induced obesity. 1961 43

Schizophrenia is a severe mental illness affecting around 1% of adults with a high degree of morbidity and mortality. Affected individuals are at increased risk for unemployment, handicap, obesity, diabetes mellitus, hearth attack and suicide. Antipsychotic drugs are the best treatment for this disease, but about 20% of patients display drug resistance, or refractoriness, and may receive a special neuroleptic named Clozapine. Despite its superiority from other neuroleptics, only 30-60% of drug-resistant patients are responsive to clozapine. Clozapine's action results from interactions between dopaminergic and serotonergic neurotransmitter systems and since clozapine appears to exert its effect strongly through the serotonergic systems, alterations in serotonin synaptic levels may influence antipsychotic response. The serotonin transporter (5-HTT) is responsible for pre-synaptic re-uptake of serotonin, making this transporter a logical candidate gene for prediction of clozapine response and to increase understanding about mechanisms of refractoriness. Therefore, we investigated the influence of two polymorphisms in the 5-HTT gene (HTTLPR/rs25531 and VNTR Stin2) in clozapine response in a sample of 116 schizophrenic individuals of European descent from South-Brazil. Significant differences between responders and non-responders to clozapine were observed for the HTTLPR/rs25531 polymorphism. Nonresponders to clozapine showed a higher frequency of S'-allele (P = 0.01) and also were more likely to be S'/S' homozygous or S'/L' heterozygous than those who did respond (P = 0.04). After controlling for confounding variables, logistic regression analyses confirmed this association (OR = 3.15; 95% CI: 1.13-8.80). The observed association suggests that increased availability of extracellular serotonin concentrations at all synapses may reduce clozapine effect.
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PMID:Influence of serotonin transporter gene polymorphisms on clozapine response in Brazilian schizophrenics. 2045 7

Individuals with schizophrenia have higher mortality rates compared to the general community. Apart from an increased risk of suicide, people with schizophrenia have an increased risk of death related to a wide range of comorbid physical conditions. There is evidence to suggest that much of this mortality is avoidable. The provision of assertive management of comorbid physical disorders has the potential to help close the differential mortality gap. While the primary data are robust, there is less empirical evidence to guide policy makers and service providers when dealing with these problems. Focused clinical programs aimed at reducing risk factors (e.g. smoking, obesity) and shared care between mental health teams and primary care providers can help reduce the burden of avoidable deaths. In light of recent evidence suggesting that the mortality gap has widened in recent decades, there is an urgent need to address the burden of avoidable deaths in those with serious mental illnesses.
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PMID:What can we do to reduce the burden of avoidable deaths in those with serious mental illness? 2048 16


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