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

Obese people as a group have similar mental health as normal weight people, and there are no psychiatric features characteristic of obesity in general. However, small subgroups of obese individuals may have psychiatric abnormalities which are specific for obesity, such as body image disturbance or periodic compulsive overeating (bulimia). Obesity is strongly related to sociocultural factors. In western countries obesity is commoner in lower than in higher social classes. Thus, the development of obesity is influenced by social status. However, also the converse is true: recent observations suggest that obese people lose social status. This is probably due to prejudice and discrimination against obese persons in the modern western society.
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PMID:Psychosocial factors in obesity. 347 94

Anorexia nervosa is a complex psychiatric disorder with endocrinologic manifestations primarily affecting adolescent females. The classic triad of presenting symptoms is weight loss in excess of 15% of ideal body weight, behavioral changes and amenorrhea (secondary or primary). The menstrual irregularities may cause the patient or family to seek gynecologic consultation before the diagnosis of primary psychiatric disorder has been made. Bulimia is a separate disease entity characterized by compulsive overeating binges followed by compensatory purging behavior to maintain a desired weight. Depending on the degree of psychiatric disturbance, purging, and ultimate body weight, such patients may or may not present with menstrual abnormalities. Hypoestrogenic hypothalamic amenorrhea in both types of patients may result in osteoporosis, stress fractures, and infertility. Obese women, in contrast to the above, most often have abnormally heavy bleeding patterns secondary to chronic anovulation. Their-short term gynecologic concerns may be cycle control or infertility, but over the long term they are at increased risk for endometrial hyperplasia and cancer.
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PMID:Managing adolescents with eating disorders. 1043 10

The ability to obtain accurate histories for a comparative study of compulsive overeating and alcoholism was severely compromised by the high degree of denial, shame and self-blame present in these two overlapping disease entities. Areas of overlap included similar progression of the disease, familial tendencies, and the presence of protein enzymatic markers for alcoholism within the bariatric population. Since both shame-based diseases tend to run in the same families, four techniques were developed to reduce the amount of shame that obese patients experienced when talking about family histories and their own compulsive, obsessive disease as it progresses through five identifiable stages. These techniques include: the use of specific non-shaming words and gestures; normalization of patients' history and experiences; education about similar biological, genetic, progressive, stress-related diseases to solidify the disease concept of obesity; and a loosely structured interview format which proceeds from the general to the specific and the past to the present, in an orderly, non-shaming fashion.
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PMID:Severe Compulsive Overeating: how to obtain a more accurate history through non-shaming, non-blaming interview techniques. 1075 10

In this paper we argue that compulsive overeating has compelling similarities to conventional drug addiction. Our case is based on their comparable clinical features, the biological mechanisms they have in common, and on evidence that the two disorders have a shared diathesis. In making the argument for overeating as an addictive behaviour, it is clearly not appropriate to include all cases of excessive food consumption in this taxon. Nor are we claiming that obesity and addiction are one and the same. However, it is proposed that Binge Eating Disorder (BED) is a phenotype particularly well-suited to such a conceptualization, and that sound clinical and scientific evidence exists to support this viewpoint. We have provided some recommendations for treatment modifications that recognize the similarities between treating drug dependence and compulsive overeating.
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PMID:Compulsive overeating as an addiction disorder. A review of theory and evidence. 1950 Jun 25

Our dramatically changed food environment--since periods in our history when food sources were highly constrained--has presented new challenges for obesity research. For example, these alterations have strongly emphasized the physiological differences between the homeostatic and the hedonic regulation of food intake--the latter being largely responsible for the pronounced increase in obesity in the past few decades. There is also increasing agreement that compulsive overeating shares many parallels with addiction disorders such as drug abuse. These factors have also fostered a renewed interest in identifying individual differences in personality and motivational systems that increase the risk for overeating and weight gain in our population. Reward sensitivity has been the focus of a recent body of compelling research, with evidence favoring two seemingly opposite points of view. On the one hand, studies have found support for a link between low reward sensitivity and obesity, whereas other evidence suggests that a strong appetitive motivation leads to overeating and weight gain. Arguments are provided to reconcile these apparently disparate theories. Finally, the role of impulsivity and its links with symptoms of attention deficit/hyperactivity disorder are discussed, as well as their respective roles in the risk profile for obesity.
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PMID:Psychobiological traits in the risk profile for overeating and weight gain. 1952 80

The question of whether (or to what degree) obesity reflects addiction to high-energy foods often narrows to the question of whether the overeating of these foods causes the same long-term neuroadaptations as are identified with the late stages of addiction. Of equal or perhaps greater interest is the question of whether common brain mechanisms mediate the acquisition and development of eating and drug-taking habits. The earliest evidence on this question is rooted in early studies of brain stimulation reward. Lateral hypothalamic electrical stimulation can be reinforcing in some conditions and can motivate feeding in others. That stimulation of the same brain region should be both reinforcing and drive inducing is paradoxical; why should an animal work to induce a drive-like state such as hunger? This is known as the drive-reward paradox. Insights into the substrates of the drive-reward paradox suggest an answer to the controversial question of whether the dopamine system--a system downstream from the stimulated fibers of the lateral hypothalamus--is more critically involved in wanting or in liking of various rewards including food and addictive drugs. That the same brain circuitry is implicated in the motivation for and the reinforcement by both food and addictive drugs extends the argument for a common mechanism underlying compulsive overeating and compulsive drug taking.
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PMID:Dual roles of dopamine in food and drug seeking: the drive-reward paradox. 2304 82

Now after many years of successful bariatric (weight-loss) surgeries directed at the obesity epidemic clinicians are reporting that some patients are replacing compulsive overeating with newly acquired compulsive disorders such as alcoholism, gambling, drugs, and other addictions like compulsive shopping and exercise. This review article explores evidence from psychiatric genetic animal and human studies that link compulsive overeating and other compulsive disorders to explain the phenomenon of addiction transfer. Possibly due to neurochemical similarities, overeating and obesity may act as protective factors reducing drug reward and addictive behaviors. In animal models of addiction withdrawal from sugar induces imbalances in the neurotransmitters, acetylcholine and dopamine, similar to opiate withdrawal. Many human neuroimaging studies have supported the concept of linking food craving to drug craving behavior. Previously our laboratory coined the term Reward Deficiency Syndrome (RDS) for common genetic determinants in predicting addictive disorders and reported that the predictive value for future RDS behaviors in subjects carrying the DRD2 Taq A1 allele was 74%. While poly genes play a role in RDS, we have also inferred that disruptions in dopamine function may predispose certain individuals to addictive behaviors and obesity. It is now known that family history of alcoholism is a significant obesity risk factor. Therefore, we hypothesize here that RDS is the root cause of substituting food addiction for other dependencies and potentially explains this recently described Phenomenon (addiction transfer) common after bariatric surgery.
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PMID:Neuro-Genetics of Reward Deficiency Syndrome (RDS) as the Root Cause of "Addiction Transfer": A New Phenomenon Common after Bariatric Surgery. 2348 16

Bulimia nervosa, binge-eating disorder, and some forms of obesity are characterised by compulsive overeating that is often precipitated by food craving. Transcranial direct current stimulation (tDCS) has been used to suppress food cravings, but there is insufficient evidence to support its application in clinical practice. Furthermore, the potential moderating role of impulsivity has not been considered. This study used a randomised within-subjects crossover design to examine whether a 20-minute session of sham-controlled bilateral tDCS to the dorsolateral prefrontal cortex (anode right/cathode left) would transiently modify food cravings and temporal discounting (TD; a measure of choice impulsivity) in 17 healthy women with frequent food cravings. Whether the effects of tDCS on food craving were moderated by individual differences in TD behaviour was also explored. Participants were exposed to food and a film of people eating, and food cravings and TD were assessed before and after active and sham stimulation. Craving for sweet but not savoury foods was reduced following real tDCS. Participants that exhibited more reflective choice behaviour were more susceptible to the anti-craving effects of tDCS than those that displayed more impulsive choice behaviour. No differences were seen in TD or food consumption after real versus sham tDCS. These findings support the efficacy of tDCS in temporarily lowering food cravings and identify the moderating role of TD behaviour.
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PMID:The effects of prefrontal cortex transcranial direct current stimulation (tDCS) on food craving and temporal discounting in women with frequent food cravings. 2465 50

Obesity has proven difficult to treat. Many approaches neglect to address the deep-rooted underlying psychological issues. This paper describes a psychodynamically oriented approach to treating compulsive overeating as an addiction. Common to all addictions is a compulsion to consume a substance or engage in a behavior, a preoccupation with using behavior and rituals, and a lifestyle marked by an inability to manage the behavior and its harmful consequences. The approach represents a shift away from primarily medical models of intervention to integrated models focusing on the psychological underpinnings of obesity. Long-term psychodynamic group psychotherapy is recommended as a primary treatment.
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PMID:A Substance Called Food: Long-Term Psychodynamic Group Treatment for Compulsive Overeating. 2607 5

This commentary discusses the evidence linking patterns of compulsive overeating, such as binge eating and grazing, with a putative psychopathological condition known commonly as 'food addiction'. It also addresses their distinctiveness as independent - albeit overlapping - clinical entities. Discussions focus largely on their respective clinical features and neuropsychobiological associations. Despite semantic issues about the appropriateness of the food-addiction label, there is accumulating evidence that some vulnerable individuals display addictive symptoms in relation to their consumption of certain highly rewarding foods. It is also argued in this paper that despite a positive relationship between obesity and addictive tendencies towards food, it is over-inclusive to model obesity as an addiction disorder, especially given the multi-faceted etiology and current pervasiveness of weight gain worldwide.
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PMID:A commentary on the associations among 'food addiction', binge eating disorder, and obesity: Overlapping conditions with idiosyncratic clinical features. 2781 64


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