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

The problem of relationship between obesity and psychological distress is debated in the literature wherein a lot of studies exists with controversial results. The phenomenon of obesity is actually considered with criteria aimed to evaluate almost exclusively the weight excess. Even if such criteria have the advantage to permit a scientific communicability, in the clinical settings the focus of obesity involves medical as well psychiatric aspects. The psychological aspects that may have a relevant role in the development of obesity must be recognized and distinguished from those that may be a direct consequence of obesity itself. In fact, certain obese subjects (no-binge obese) may not experience any psychological distress during lifetime whereas other obese subjects (binge obese) may have a significant and highly distressing psychological suffering. Therefore, obese persons seem to represent a heterogeneous population with different adaptive characteristics who may show several and complex psychological mechanisms and distresses. A psychotherapeutic approach seems to be essential to treat such psychological distress that may heavily concur to the development and the maintenance of obesity.
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PMID:[Psychopathologic patterns in obesity]. 1669 20

Psychological stress has been implicated as a cause of several psychosomatic disorders, but also as a factor that can unfavourably influence many diseases including diabetes mellitus. Measure of psychological stress in diabetes was performed by Psychological Stress Measure (PSM), a validated instrument, designed using 49 items drawn from descriptors generated by focus groups on stress. Clinical and psychological framework was assessed in a cohort of 100 type 2 diabetic patients (30 m, 70 f), aged 66.99 +/- 13.68 years considering disease grade, complications and level of instruction. Three other questionnaires were administered concurrently to all patients: Sickness Impact Profile (SIP), Functional Living Index (FLI) and SF-36 QOL. ANOVA statistical testing and Spearman correlation matrix were used also vs socio-cultural and clinical profile. Gender, obesity, diet compliance, smoking do not affect PSM response. Hypertensive patients and those with family history of diabetes show lower PSM scores, according to a sort of moderator effect on stress of concurrent and/or previous experience with chronic disease. Neuromuscular ailments are more prevalent in women; men vs women experience severe limitations of their working capacities and relational possibilities, with severe discomfort. In the whole, higher scores of PSM (greater stress p < 0.01) and lower scores of FLI (fair well-being perception; p < 0.01) are reciprocally related inside any school instruction level. Despite the great reciprocal association of the PSM vs FLI and SIP, no significant correlation is found between PSM vs SF-36 QOL. Socio-cultural elements interfere, and particularly instruction level quantified as school grades achieved, with the manner of living their disease. Interventions on psychological distress of type 2 diabetes mellitus patients is warranted, specially in the groups with lower levels of instruction which may need an attentive strategy for achieving a satisfactory coping with this disease.
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PMID:Psychological stress measure in type 2 diabetes. 1670 51

Obesity has epidemic proportions in Western societies and, because of its significant association with morbidity and mortality, is a major public health issue. Excessive daytime sleepiness (EDS) and fatigue (tiredness without increased sleep propensity)--which have been associated with obesity--have a significant impact on individual well-being and public safety. In this article, we review data that challenge the belief that sleep apnea and sleep disruption per se are the primary determinants of obesity-related daytime sleepiness and fatigue. Specifically, it appears that obesity per se is associated with objective and subjective daytime sleepiness compared to normal-weight controls regardless of sleep apnea and sleep loss. Indeed, obese patients without sleep apnea are sleepier compared to nonobese controls whereas within the morbidly obese, those who have high sleep efficiency at night are sleepier than those who have low sleep efficiency. In addition, in recent studies based on large random samples of the general population, the primary determinants of subjective EDS were depression and metabolic disturbances, that is, obesity/diabetes, and not sleep apnea or objective sleep disruption. Furthermore, sleepiness and fatigue are very prevalent in conditions associated with insulin resistance, for instance, the polycystic ovary syndrome (PCOS), independently of sleep apnea or obesity, or in conditions of insufficient physical activity. On the basis of these data, we propose that obesity-related objective daytime sleepiness and fatigue are associated primarily with metabolic and psychological factors and less with sleep apnea and sleep disruption per se. Furthermore, we suggest that objective sleepiness is primarily related to metabolic factors, whereas fatigue appears to be related to psychological distress. Finally, based on data from studies in normal controls and patients with sleep disorders, we propose that the interaction of the hypothalamic-pituitary-adrenal (HPA) axis and proinflammatory cytokines determines the level of sleep/arousal within the 24-h cycle, that is, "hypercortisolemia" plus hypercytokinemia is associated with low sleep efficiency and fatigue, whereas "eucortisolemia" or "hypocortisolemia" plus hypercytokinemia is associated with high sleep efficiency and objective sleepiness.
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PMID:Obesity-related sleepiness and fatigue: the role of the stress system and cytokines. 1714 48

The purpose of the present study was to understand differences in obese/overweight individuals who do and do not seek ongoing external assistance for weight loss. Help-seeking was examined as a dichotomous and as a continuous variable. Measures of body mass index, comorbid medical conditions, socioeconomic status, psychological distress, disordered eating behavior, body image, and obesity-related knowledge were administered to a community sample of 120 overweight women (age: 22-65 y, BMI: 25-63 kg/m(2)). Fewer predictors of help-seeking were identified when measuring help-seeking as a dichotomy than when measuring it as a continuum. All predictors were from psychosocial domains, with obesity-related knowledge being the strongest, most consistent predictor. Help-seeking for weight control in a community sample of overweight and obese individuals appears to be motivated by psychological aspects of obesity, rather than obesity's physical or medical burden.
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PMID:Taking action to lose weight: toward an understanding of individual differences. 1733 89

Women with polycystic ovary syndrome (PCOS) fail to conform with societal norms for outer appearance. Many PCOS patients thus feel stigmatized in the sense of a loss of "feminine identity." In addition to somatic impairment, mood disturbances such as depression and limitations in emotional well-being, quality of life, and life satisfaction, the diagnosis of PCOS also has a negative impact on sexual self-worth and sexual satisfaction. Both obesity and hirsutism are major determinants of the physical component of quality of life in affected women. However, its psychological aspect appears to be inherent and specific for PCOS. Confirmation of the diagnosis and provision of detailed information to affected women, together with the availability of interdisciplinary treatment aimed at improving PCOS-related symptoms, such as hirsutism, obesity, menstrual irregularity, and infertility, will also reduce psychological distress and improve sexual self-worth. New treatment options, including insulin sensitizers, psychological counseling, and participation in a PCOS support group, are likely to further improve life satisfaction and coping of affected women.
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PMID:Mood and sexual function in polycystic ovary syndrome. 1818 Oct 82

The study examined the simultaneous longitudinal relationships of cigarette use in adolescence to continuing cigarette use, psychological distress, physical activity, subjective rating of health in emerging adulthood and, finally, to body mass index (BMI) in early adulthood. The study utilized data (N=414) from a drug abuse prevention trial, Midwestern Prevention Project, with subjects participating from ages 11-34 years. Structural equation modeling showed that cigarette use in early adolescence had direct paths to distress in the beginning of emerging adulthood, which in turn had significant relationships to cigarette use, physical activity, and subjective rating of health in mid-emerging adulthood. Finally, both cigarette use and physical activity had significant negative relationships to BMI in early adulthood. Results suggest that prevention programs that have been previously applied to either cigarette use or distress prevention might be re-examined for their potential to also affect obesity risk in adulthood.
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PMID:Early cigarette use and psychological distress as predictors of obesity risk in adulthood. 1823 97

In this paper, we use data collected from a statewide probability sample of Texas, USA adults to test whether perceptions of neighborhood disorder are associated with increased risk of obesity. Building on prior research, we also test whether the association between neighborhood disorder and obesity is mediated by psychological, physiological, and behavioral mechanisms. We propose and test a theoretical model which suggests that psychological distress is a lynchpin mechanism that links neighborhood disorder with obesity risk through chronic activation of the physiological stress response, poor self-rated overall diet quality, and irregular exercise. The results of our analyses are generally consistent with this theoretical model. We find that neighborhood disorder is associated with increased risk of obesity, and this association is entirely mediated by psychological distress. We also observe that the positive association between psychological distress and obesity is fully mediated by physiological distress and poor self-rated overall diet quality and only partially mediated by irregular exercise.
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PMID:An examination of processes linking perceived neighborhood disorder and obesity. 1843 64

Psychosocial stress is associated with risk of obesity although little is known about stress-induced biological mechanisms of obesity. We examined the potential mediating role of inflammatory processes. Data were collected from a nationally representative sample of 7540 individuals (54% women, mean age 46.8+/-15.4 years), from the Scottish Health Surveys. We calculated risk estimates of obesity for increasing numbers of psychosocial stressors (based on social position, education, psychological distress and marital/partner discord) using logistic regression analyses. Obesity was assessed using body mass index and central obesity using waist circumference. Potential mediators included inflammatory markers (C-reactive protein and fibrinogen) and health behaviours (physical activity, smoking, alcohol, and dietary intake). The unadjusted odds ratio of obesity for three or more psychosocial stressors was 1.81 (95% CI, 1.39-2.36, p<0.001). In multivariate analyses that adjusted for age, gender, health behaviours and inflammatory markers the association between psychosocial stress and obesity was attenuated but remained significant (1.49, 1.11-2.00, p<0.001). Inflammatory markers independently accounted for approximately 25% of the association between stress and obesity. We found similar associations in separate analyses of psychosocial stress and central obesity, although results were confounded by overall obesity. In summary, inflammatory processes appear to be an important intermediate pathway in the association between psychosocial stress and obesity.
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PMID:Inflammation as an intermediate pathway in the association between psychosocial stress and obesity. 1847 84

Obesity, excessive daytime sleepiness (EDS), and self-reported short sleep duration appear to be on the rise, while there is evidence that obesity and these sleep disorders are strongly connected. In this paper, we review data that challenge the common belief that the sleep apnoea and sleep loss, frequently associated with obesity, are the primary determinants of obesity-related objective daytime sleepiness and subjective fatigue (tiredness without increased sleep propensity). Specifically, obesity is associated with objective and subjective EDS regardless of the presence of sleep apnoea. The association between obesity and EDS was confirmed in recent studies of large random samples of the general population or clinical samples, which showed that the primary determinants of subjective EDS were depression, metabolic disturbances, i.e. obesity/diabetes and insulin resistance, and lack of physical activity, and, secondarily, sleep apnoea or sleep loss. Paradoxically, within the obese, with or without sleep apnoea, those who slept objectively better at night are sleepier (objectively) during the day than those who slept worse. The distinguishing factor between those that slept better vs. those that slept worse appears to be level of emotional stress. Furthermore, many studies reported that obesity is associated with self-reported short sleep duration; however, it appears that short sleep duration is a marker of emotional stress rather than a reflection of true sleep loss. Based on these data, we propose that obesity-related deeper sleep and objective EDS are primarily related to metabolic disturbances, whereas obesity-related poorer sleep and subjective fatigue appear to be the result of psychological distress. Furthermore, based on data from studies in normal controls and patients with sleep disorders, it appears that the interaction of the hypothalamic-pituitary-adrenal (HPA) axis and pro-inflammatory cytokines determines the level of sleep/arousal within the 24-hour cycle, i.e. "eucortisolemia" or "hypocortisolemia" plus hypercytokinemia is associated with high sleep efficiency and objective sleepiness, whereas "hypercortisolemia" plus hypercytokinemia is associated with low sleep efficiency and fatigue. In conclusion, we propose that the above-reviewed data provide the basis for a meaningful phenotypic and pathophysiologic sub-typing of obesity. One subtype is associated with emotional distress, poor sleep, fatigue, HPA axis "hyperactivity," and hypercytokinemia while the other is associated with non-distress, better sleep but more sleepiness, HPA axis "normo or hypoactivity," and hypercytokinemia. This proposed sub-typing may lead to novel, preventive and therapeutic strategies for obesity and its associated sleep disturbances.
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PMID:Obesity and sleep disturbances: meaningful sub-typing of obesity. 1894 83

This study examined the clinical significance of self-reported frequency of time spent dieting in obese patients with binge eating disorder (BED). A total of 207 treatment-seeking obese BED patients (57 men and 150 women) were dichotomized by dieting frequency and gender and compared on a number of historical, psychological, and metabolic variables. Frequent dieters reported significantly earlier age of onset for binge eating, dieting, and obesity, more episodes of weight cycling, greater weight suppression, and greater eating disorder pathology than infrequent dieters; no differences, however, emerged on current binge eating frequency or psychological distress. Among women but not among men, frequent dieters had consistently lower chances of abnormalities in total cholesterol, high-density lipoprotein (HDL) cholesterol, and the total/HDL cholesterol ratio while infrequent dieters had greater chances of abnormalities on these variables. Dietary restraint was inversely correlated with abnormalities in triglycerides, HDL cholesterol, and the total/HDL cholesterol ratio but was unrelated to low-density lipoprotein (LDL) cholesterol. In summary, frequent dieters of both genders had greater lifetime and current eating and weight concerns, and in women, decreased chance of metabolic abnormalities than infrequent dieters. Our findings suggest that frequent dieting attempts, particularly in women, are associated with greater eating disorder pathology but may have a beneficial effect on metabolic functioning and cardiovascular disease risk independent of actual weight status. These findings may have implications for clinical advice provided to obese BED patients.
Obesity (Silver Spring) 2009 Apr
PMID:Dieting frequency in obese patients with binge eating disorder: behavioral and metabolic correlates. 1916 72


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