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

Behaviour therapies using conditioning principles have been successful in the treatment of some psychopatological eating behaviours. Such have been the cases for anorexia nervosae in adolescents and adults, refusal to eat in the young child and difficulties of swallowing. Some of these cases are described. Research has been done in different countries on the applications of these methods to the treatment of obesity caused by overeating which appears very frequently in our societies. Systematic and covert desensitization and operant conditioning using positive reinforcements are more frequently used in these behaviour modification procedures than aversive methods. More recently, researches on self-control (self-reward and self-punishment) have shown it as a very efficient tool for inducing weight loss. These methods using self-control have been applied to large populations: after a first, careful examination of the patient's eating behaviour, the program of reinforcement is established. It can be partially controlled by written instructions and letters. Results are already encouraging although they need to be followed up. But more research should be done on overeating behaviours, the way they appear and are maintained and on different programs of reinforcement for weight loss.
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PMID:[Behavior therapy in disorders of dietary behavior]. 1 79

Obesity results when the ingestion of energy exceeds its utilization, leading to an excessive expansion of the adipose tissue mass. Current pharmacological therapy for the obese patient focuses primarily on reducing energy intake. Anorectic agents reduce food consumption by modifying central systems in the brain which are involved in appetite regulation. These agents are reviewed in terms of mechanism of action, and clinical safety and efficacy in suppressing appetite and promoting weight loss. Newer anorectic agents which are being evaluated currently in clinical and animal studies are described. Clinical assessments of therapeutic regimens utilizing the thyroid hormones and human chorionic gonadotropin are evaluated. Finally, an overview of novel pharmacological approaches to the treatment of obesity is presented.
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PMID:Pharmacological treatment of obesity. 3 Jul 32

Three cases of severe anorexia are reported. It results in a strong protein malabsorption with hepatic steatosis and in a syndrome of mental depression which needed the re-establishment of the intestinal-continuity. Although a mild post-operative anorexia is regular and contributes to the weight loss, massive anorexia must be considered as a new and redoubtable unpredictible complication of the surgical treatment for obesity, which may hinder the intestinal adaptation and increase the protein malabsorption.
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PMID:[Anorexia: a redoubtable complication of the surgical treatment for obesity after jejuno ileal by-pass (author's transl)]. 9 23

Results of a study involving dynamic testing of hypothalamic-pituitary function in 26 patients attending the Gynecologic Reproductive Endocrine Service at John Hopkins University are presented. Patients included women with primary amenorrhea and few if any secondary sex characteristics (Group 1), primary amenorrhea with secondary sexual development (Group 2), secondary amenorrhea (Group 3), and amenorrhea with pituitary or supracellar tumors (Group 4). Subjects received a combined luteinizing hormone-releasing hormone (LH-RH)-clomiphene test and an estrogen provocation test. 100 mcg LH-RH was administered and blood samples obtained at 15, 30, and 45 minutes and at 1, 1 1/2, 2, 2 1/2, and 3 hours. 100 mg of clomiphene citrate was given daily for 7 days (the dosage of clomiphene varied somewhat with history of preexisting conditions). Blood was assayed for serum LH and follicle stimulating hormone (FSH) In the provocation test, 1 mg of estradiol was given and blood samples drawn 48, 72, and 96 hours thereafter. In Group 1, 3 patients were unresponsive to LH-RH stimulation and were without change in the baseline after either clomiphene or Enovid suppression. 3 other patients in this group had a fairly normal delta percent peak LH response to LH-RH. However, baseline or the delta percent peak LH response to LH-RH remained unchanged after clomiphene. The 7th patient in Group 1 has an immature hypothalamus. Group 2 consisted of 3 patients. 2 were found to have elevated baseline values of LH with normal FSH levels. 1 had a poor but mature response to clomiphene of the negative estrogen feedbacK. LH peak remained unchanged in response to LH-RH after clomiphene and estrogen response was negative. 2 of these patients conceived and 1 was diagnosed as able to conceive. In Group 3, 2 patients with massive obesity showed elevated serum LH values, 2 patients were infertile after oral contraceptives and were stimulated with human chorionic gonadotropin and clomiphene, 7 had anorexia and were diagnosed with the aestrogen provocation test. The patients in Group 4 were all studied in an effort to assess the pituitary gonadotropin reserve. These tests can be useful in this regard but must be considered in light of the patient's history and physical findings. Thus initial diagnoses were further subdivided by this method of dynamic testing. It helps establish areas of further testing.
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PMID:Dynamic testing of hypothalamic-pituitary function in abnormalities of ovulation. 34 92

Fifty women with refractory obesity received fenfluramine for 20 weeks. Every two weeks details of weight change, drug dose, degree of anorexia, and any side effects were recorded and plasma was obtained for fenfluramine and norfenfluramine measurements. Of the 41 patients available for final analysis 26 achieved a maximum plateau dose of 160 mg/day. Plasma fenfluramine concentrations did not correlate with the degree of anorexia or with the incidence of side effects other than the severity of dream disturbance. There was a highly significant relation between weight loss and plasma fenfluramine and norfenfluramine concentrations and also between weight loss and the presence of sustained anorexia. Women who achieved mean plateau concentrations over 200 ng/ml lost a mean 8.8 kg while those with concentrations less than 100 ng/ml lost a mean of only 2.1 kg. When fenfluramine is prescribed in refractory obesity the dose should be increased stepwise until either satisfactory weight loss is achieved or troublesome side effects appear.
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PMID:Plasma fenfluramine levels, weight loss, and side effects. 58 67

An account is given for non-psychiatric physicians of the psychodynamic, psychiatric, and psychoterapeutic aspects of obesity. A primarily psychoanalytic explanation is presented of the unconscious meanings that the words involved assume in children and "fixed" obese subjects with regression to the "oral stage" of their libido development. The meanings associated with food and feeding are examined in an interpersonal, familial, social and environmental context. A summary psychopathological classification is made of obesity, together with an evaluation of what appears to be the direct opposite of obesity, i. e. mental anorexia. Lastly, the relevant prognostic and therapeutic criteria are considered. The latter are mainly centred on the various forms of psychotherapeutic intervention (individual, group, analytical and inspiration therapy, etc.).
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PMID:[Psychiatric (psychodynamic and psychotherapeutic) aspects of obesity]. 68 56

Weight and height data from two studies were recomputed, and original data were computed using a Weight Index formula that accounts for the interaction of actual weight/height changes in growing children and compares this ratio with that of normed weight/height ratios for equal-aged children. Recomputing the data of one study showed that the Weight Index is a more sensitive procedure for assessing long-term behavioral treatment of obesity for girls than weight alone. Recomputing the data of a second study showed that the Weight Index formula is consistent for boys and girls and is a more sensitive procedure for assessing long-term effects of a variety of medical treatments for obesity than the Ponderal Index or weight alone. Computation of the data for 17 "normal" children in a preschool class showed a zero Weight Index score before and after a six-month interval elapsed without treatment. The procedure may be useful in assessing ponderosity or anorexia over intervals of six months or more with growing children or difference between actual and normed weight over shorter intervals.
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PMID:An index for assessing weight change in children: weight/height ratios. 70 Dec 5

The treatment of obesity is one of the major measures available today in the field of preventive medicine. In particular, the coronary epidemic of Western civilisation would be halted, and most cases of maturity-onset diabetes prevented, if obesity were to be treated effectively. Anorectic drugs act mainly on the satiety centre in the hypothalamus to produce anorexia. They also have various metabolic effects involving fat and carbohydrate metabolism, but many of these may be secondary to loss of weight. Most of the drugs are related directly or indirectly to amphetamine and in addition act by increasing general physical activity. Anorectic drugs tend to lose their effect after some months, and part of this reduction in effect may be due to chemical alterations produced by the drugs in the brain. All the drugs, with the exception of fenfluramine, have a stimulant effect on the central nervous system in some individuals, resulting in restlessness and nervousness, irritability and insomnia. Fenfluramine commonly produces drowsiness in normal doses, but has stimulant effects with overdosage. Dexamphetamine, phenmetrazine and benzphetamine all tend to cause euphoria and the risk of addiction is therefore considerable. Euphoria occasionally occurs with diethylpropion, phentermine and chlorphentermine, but to a much lesser extent. Side-effects also occur due to sympathetic stimulation and gastro-intestinal irritation. These side-effects may cause some individuals to stop taking the drug, but are never serious or dangerous. Drug interactions may occur with monoamine oxidase inhibitors and to a clinically unimportant extent, with antihypertensive drugs. The anorectic drugs have a very definite part to play in the treatment of obesity, mainly for those individuals who have altered their eating habits but have come to a plateau of weight which they find difficult to get below. The drugs are best given in a long-acting form and can safely be continued as long as weight loss persists, provided that the clinician exercises careful supervision. Dexamphetamine, phenmetrazine and benzphetamine should rarely be used because of the danger of addiction, and chlorphentermine is potentially hazardous for long-term use. Diethylpropion emerges as the drug of first choice, as fenfluramine has a tendency to cause depression and has a higher incidence of side-effects. Fenfluramine is mainly useful for people who are especially tense and for obese maturity-onset diabetics who have been unable to lose weight with the biguanides. Mazindol and phentermine appear to be useful as alternative drugs.
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PMID:Anorectic drugs: use in general practice. 78 35

Hyperphagia and obesity are produced both by parasagittal knife cuts through the medial hypothalamus and by coronal knife cuts through the posterior hypothalamus. The results of this study indicate that the two types of cuts produce their overeating effect by severing the same neural pathway. Experiment 1 demonstrated that unilateral parasagittal knife cuts combined with contralateral coronal cuts in either the posterior hypothalamus or the midbrain significantly increase food intake and body weight. Experiment 2 revealed that bilateral parasagittal cuts and bilateral coronal cuts in the hypothalamus produce qualitatively similar effects on food intake, diurnal ingestive pattern, finickiness, and amphetamine anorexia. The two types of cuts differentially altered water intake, however. In Experiment 3, coronal cuts in the posterior hypothalamus, like parasagittal cuts in the medial hypothalamus, were found to increase the food intake and body weight of rats previously given bilateral parasagittal transections through the lateral perifornical region. The neuroanatomy and neurochemistry of the longitudinal feeding inhibitory pathway suggested by these results are discussed.
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PMID:Hyperphagia and obesity produced by parasagittal and coronal hypothalamic knife cuts: further evidence for a longitudinal feeding inhibitory pathway. 92 5

The objective of this paper is to characterize the fat cow syndrome. This condition refers to a combination of metabolic, digestive, infectious, and reproductive conditions which affects the obese periparturient cow. The condition develops primarily due to faulty feed management which permits excessive consumption of unbalanced diets. The syndrome is frequently a herd problem characterized by a high morbidity and mortality due to an increase in disease in periparturient cows. Clinical signs include depression, anorexia, ketonuria, marked decrease in production, progressive debilitation, weakness, nervous signs, and an elevation in temperature due to infectious disease. The obesity is generalized throughout the body with extensive fatty metamorphosis in the liver. Histological changes are primarily in the liver and kidney. Treatment of the condition consists of feeding a balanced diet, symptomatic treatment, and good supportive care. The condition can be prevented by feeding a balanced diet according to nutrient requirements of the National Research Council.
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PMID:Fat cow syndrome. 96 40


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