Object Deep brain stimulation (DBS) of the lateral hypothalamic area (LHA) has been suggested as a potential treatment for intractable obesity. The authors present the 2-year safety results as well as early efficacy and metabolic effects in 3 patients undergoing bilateral LHA DBS in the first study of this approach in humans. Methods Three patients meeting strict criteria for intractable obesity, including failed bariatric surgery, under-went bilateral implantation of LHA DBS electrodes as part of an institutional review board– and FDA-approved pilot study. The primary focus of the study was safety; however, the authors also received approval to collect data on early efficacy including weight change and energy metabolism. Results No serious adverse effects, including detrimental psychological consequences, were observed with continuous LHA DBS after a mean follow-up of 35 months (range 30–39 months). Three-dimensional nonlinear transformation of postoperative imaging superimposed onto brain atlas anatomy was used to confirm and study DBS contact proximity to the LHA. No significant weight loss trends were seen when DBS was programmed using standard settings derived from movement disorder DBS surgery. However, promising weight loss trends have been observed when monopolar DBS stimulation has been applied via specific contacts found to increase the resting metabolic rate measured in a respiratory chamber. Conclusions Deep brain stimulation of the LHA may be applied safely to humans with intractable obesity. Early evidence for some weight loss under metabolically optimized settings provides the first “proof of principle” for this novel antiobesity strategy. A larger follow-up study focused on efficacy along with a more rigorous metabolic analysis is planned to further explore the benefits and therapeutic mechanism behind this investigational therapy.

Although studies have examined the personality characteristics of bulimic individuals, these studies have been few and characterized by methodological shortcomings. To address these difficulties, this study compared 20 bulimic women and 20 non‐eating‐disordered normal weight controls on a variety of standardized psychological questionnaires. A comprehensive cognitive behavioral model of bulimia (Mizes, 1985) was evaluated by this comparison. Results showed that bulimic individuals showed significantly more pathological personality characteristics than control subjects. In specific, bulimics showed evidence of significant anxiety, depression, restrictive eating standards, low self‐efficacy for dieting, distorted eating‐related attitudes (i.e., weight as basis of self‐esteem, striving for perfect self‐control), self‐control deficits, generalized irrational thinking styles (particularly helplessness and demand for approval), and body image distortion. A trend was found suggesting discomfort in social situations. Contrary to expectations, assertion deficits and concerns about sexual functioning were not found.

Objective: This project was designed to develop and test the psychometric properties and factor structure of a revision of the Mizes Anorectic Cognitions questionnaire (MAC). The goals of the revision were to improve the reliability and discriminant validity of the Weight and Approval subscale and to equalize the length of the three subscales. Also, the study compared the original MAC and the MAC-R in terms of their psychometric properties. Method: Twenty-four new items were developed for potential inclusion in the MAC-R, in addition to the original 33 items of the MAC. These items were administered to 205 eating disorder patients from five eating disorder clinics or programs, including inpatient, outpatient, and residential treatment settings that served diverse patient populations. Additionally, other measures of eating disorder constructs were administered to assess construct validity. Results: Factor analysis of the large pool of items and item reduction resulted in the final 24-item MAC-R, each subscale being eight items in length. Results showed that the MAC-R highly correlated with the MAC and other eating disorder questionnaires. Reliability of the MAC-R was improved over that of the MAC. Two subscales of the MAC-R discriminated among diagnostic groups, whereas the original MAC did not, indicating improved sensitivity of the revised scale. Discussion: The MAC-R appears to be an improvement over the original MAC. It provides useful information on the cognitions of eating-disordered patients and merits further investigation into its psychometric properties.

The present study sought to determine the self‐help dieting strategies used by college men and women. There were 204 adults (102 males, 102 females) asked (1) the degree of importance placed on achieving and maintaining their ideal weight, (2) the reasons (i. e., health, appearance, or psychological) for dieting, and (3) the specific types of food restriction and physical activity methods used. Results indicated that females were much more likely to have actively dieted during the past 6 months and were more likely to see a discrepancy between their real and ideal weight. Furthermore, females placed a much higher importance on the appearance benefits of maintaining an ideal weight. Females were much more likely to engage in physical activity strategies (both appropriate and inappropriate) primarily for weight reduction than males. Similarly, females were much more likely to engage in both dangerous and safe food restriction strategies than males. The results are discussed, and implications for future research are offered.

Objective This project was designed to develop and test the psychometric properties and factor structure of a revision of the Mizes Anorectic Cognitions questionnaire (MAC). The goals of the revision were to improve the reliability and discriminant validity of the Weight and Approval subscale and to equalize the length of the three subscales. Also, the study compared the original MAC and the MAC‐R in terms of their psychometric properties. Method Twenty‐four new items were developed for potential inclusion in the MAC‐R, in addition to the original 33 items of the MAC. These items were administered to 205 eating disorder patients from five eating disorder clinics or programs, including inpatient, outpatient, and residential treatment settings that served diverse patient populations. Additionally, other measures of eating disorder constructs were administered to assess construct validity. Results Factor analysis of the large pool of items and item reduction resulted in the final 24‐item MAC‐R, each subscale being eight items in length. Results showed that the MAC‐R highly correlated with the MAC and other eating disorder questionnaires. Reliability of the MAC‐R was improved over that of the MAC. Two subscales of the MAC‐R discriminated among diagnostic groups, whereas the original MAC did not, indicating improved sensitivity of the revised scale. Discussion The MAC‐R appears to be an improvement over the original MAC. It provides useful information on the cognitions of eating‐disordered patients and merits further investigation into its psychometric properties. © 2000 by John Wiley & Sons, Inc. Int J Eat Disord 28: 415–421, 2000.

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