Effect of Diet on Self-starvation in the Rat

Barboriak, Joseph J.; Wilson, Arthur S.

doi:10.1093/jn/102.11.1543

Cited by 7 publications

(3 citation statements)

References 17 publications

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“…Advising the patient to adopt a KG diet was prompted by two factors. First, two studies employing an activity-based-anorexia model demonstrated that a KG diet rescued the animals from self-starvation ( 20 ); and a high-fat diet (although not ketogenic) prevented the animals’ self starvation ( 21 ). Secondly, the KG diet has an impressive record of safety and efficacy for treating seizure disorders in children, and has been used continuously since the 1920s ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report

Scolnick

Zupec‐Kania²,

Calabrese

et al. 2020

Front. Psychiatry

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Background Chronic anorexia nervosa is a tragic disease with no known effective pharmacological or behavioral treatment. We report the case of a 29 year-old woman who struggled with severe and enduring anorexia nervosa for 15 years, and experienced a complete recovery following a novel treatment of adopting a ketogenic diet followed by ketamine infusions. Her remission has persisted for over 6 months. Case Presentation At age 14.5, the patient embarked on an effort to “eat healthy.” She quickly lost control of the dieting, developed associated compulsions and obsessions about food, body dissatisfaction, emotional lability, and lost nearly 13.6 kilograms (30 pounds). She was hospitalized for 6 weeks, and while she regained some weight, she did not attain full weight restoration. For 15 years, she continued to eat in a restrictive manner, exercise compulsively, and have intermittent periods of alcohol dependence. Nevertheless, she always hoped to get well, and at age 29, she began a novel treatment for anorexia nervosa. Conclusions This is the first report of a ketogenic diet used specifically for the treatment of anorexia nervosa, followed by a short series of titrated IV ketamine infusions leading to complete remission of severe and enduring anorexia nervosa, with weight restoration, and sustained cessation of cognitive and behavioral symptoms, for 6 months. Although these treatments were used sequentially the relationship between these modalities, and possible synergy, is unclear, and deserves further study. Complete and sustained remission of chronic anorexia nervosa is quite rare, and the novel use of a ketogenic diet and IV ketamine treatment in this potentially lethal condition suggests avenues for further research, and hope for patients and their families.

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Section: Discussionmentioning

confidence: 99%

Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report

Scolnick

Zupec‐Kania²,

Calabrese

et al. 2020

Front. Psychiatry

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“…Thus, it is possible that increasing the fat and protein content of an AN refeeding diet may be beneficial. Indeed, during the timed food restriction, induction phase of ABA, a high fat diet can prevent AN in rats [ 33 , 34 ]. This effect is due to both the preservation of caloric intake during the AN induction phase and decreased physical activity relative to standard rat chow which is a high carbohydrate food [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats

et al. 2016

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BackgroundThere is currently no standard clinical refeeding diet for the treatment of anorexia nervosa (AN). To provide the most efficacious AN clinical care, it is necessary to define the metabolic effects of current refeeding diets.MethodsAn activity-based model of anorexia nervosa (AN) was used in female rats. AN was induced over 7d by timed access to low fat (LF) diet with free access to a running wheel. Plasma hormones/metabolites and body composition were assessed at baseline, AN diagnosis (day 0), and following 28d of refeeding on LF diet. Energy balance and expenditure were measured via continuous indirect calorimetry on days −3 to +3.ResultsAN induction caused stress as indicated by higher levels of corticosterone versus controls (p < 0.0001). The rate of weight gain during refeeding was higher in AN rats than controls (p = 0.0188), despite lower overall energy intake (p < 0.0001). This was possible due to lower total energy expenditure (TEE) at the time of AN diagnosis which remained significantly lower during the entire refeeding period, driven by markedly lower resting energy expenditure (REE). AN rats exhibited lower lipid accumulation in visceral adipose tissues (VAT) but much higher liver accumulation (62 % higher in AN than control; p < 0.05) while maintaining the same total body weight as controls. It is possible that liver lipid accumulation was caused by overfeeding of carbohydrate suggesting that a lower carbohydrate, higher fat diet may be beneficial during AN treatment. To test whether such a diet would be accepted clinically, we conducted a study in adolescent female AN patients which showed equivalent palatability and acceptability for LF and moderate fat diets. In addition, this diet was feasible to provide clinically during inpatient treatment in this population.ConclusionRefeeding a LF diet to restore body weight in female AN rats caused depressed TEE and REE which facilitated rapid regain. However, this weight gain was metabolically unhealthy as it resulted in elevated lipid accumulation in the liver. It is necessary to investigate the use of other diets, such as lower carbohydrate, moderate fat diets, in pre-clinical models to develop the optimal clinical refeeding diets for AN.

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“…Two animal clinical trials, one from 1971 and one from 2008 demonstrated that a very high fat diet interrupts self-starvation in a rodent model of anorexia (Barbotiak and Wilson, 1971 ; Brown et al, 2008 ). The activity based anorexia model, although not perfect, is considered the best animal model because it replicates the self-starvation, hyperactivity, and changes in leptin, ghrelin, and cortisol seen in human AN (Gutierrez, 2013 ).…”

Section: Methodsmentioning

confidence: 99%

Hypothesis: Clues From Mammalian Hibernation for Treating Patients With Anorexia Nervosa

Scolnick

2018

Front. Psychol.

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This hypothesis is that anorexia nervosa (AN) is a biologically driven disorder, and mammalian hibernation may offer clues to its pathogenesis. Using this approach, this hypothesis offers suggestions for employing heart rate variability as an early diagnostic test for AN; employing the ketogenic diet for refeeding patients, attending to omega 3:6 ratio of polyunsaturated fatty acids (PUFAs) in the refeeding diet; and exploring clinical trials of the endocannabinoid-like agent, palmitoylethanolamde for patients with AN. This hypothesis also explores the role of lipids and autoimmune phenomena in AN, and suggest a lipodomics study to search for antibodies in the serum on patients with AN.

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Effect of Diet on Self-starvation in the Rat

Cited by 7 publications

References 17 publications

Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report

Remission from Chronic Anorexia Nervosa With Ketogenic Diet and Ketamine: Case Report

Weight restoration on a high carbohydrate refeeding diet promotes rapid weight regain and hepatic lipid accumulation in female anorexic rats

Hypothesis: Clues From Mammalian Hibernation for Treating Patients With Anorexia Nervosa

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