Hunger and Satiety in Anorexia and Bulimia Nervosaa

Halmi, Katherine A.; Sunday, Suzanne R.; Puglisi, Angela; Marchi, Peggy

doi:10.1111/j.1749-6632.1989.tb53264.x

Cited by 37 publications

(20 citation statements)

References 5 publications

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“…The underlying pathophysiologic mechanisms that contribute to this aberrant behavior are complex and poorly understood. Individuals with BN report altered perceptions in hunger, fullness, and satiety [1]. Laboratory studies have shown that cholecystokinin (CCK) response, a satiety producing gastric hormone, following a meal is decreased in individuals with active BN when compared to matched healthy controls [2-4].…”

Section: Introductionmentioning

confidence: 99%

CCK response in bulimia nervosa and following remission

Hannon-Engel¹,

Filin²,

Wolfe³

2013

Physiology & Behavior

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The core defining features of bulimia nervosa (BN) are repeated binge eating episodes and inappropriate compensatory (e.g. purging) behavior. Previous studies suggest an abnormal postprandial response in the satiety-signaling peptide cholecystokinin (CCK) in persons with BN. It is unknown whether this altered response persists following remission or if it may be a potential target for the development of clinical treatment strategies. To examine the nature of this altered response, this study assessed whether CCK normalizes following remission from BN (RBN). This study prospectively evaluated the plasma CCK response and corresponding eating behavior-related ratings (e.g. satiety, fullness, hunger, urge to binge and vomit) in individuals with BN-purging subtype (n=10), RBN-purging subtype (n =14), and healthy controls (CON, n=13) at baseline, +15, +30, and +60 minutes following the ingestion of a standardized liquid test meal. Subject groups did not significantly differ in CCK response to the test meal. A significant relationship between CCK response and satiety ratings was observed in the RBN group (r=.59, p<.05 two-tailed). A new and unanticipated finding in the BN group was a significant relationship between CCK response and ratings of “urge to vomit” (r=.86, p < .01, two-tailed). Unlike previous investigations CCK response did not differ in BN and CON groups. Thus the role of symptom severity remains an area of further investigation. Additionally, findings suggest that in this sample, CCK functioning following remission from BN-purging subtype is not different from controls. It remains unknown whether or not CCK functioning may be a protective or liability factor in the stabilization and recovery process. Replication studies utilizing a larger sample size are needed to further elucidate the role of CCK in recovery from BN and its potential target of related novel treatment strategies.

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Section: Introductionmentioning

confidence: 99%

CCK response in bulimia nervosa and following remission

Hannon-Engel¹,

Filin²,

Wolfe³

2013

Physiology & Behavior

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“…Over the course of eating episodes, women with BN report little increase in fullness relative to control participants. 62 They also report less fullness at the end of meals 63,64 ; and less decrease in their desire for foods that have been recently eaten (sensory specific satiety 65 than controls). Satiety-related physiological disturbances that are associated with binge eating, in cholecystokinin, 66 ghrelin, 67 peptide YY, 68 and gastric distention, 26 may account for patients' difficulties with terminating eating.…”

Section: Additional Criteriamentioning

confidence: 99%

The diagnostic validity of the criteria for binge eating disorder

Latner

Clyne

2007

Intl J Eating Disorders

112

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Objective: This paper considers whether the criteria currently used to classify the diagnosis of binge eating disorder (BED) are valid and appropriate.Method: We review evidence that reflects on the validity of the current criteria for binge eating episodes and BED, using literature retrieved through major psychology and psychiatry search engines (e.g., PsycInfo, PubMed).Results: Evidence from experimental research points to the relative importance of episode frequency, the amount of food consumed at episodes, the subjective sense of loss of control over eating, and several additional criteria associated with binge episodes in BED. Evidence on the differences in psychopathology between BED and bulimia nervosa and between BED and obesity without binge eating, as related to diagnostic criteria, is reviewed. Binge eating disorder (BED) is highly prevalent among individuals seeking treatment for obesity, with prevalence estimates ranging between 15 and 50%. In the general population, the lifetime prevalence of BED is between 0.7% and 4%. Conclusion1 BED is defined in the fourth edition (text revision) of the Diagnostic and Statistical Manual (DSM-IV-TR) as frequent binge eating episodes, characterized by the consumption of a large quantity of food in a discrete period of time, accompanied by a subjective sense of loss of control over eating. Individuals with BED must also experience distress about their binge eating, and binge episodes are associated with at least three of the following: eating more rapidly than normal, eating until uncomfortably full, eating large amounts when not hungry, eating alone because of embarrassment, and feeling disgusted, depressed, or guilty about overeating. 1 BED, as it is currently defined, is associated not only with eating disorder psychopathology, but also with comorbid psychiatric disorders, health problems, and obesity.2 Health-related quality of life is significantly impaired in obese women with BED relative to obese women without BED.3,4 For these reasons, it has been argued that BED is a distinct and significant disorder of clinical severity that requires specific treatment.5 However, it has also been proposed that the frequent psychiatric comorbidity, good response to many forms of treatment, and the lack of agreement on what constitutes a large amount of food make the BED diagnosis more useful as a marker for other psychopathology in obese individuals than as a clinical disorder in its own right. 6 Another potential problem with the diagnostic definition of BED lies in the question of whether the criteria for the disorder are valid. Kendell and Jablensky 7 have suggested that validity in psychiatric disorders is present if the defining characteristics of a syndrome can be demonstrated to be an entity, separated clearly from neighboring syndromes and from normality. This article examines the evidence regarding the DSM-IV criteria for BED. The diagnostic criteria have two major components: the definition of a binge episode, and BED-specific criteria. This review first...

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“…This diagnostic hypothesis is reinforced by the reported reduction in previously enjoyable activities (a condition described by the patient as the consequence of unemployment and of the time spent with his sick mother). We tend to exclude that the initial process of weight loss was secondary to a well-defined eating disorder (e.g., anorexia nervosa) because the loss of appetite which triggered weight loss is not a typical symptom of anorexia nervosa [20]. Unfortunately, the patient had no psychological assessment of eating disorder at the time of initial weight loss, but this conclusion is also supported by the psychiatric consultation at the time of BIB positioning, that did not find any contraindication to the procedure.…”

Section: Discussionmentioning

confidence: 99%

Massive Weight Loss Without Surgery in a Super Obese Patient

et al. 2009

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Large weight losses are rarely achieved through non-surgical procedures, but are also possible without professional help. A massive weight loss may be complicated by the development of an eating disorder psychopathology, followed by weight regain. We report the case of a male patient with super obesity (BMI, 86.2 kg/m 2 ), who achieved a massive weight loss (170 kg in 2 years) largely without professional help and without surgery. The final body weight (∼100 kg; BMI, 32.6) has now been maintained for nearly 2 years. After weight loss, the patient had massive skin redundancy in several areas including the breasts, arms, abdomen, back, and thighs and a true body weight probably in the normal range. All laboratory tests were normal, with the exception of low free testosterone. Sonographic examination showed gall bladder microlithiasis. No eating disorders and other axis I and axis II psychiatric disorders were present. The case illustrates how much weight loss and weight-loss maintenance can be exceptionally achieved without surgery and without developing an eating disorder of clinical severity or other psychiatric disorders.

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Hunger and Satiety in Anorexia and Bulimia Nervosaa

Cited by 37 publications

References 5 publications

CCK response in bulimia nervosa and following remission

CCK response in bulimia nervosa and following remission

The diagnostic validity of the criteria for binge eating disorder

Massive Weight Loss Without Surgery in a Super Obese Patient

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