RESUMO
Ad libitum feeding over 24 hours was assessed in underweight restrictor anorectic (RAN) women (n = 8) and matched healthy control subjects (n = 9) in a relatively naturalistic laboratory setting. RAN consumed 828 +/- 210 kcal/day (20 +/- 6 kcal/kg/day); controls ingested 2274 +/- 564 kcal/day (41 +/- 13 kcal/kg/day). Expressed as macronutrient consumption, RAN, compared to healthy controls, ate less fat (13% vs 31%), more carbohydrate (73% vs 57%), and similar amounts of protein (14% vs 12%). RAN initiated fewer eating episodes than controls (4 vs 7). This study quantitatively confirms the growing body of evidence suggesting that RAN avoid fat-containing foods. Such persistent fat avoidance may significantly contribute to the difficulty RAN experience in gaining and maintaining body weight.
Assuntos
Anorexia Nervosa/diagnóstico , Ingestão de Energia , Comportamento Alimentar/psicologia , Adolescente , Adulto , Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Peso Corporal , Dieta Redutora/psicologia , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Feminino , Humanos , Valor Nutritivo , Admissão do PacienteRESUMO
OBJECTIVE: This study tested previous findings that patients with eating disorders who attain normal weight have abnormal caloric requirements for maintaining weight. METHOD: Fifty-three female patients meeting the DSM-III-R criteria for anorexia nervosa and/or bulimia nervosa were divided into four subgroups, and their daily caloric intake was measured over a weight-stable period. Patients with anorexia nervosa (restricting and bulimic subtypes) were studied 4 weeks after refeeding and weight gain, when they had attained 95% of average body weight. Patients with normal-weight bulimia (previously anorexic or never previously anorexic) were studied 1-4 weeks after admission to an inpatient unit. RESULTS: After weight restoration, restricting anorexic patients required significantly more calories per day to maintain weight than did bulimic anorexic patients, as measured with corrections for weight, body surface area, and fat-free mass. Previously anorexic normal-weight bulimic patients required significantly more calories per day to maintain weight than never-anorexic normal-weight bulimic patients, as measured with correction for weight but not with the other factors used to correct caloric intake. CONCLUSIONS: To maintain stable weight after weight restoration, restricting anorexic patients require a significantly higher caloric intake than do bulimic anorexic patients. Differences in caloric needs between normal-weight bulimic patients with and without histories of anorexia may depend on the methods used to correct caloric requirements. Body surface area may be the most precise correction factor across different subgroups of eating disorder patients. Elevated caloric requirements, when coupled with reduced food intake, may particularly contribute to relapse in anorexic patients.
Assuntos
Anorexia Nervosa/metabolismo , Peso Corporal , Bulimia/metabolismo , Ingestão de Energia , Metabolismo Energético , Adolescente , Adulto , Anorexia Nervosa/psicologia , Anorexia Nervosa/terapia , Composição Corporal , Índice de Massa Corporal , Superfície Corporal , Bulimia/psicologia , Bulimia/terapia , Comportamento Alimentar , Feminino , Seguimentos , Hospitalização , Humanos , Necessidades NutricionaisRESUMO
The thermogenic effect of nicotine intake after calorie consumption was investigated to determine if nicotine influences metabolic response to a calorie challenge. Smokers and nonsmokers (10 males in each group), matched for body weight, age, and physical fitness, each participated in four sessions that involved consuming a liquid calorie load (4.77 kcal/kg body wt) or water, followed by nicotine (15 micrograms/kg body wt) or placebo via nasal spray every 20 min for 2 h. Energy expenditure was significantly increased above baseline resting metabolic rate (RMR) over the 2 h by nicotine alone (6.5% of RMR, p less than 0.01). However, the combined effect of nicotine after calorie load (20.1% of RMR, p less than 0.001) was not significantly greater than the effect of calorie load alone (18.4% of RMR, p less than 0.001). Smokers and nonsmokers did not differ in baseline RMR or in response to nicotine or calorie load. These results confirm the thermogenic effect of nicotine but suggest that the effect of nicotine after calorie consumption is less than additive.
Assuntos
Ingestão de Energia/fisiologia , Nicotina/farmacologia , Fumar/metabolismo , Administração Intranasal , Adulto , Aerossóis , Metabolismo Basal , Regulação da Temperatura Corporal , Relação Dose-Resposta a Droga , Metabolismo Energético , Frequência Cardíaca , Humanos , Masculino , Nicotina/administração & dosagemRESUMO
As part of the Pittsburgh Appetite Test, 50 depressed outpatients reported their perceptions of appetite and weight change prior to and during chronic treatment with imipramine and psychotherapy. At the end of 4 months, as a group, patients were significantly more conscious of what they were eating, and reported a significant change in the frequency of regular meal consumption. No group changes were noted in frequency of snacking or late night eating, although weight change during treatment and obesity status modified these responses. Clinical response was unrelated to eating behavior. Perception of weight change varied with treatment: a 5 pound weight gain became highly problematic during recovery compared to the depressive episode. The interaction of these factors and antidepressant-induced weight gain are discussed.
Assuntos
Apetite/efeitos dos fármacos , Imagem Corporal , Depressão/tratamento farmacológico , Adulto , Depressão/terapia , Comportamento Alimentar/efeitos dos fármacos , Feminino , Humanos , Imipramina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Psicoterapia , Aumento de Peso/efeitos dos fármacosRESUMO
Body weight change was monitored in 73 hospitalized depressed patients treated with one of four antidepressants for 1 month. After a 2-week medication-free period, patients were randomly assigned to treatment with amitriptyline, nortriptyline, desipramine, or zimelidine. By the end of 1 month, treatment with all three tricyclic compounds promoted weight gain, with the greatest increase observed during amitriptyline treatment; less weight was gained by patients treated with nortriptyline and desipramine. In contrast, most patients treated with zimelidine showed no weight gain and, in many cases, demonstrated weight loss. Weight change during treatment was not associated with age, sex, severity of depression, obesity, weight loss during depression, or clinical response.
Assuntos
Antidepressivos/efeitos adversos , Transtorno Depressivo/tratamento farmacológico , Aumento de Peso/efeitos dos fármacos , Adulto , Amitriptilina/efeitos adversos , Antidepressivos/uso terapêutico , Desipramina/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nortriptilina/efeitos adversos , Zimeldina/efeitos adversosRESUMO
Antidepressant-induced changes in food preference were investigated in a group of 40 depressed patients before and during treatment with imipramine. As part of a validated survey, the Pittsburgh Appetite Test, self-reported food preference was categorized by both nutrient and hedonic properties to define individual response. After 4 months of treatment, 14 patients (35%) expressed a clear desire for high-carbohydrate/high-fat foods with a sweet taste. Within this group, eight patients already preferred these foods while medication-free, while six subjects demonstrated a change in preference to these foods during treatment. The other 26 patients (65%) showed no consistent changes in food preference. These results suggest that while approximately one-third of imipramine-treated patients report a preference for sweets, only 15% actually developed this preference during treatment.