scholarly journals Exploring the Mechanisms of Recovery in Anorexia Nervosa through a Translational Approach: From Original Ecological Measurements in Human to Brain Tissue Analyses in Mice

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2786
Author(s):  
Philibert Duriez ◽  
Ida A. K. Nilsson ◽  
Ophelia Le Thuc ◽  
David Alexandre ◽  
Nicolas Chartrel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Recovery Process ◽  
Cardiac Monitoring ◽  
Preclinical Model ◽  
Translational Study ◽  
Nutritional Recovery ◽  
Hypothalamic Regulation ◽  
Life Threatening ◽  
Acyl Ghrelin

Anorexia nervosa (AN) is a severe eating disorder where caloric restriction, excessive physical activity and metabolic alterations lead to life-threatening situations. Despite weight restoration after treatment, a significant part of patients experience relapses. In this translational study, we combined clinical and preclinical approaches. We describe preliminary data about the effect of weight gain on the symptomatology of patients suffering from acute AN (n = 225) and partially recovered (n = 41). We measured more precisely physical activity with continuous cardiac monitoring in a sub-group (n = 68). Using a mouse model, we investigated whether a long-term food restriction followed by nutritional recovery associated or not with physical activity may differentially impact peripheral and central homeostatic regulation. We assessed the plasma concentration of acyl ghrelin, desacyl ghrelin and leptin and the mRNA expression of hypothalamic neuropeptides and their receptors. Our data show an effect of undernutrition history on the level of physical activity in AN. The preclinical model supports an important role of physical activity in the recovery process and points out the leptin system as one factor that can drive a reliable restoration of metabolic variables through the hypothalamic regulation of neuropeptides involved in feeding behavior.

scholarly journals Unexpected Association of Desacyl-Ghrelin with Physical Activity and Chronic Food Restriction: A Translational Study on Anorexia Nervosa

2020 ◽  
Vol 9 (9) ◽  
pp. 2782 ◽  
Author(s):  
Philibert Duriez ◽  
Lauralee Robichon ◽  
Roland Dardennes ◽  
Guillaume Lavoisy ◽  
Dominique Grouselle ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Food Restriction ◽  
Plasma Concentrations ◽  
Caloric Intake ◽  
Positive Association ◽  
Recovery Process ◽  
Post Discharge ◽  
Ad Libitum ◽  
Energy Deprivation

Anorexia nervosa (AN) is a severe metabopsychiatric disorder characterised by caloric intake restriction and often excessive physical exercise. Our aim is to assess in female AN patients and in a rodent model, the co-evolution of physical activity and potential dysregulation of acyl—(AG) and desacyl—(DAG) ghrelin plasma concentrations during denutrition and weight recovery. AN inpatients were evaluated at inclusion (T0, n = 29), half—(T1) and total (T2) weight recovery, and one month after discharge (T3, n = 13). C57/Bl6 mice with access to a running wheel, were fed ad libitum or submitted to short—(15 days) or long—(50 days) term quantitative food restriction, followed by refeeding (20 days). In AN patients, AG and DAG rapidly decreased during weight recovery (T0 to T2), AG increased significantly one-month post discharge (T3), but only DAG plasma concentrations at T3 correlated negatively with BMI and positively with physical activity. In mice, AG and DAG both increased during short- and long-term food restriction. After 20 days of ad libitum feeding, DAG was associated to persistence of exercise alteration. The positive association of DAG with physical activity during caloric restriction and after weight recovery questions its role in the adaptation mechanisms to energy deprivation that need to be considered in recovery process in AN.

Energy expenditure and physical activity in patients with anorexia nervosa

2013 ◽  
Vol 121 (03) ◽  
Author(s):  
U Elbelt ◽  
V Haas ◽  
T Hofmann ◽  
S Jeran ◽  
H Pietz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Energy Expenditure

scholarly journals Treatment of Anorexia Nervosa: The Importance of Disease Progression in the Prognosis

2017 ◽  
Vol 30 (7-8) ◽  
pp. 517
Author(s):  
Rodrigo Andrade ◽  
Manuel Gonçalves-Pinho ◽  
António Roma-Torres ◽  
Isabel Brandão
Keyword(s):  
Anorexia Nervosa ◽  
Dropout Rate ◽  
University Hospital ◽  
High Rate ◽  
Prognostic Features ◽  
Illness Duration ◽  
Intense Fear ◽  
Life Threatening ◽  
Fear Of Weight Gain ◽  
The Impact

Introduction: Anorexia nervosa is a severe, usually chronic, life-threatening disease of complex etiology characterized by food restriction, overestimation of the importance of body weight and image, intense fear of weight gain and distortion of body image. Anorexia nervosa is associated with high rates of mortality, suicide and decreased quality of life. Our aim is to present an anorexia nervosa treatment program offered in a major university hospital in Portugal, and to determine the impact of illness duration before admission on the outcome. Our hypothesis is that patients with greater disease longevity may have worse prognosis and poorer outcome.Material and Methods: The sample included data from case records of 169 patients seen consecutively and for the first time at Centro Hospitalar São João, between 2010 and 2015. We performed a retrospective observational study which included data collected at admission and from later follow-up years.Results: From the initially selected patients, 14.8% reached total remission, 16% accomplished partial remission and 14.2% ended up with exacerbation/stagnation of the disease. The dropout rate was of 55% throughout our study period. We found significant differences on outcome rates between distinct illness duration groups (p = 0.007).Discussion: There are several factors frequently associated with poor outcome for anorexia nervosa. The interpretation of outcome findings was limited by the high rate of dropout and lack of consistent definition criteria.Conclusion: Our results support the idea that illness duration has an important role on the outcome and prognostic features of these patients.

scholarly journals Stigmatization toward People with Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder: A Scoping Review

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2834
Author(s):  
Lisa Brelet ◽  
Valentin Flaudias ◽  
Michel Désert ◽  
Sébastien Guillaume ◽  
Pierre-Michel Llorca ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Scoping Review ◽  
Low Income ◽  
Research Question ◽  
Recovery Process

Research about stigmatization in eating disorders (EDs) has highlighted stereotypes, prejudices, and discrimination against people with EDs, as well as their harmful effects on them, including self-stigma and a difficult recovery process. Whereas a recent review focused on the consequences of ED stigma, our work aimed to provide a broader synthesis of ED stigma, including its consequences, but also its content and distribution. More precisely, we focused on three EDs—namely, anorexia nervosa, bulimia nervosa, and binge eating disorder. Based on a systematic search of four major databases in psychology, the present scoping review includes 46 studies published between 2004 and 2021. We did not conduct any quality assessment of the studies included, because our aim was to provide a wide-ranging overview of these topics instead of an appraisal of evidence answering a precise research question. The review confirmed the existence of a common ED stigma: all individuals affected by EDs reviewed here were perceived as responsible for their situation, and elicited negative emotions and social distance. However, our review also depicted a specific stigma content associated with each ED. In addition, the demographic characteristics of the stigmatizing individuals had a notable influence on the extent of ED stigma: men, young adults, and low-income individuals appeared to be the most stigmatizing toward individuals with EDs. It is important to note that ED stigma had a negative effect on individuals’ eating disorders, psychological wellbeing, and treatment-seeking behavior. There is an urgent need for further research on the adverse effects of ED stigma and its prevention.

scholarly journals THE THERAPEUTIC EFFECT OF PHYSICAL ACTIVITY IN A DAY-HOSPITAL PATIENT WITH ANOREXIA NERVOSA

2019 ◽  
Vol 31 (2) ◽  
pp. 201-203 ◽  
Author(s):  
Kathryn Hughes ◽  
◽  
David Woodgate ◽  
Sarah J. Halford ◽  
Mary Cowan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Anorexia Nervosa ◽  
Therapeutic Effect ◽  
Day Hospital ◽  
Hospital Patient

Anorexia nervosa and the gastrointestinal tract

2021 ◽  
pp. flgastro-2021-101857
Author(s):  
Wisam Jafar ◽  
James Morgan
Keyword(s):  
Anorexia Nervosa ◽  
Healthcare Professionals ◽  
Signs And Symptoms ◽  
Nutritional Therapy ◽  
Nutrition Support ◽  
Multidisciplinary Teams ◽  
High Morbidity ◽  
Support Teams ◽  
Life Threatening ◽  
Acute Admissions

Anorexia nervosa (AN) is a complex eating disorder associated with a high morbidity and mortality, however, there is a lack of dedicated training for healthcare professionals outside of mental health specialities. There has been a reported increase in acute admissions of patients with AN, which may have been precipitated by the isolation and loss of support networks created by the COVID-19 pandemic. The purpose of this review is to highlight that AN can present with a wide variety of signs and symptoms relating to both the hollow and solid organs of the gastrointestinal (GI) tract some of which may even be life threatening. The overlap of symptoms with several other functional and organic GI diseases makes diagnosis challenging. Gastroenterologists and allied healthcare professionals need to be aware of the wide array of possible GI manifestations not only to help rationalise investigations but to also facilitate early involvement of the relevant multidisciplinary teams. Many of the GI manifestations of AN can be reversed with careful nutritional therapy under the guidance of nutrition support teams.

The Contribution of mHealth in the Care of Obese Pediatric Patients

2016 ◽  
pp. 126-146 ◽  
Author(s):  
Elpis Vlachopapadopoulou ◽  
Dimitrios I. Fotiadis
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Remote Monitoring ◽  
Chronic Health Condition ◽  
Health Condition ◽  
Self Management ◽  
Closed Loops ◽  
Global Health Issue ◽  
Life Threatening ◽  
Motivational Approaches

In this chapter the evolution of mHealth solutions for monitoring and treatment of children suffering from obesity is discussed. Nowadays, obesity emerges as a major chronic health condition that affects the general population, both children and adults. mhealth solutions are already used for self-management, remote monitoring and counseling of several chronic conditions, including diabetes mellitus, heart failure, Parkinson's disease, etc. Today, those solutions can result to closed loops, which support health self-management for chronic diseases, in a personalized manner. Concerning childhood obesity, those solutions can combine targeted games and motivational approaches towards both physical activity and diet, which could help in addressing this serious and global health issue, in the direction of minimizing co-morbidities and eventually preventing serious, life threatening events.

Cardiovascular assessment and care

2020 ◽  
pp. 57-100
Author(s):  
Christine Spiers
Keyword(s):  
Early Recognition ◽  
Rapid Assessment ◽  
Cardiac Monitoring ◽  
Compensatory Mechanisms ◽  
The United Kingdom ◽  
Cardiovascular Assessment ◽  
Assessment And Treatment ◽  
Cardiac Assessment ◽  
Life Threatening ◽  
Coronary Syndromes

Cardiovascular disease remains a major cause of death in the United Kingdom. The early recognition of cardiovascular deterioration in the acutely ill patient is an essential skill for practitioners in acute care. This chapter offers an overview of the cardiovascular system and normal physiological and compensatory mechanisms which support cardiovascular function. Cardiac assessment is explored in some detail including symptom review, cardiac monitoring, and chest pain assessment. The complex subject of arrhythmia interpretation and management is reviewed in some depth. The chapter concludes with a focus on the management of acute coronary syndromes, heart failure, and cardiogenic shock. All three conditions are potentially life-threatening and rapid assessment and treatment is essential to prevent mortality; evidence-based management of these conditions is considered in detail within this chapter.

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