scholarly journals Unveiling Metabolic Phenotype Alterations in Anorexia Nervosa through Metabolomics

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4249
Author(s):  
Laura Mayo-Martínez ◽  
Francisco J. Rupérez ◽  
Gabriel Á. Martos-Moreno ◽  
Montserrat Graell ◽  
Coral Barbas ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Behaviors ◽  
Metabolic Phenotype ◽  
Psychological Consequences ◽  
Review Of The Literature ◽  
Ongoing Research ◽  
Negative Body Image ◽  
Disease Mechanisms ◽  
Intense Fear ◽  
Fear Of Weight Gain

Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. Although its origin is postulated to be multifactorial, the etiology of AN remains unknown, and this increases the likelihood of chronification and relapsing. Thus, expanding the available knowledge on the pathophysiology of AN is of enormous interest. Metabolomics is proposed as a powerful tool for the elucidation of disease mechanisms and to provide new insights into the diagnosis, treatment, and prognosis of AN. A review of the literature related to studies of AN patients by employing metabolomic strategies to characterize the main alterations associated with the metabolic phenotype of AN during the last 10 years is described. The most common metabolic alterations are derived from chronic starvation, including amino acid, lipid, and carbohydrate disturbances. Nonetheless, recent findings have shifted the attention to gut-microbiota metabolites as possible factors contributing to AN development, progression, and maintenance. We have identified the areas of ongoing research in AN and propose further perspectives to improve our knowledge and understanding of this disease.

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.

Atypical Anorexia Nervosa

2018 ◽  
pp. 279-287
Author(s):  
Nadia E. Saldanha ◽  
Khalida Itriyeva
Keyword(s):  
Weight Loss ◽  
Body Image ◽  
Anorexia Nervosa ◽  
Weight Gain ◽  
Mental Disorders ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Intense Fear ◽  
Atypical Anorexia Nervosa ◽  
Fear Of Weight Gain

Atypical anorexia nervosa is defined in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) as a disorder that shares the same diagnostic criteria as anorexia nervosa (AN), including dysmorphic body image, intense fear of weight gain, and restriction of energy intake, with the exception that patients with atypical AN present at a weight that is at or above the normal range despite a significant weight loss. Patients with atypical AN share many of the same medical and psychological complications and comorbidities as those with AN but with some differences in the way they are manifested. Treatment for these patients includes medical, nutritional, and psychological aspects of care, but choosing the appropriate goal weight and understanding the expected prognosis for these patients remain areas of research and discussion.

scholarly journals Overcoming limitations of self-report: an assessment of fear of weight gain in anorexia nervosa and healthy controls using implicit association tests

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Tiana Borgers ◽  
Nathalie Krüger ◽  
Silja Vocks ◽  
Jennifer J. Thomas ◽  
Franziska Plessow ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Weight Gain ◽  
Normal Weight ◽  
Self Report ◽  
Healthy Controls ◽  
Drive For Thinness ◽  
Implicit Association ◽  
Association Tests ◽  
Implicit Assessment ◽  
Fear Of Weight Gain

Abstract Background Fear of weight gain is a characteristic feature of anorexia nervosa (AN), and reducing this fear is often a main target of treatment. However, research shows that 20% of individuals with AN do not report fear of weight gain. Studies are needed that evaluate the centrality of fear of weight gain for AN with a method less susceptible to deception than self-report. Methods We approximated implicit fear of weight gain by measuring implicit drive for thinness using implicit association tests (IATs). We asked 64 participants (35 AN, 29 healthy controls [HCs]) to categorize statements as pro-dieting vs. non-dieting and true vs. false in a questionnaire-based IAT, and pictures of underweight vs. normal-weight models and positive vs. negative words in a picture-based IAT using two response keys. We tested for associations between implicit drive for thinness and explicitly reported psychopathology within AN as well as group differences between AN and HC groups. Results Correlation analyses within the AN group showed that higher implicit drive for thinness was associated with more pronounced eating disorder-specific psychopathology. Furthermore, the AN group showed a stronger implicit drive for thinness than HCs in both IATs. Conclusion The results highlight the relevance of considering fear of weight gain as a continuous construct. Our implicit assessment captures various degrees of fear of weight gain in AN, which might allow for more individually tailored interventions in the future.

Dropout from inpatient treatment for anorexia nervosa: Critical review of the literature

2009 ◽  
Vol 42 (7) ◽  
pp. 636-647 ◽  
Author(s):  
Jenny Wallier ◽  
Sarah Vibert ◽  
Sylvie Berthoz ◽  
Caroline Huas ◽  
Tamara Hubert ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Critical Review ◽  
Inpatient Treatment ◽  
Review Of The Literature

Association and Familial Coaggregation of Type 1 Diabetes and Eating Disorders: A Register-Based Cohort Study in Denmark and Sweden

2021 ◽  
Author(s):  
Ashley E. Tate ◽  
Shengxin Liu ◽  
Ruyue Zhang ◽  
Zeynep Yilmaz ◽  
Janne T. Larsen ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Type 1 Diabetes ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Eating Behaviors ◽  
Diabetes Diagnosis ◽  
Disordered Eating Behaviors ◽  
Increased Risk ◽  
Clinical Diagnoses

OBJECTIVE <p>To ascertain the association and co-aggregation of eating disorders and childhood-onset type 1 diabetes in families. </p> <p>RESEARCH DESIGN AND METHODS</p> <p>Using population samples from national registers in Sweden (n= 2 517 277) and Demark (n= 1 825 920) we investigated the within-individual association between type 1 diabetes and EDs, and their familial co-aggregation among full siblings, half-siblings, full cousins, and half-cousins. Based on clinical diagnoses we classified eating disorders (EDs) into: any eating disorder (AED), anorexia nervosa and atypical anorexia nervosa (AN), and other eating disorder (OED). Associations were determined with hazard ratios (HR) with confidence intervals (CI) from Cox regressions. </p> <p>RESULTS</p> <pre>Swedish and Danish individuals with a type 1 diabetes diagnosis had a greater risk of receiving an ED diagnosis (HR [95% CI] Sweden: AED 2.02 [1.80 – 2.27], AN 1.63 [1.36 – 1.96], OED 2.34 [2.07 – 2.63]; Denmark: AED 2.19 [1.84 – 2.61], AN 1.78 [1.36 – 2.33], OED 2.65 [2.20 – 3.21]). We also meta-analyzed the results: AED 2.07 [1.88 – 2.28], AN 1.68 [1.44 – 1.95], OED 2.44 [2.17 – 2.72]. There was an increased risk of receiving an ED diagnosis in full siblings in the Swedish cohort (AED 1.25 [1.07 – 1.46], AN 1.28 [1.04 – 1.57], OED 1.28 [1.07 – 1.52]), these results were non-significant in the Danish cohort.</pre> <p>CONCLUSION</p> <p>Patients with 1 diabetes are at a higher risk of subsequent EDs; however, there is conflicting support for the relationship between having a sibling with type 1 diabetes and ED diagnosis. Diabetes healthcare teams should be vigilant for disordered eating behaviors in children and adolescents with type 1 diabetes. </p>

Immunology of Eating Disorders

2018 ◽  
pp. 241-250
Author(s):  
Adaliene Versiani Matos Ferreira ◽  
Laís Bhering Martins ◽  
Nayara Mussi Monteze ◽  
Geneviève Marcelin ◽  
Karine Clément
Keyword(s):  
Eating Disorders ◽  
Body Weight ◽  
Anorexia Nervosa ◽  
Immune Cells ◽  
Eating Behaviors ◽  
Viral Infections ◽  
Low Grade ◽  
Obese People ◽  
Obese Subjects ◽  
Low Grade Inflammation

Eating disorders (EDs) are characterized by dysregulation in eating behavior leading to extreme increase or decrease in food intake that, in turn, changes body weight, adiposity, and physical health. Anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) are the three major eating disorders. Peculiar immune abnormalities occur in these conditions. Previous studies have reported a higher number of CD4+ T lymphocytes in patients with AN, which are related to a relative resistance to viral infections, even in the presence of leukopenia. It has also been proposed that a cluster of cytokines is altered in these patients. A chronic low-grade inflammation has been observed in obese people with BED and in patients with AN, but with a different profile in each condition. In this context, antagonist drugs of specific cytokines, such as anti-TNF, showed improvement of AN-related symptoms, but increased weight gain in obese subjects. The identification of specific molecules and/or immune cells that impair neuronal circuits implicated in eating behaviors may contribute to the development of pharmacological strategies for eating disorders.

Eating Disorders

2017 ◽  
pp. 179-186
Author(s):  
Myrna M. Weissman ◽  
John C. Markowitz ◽  
Gerald L. Klerman
Keyword(s):  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Bulimia Nervosa ◽  
Binge Eating ◽  
Binge Eating Disorder ◽  
Eating Behaviors ◽  
Negative Mood ◽  
Few Data ◽  
Maladaptive Eating

This chapter provides an overview of the use of IPT for patients with eating disorders. The most common eating disorders are anorexia nervosa, bulimia nervosa, and binge eating disorder. The chapter discusses the adaptations of IPT that have been used for the treatment of eating disorders and evaluates their performance in research studies. The assumption for testing IPT with eating disorders is that they occur in response to distress at poor social and interpersonal functioning and consequent negative mood, to which the patient responds with maladaptive eating behaviors. For anorexia nervosa, few data provide evidence for the benefit of IPT. For bulimia and binge eating disorder, however, IPT is considered a viable option for treatment and is recommended in numerous guidelines. A case example of a woman with bulimia nervosa is provided.

scholarly journals Effects of a short residential thermal spa program to prevent work-related stress/burnout on stress biomarkers: the ThermStress proof of concept study

2019 ◽  
Vol 47 (10) ◽  
pp. 5130-5145
Author(s):  
Frédéric Dutheil ◽  
Elodie Chaplais ◽  
Audrey Vilmant ◽  
Denise Lanoir ◽  
Daniel Courteix ◽  
...  
Keyword(s):  
Psychological Intervention ◽  
Electrodermal Activity ◽  
Public Health Issue ◽  
Proof Of Concept ◽  
Psychological Consequences ◽  
Work Related Stress ◽  
Ongoing Research ◽  
Concept Study ◽  
Work Related ◽  
Related Stress

Objective Work-related stress is a public health issue. Stress has multiple physical and psychological consequences, the most serious of which are increased mortality and cardiovascular morbidity. The ThermStress protocol was designed to offer a short residential thermal spa program for work-related stress prevention that is compatible with a professional context. Methods Participants will be 56 male and female workers aged 18 years or above. All participants will undergo a 6-day residential spa program comprising psychological intervention, physical activity, thermal spa treatment, health education, eating disorder therapy and a follow-up. On six occasions, participants’ heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometry and body composition, psychology and quality of life will be measured using questionnaires and bone parameters. Results This study protocol reports the planned and ongoing research for this intervention. Discussion The ThermStress protocol has been approved by an institutional ethics committee (ANSM: 2016 A02082 49). It is expected that this proof of concept study will highlight the effect of a short-term specific residential thermal spa program on the prevention of occupational burnout and work-related stress. The findings will be disseminated at several research conferences and in published articles in peer-reviewed journals. Trial Registration: ClinicalTrials.gov (NCT 03536624, 24/05/2018)

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