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Psychological Medicine Dec 2021Anorexia nervosa (AN) and bulimia nervosa (BN) are complex psychiatric conditions, in which both psychological and metabolic factors have been implicated. Critically,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Anorexia nervosa (AN) and bulimia nervosa (BN) are complex psychiatric conditions, in which both psychological and metabolic factors have been implicated. Critically, the experience of stress can precipitate loss-of-control eating in both conditions, suggesting an interplay between mental state and metabolic signaling. However, associations between psychological states, symptoms and metabolic processes in AN and BN have not been examined.
METHODS
Eighty-five women ( = 22 AN binge/purge subtype, = 33 BN, = 30 controls) underwent remote salivary cortisol sampling and a 2-day, inpatient study session to examine the effect of stress on cortisol, gut hormones [acyl-ghrelin, peptide tyrosine tyrosine (PYY) and glucagon-like peptide-1] and food consumption. Participants were randomized to either an acute stress induction or control task on each day, and plasma hormones were serially measured before a naturalistic, meal.
RESULTS
Cortisol-awakening response was augmented in AN but not in BN relative to controls, with body mass index explaining the most variance in post-awakening cortisol (36%). Acute stress increased acyl-ghrelin and PYY in AN compared to controls; however, stress did not alter gut hormone profiles in BN. Instead, a group-by-stress interaction showed nominally reduced cortisol reactivity in BN, but not in AN, compared to controls. consumption was lower in both patient groups and unaffected by stress.
CONCLUSIONS
Findings extend previous reports of metabolic dysfunction in binge-eating disorders, identifying unique associations across disorders and under stress. Moreover, we observed disrupted homeostatic signaling in AN following psychological stress, which may explain, in part, the maintenance of dysregulated eating in this serious illness.
Topics: Female; Humans; Bulimia Nervosa; Anorexia; Bulimia; Hydrocortisone; Anorexia Nervosa; Tyrosine
PubMed: 32460904
DOI: 10.1017/S0033291720001440 -
Psychiatria Polska Feb 2022Anorexia nervosa is achronic disease classified as an eating disorder. It has amultifactorial aetiology and should be treated by a multidisciplinary team of specialists.... (Review)
Review
Anorexia nervosa is achronic disease classified as an eating disorder. It has amultifactorial aetiology and should be treated by a multidisciplinary team of specialists. Anorexia has many signs and symptoms, and usually affects young women. The complex clinical picture of anorexia is formed by numerous somatic and psychological symptoms. A high risk of mortality is associated with complications in all organs and systems. Body mass index (BMI) is an indicator in the diagnosis of anorexia, and BMI <15 kg/m² defines an extreme state in a patient. Data from a literature review and clinical practice show that a BMI <10 kg/m² is not uncommon. Aspecific BMI value associated with a particular medical complication has not been established, but many relationships have been reported. This article presents gastrointestinal and endocrine complications related to anorexia. It explains metabolic adaptations activated by the body to enable the survival of patients with very low body mass index (the lowest reported BMI was only 6.7 kg/m²).
Topics: Anorexia; Anorexia Nervosa; Body Mass Index; Endocrine System; Feeding and Eating Disorders; Female; Humans
PubMed: 35569150
DOI: 10.12740/PP/126233 -
Nutrients Oct 2013Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail... (Review)
Review
Anorexia of aging, defined as a loss of appetite and/or reduced food intake, affects a significant number of elderly people and is far more prevalent among frail individuals. Anorexia recognizes a multifactorial origin characterized by various combinations of medical, environmental and social factors. Given the interconnection between weight loss, sarcopenia and frailty, anorexia is a powerful, independent predictor of poor quality of life, morbidity and mortality in older persons. One of the most important goals in the management of older, frail people is to optimize their nutritional status. To achieve this objective it is important to identify subjects at risk of anorexia and to provide multi-stimulus interventions that ensure an adequate amount of food to limit and/or reverse weight loss and functional decline. Here, we provide a brief overview on the relevance of anorexia in the context of sarcopenia and frailty. Major pathways supposedly involved in the pathogenesis of anorexia are also illustrated. Finally, the importance of treating anorexia to achieve health benefits in frail elders is highlighted.
Topics: Aged; Aging; Anorexia; Frail Elderly; Geriatric Assessment; Humans; Malnutrition; Nutritional Status; Risk Factors; Sarcopenia; Weight Loss
PubMed: 24128975
DOI: 10.3390/nu5104126 -
Critical Reviews in Oncology/hematology Sep 2017Most advanced cancer patients suffer loss of appetite (anorexia) and loss of weight. Despite the fact that cancer anorexia and weight loss are associated with a poor... (Review)
Review
Most advanced cancer patients suffer loss of appetite (anorexia) and loss of weight. Despite the fact that cancer anorexia and weight loss are associated with a poor prognosis and detract from quality of life, no interventions have been demonstrated to palliate this syndrome in its entirety, particularly in patients with treatment-refractory malignancies. Recently, two registration trials - one with anamorelin and another with enobosarm - failed to reach their primary endpoints, thus raising questions. Were both these agents ineffective? Alternatively, did study design issues compromise the ability of these trials to identify effective agents? Thus, this review is timely insofar it serves as an introduction to study design, offers guidance on how to test promising agents for cancer anorexia/weight loss, and provides advice for overcoming trial design obstacles.
Topics: Anorexia; Cachexia; Clinical Trials as Topic; Humans; Neoplasms; Quality of Life; Research Design; Weight Loss
PubMed: 28807233
DOI: 10.1016/j.critrevonc.2017.06.008 -
Journal of Medical Internet Research Nov 2015Pro-anorexia communities exist online and encourage harmful weight loss and weight control practices, often through emotional content that enforces social ties within...
BACKGROUND
Pro-anorexia communities exist online and encourage harmful weight loss and weight control practices, often through emotional content that enforces social ties within these communities. User-generated responses to videos that directly oppose pro-anorexia communities have not yet been researched in depth.
OBJECTIVE
The aim was to study emotional reactions to pro-anorexia and anti-pro-anorexia online content on YouTube using sentiment analysis.
METHODS
Using the 50 most popular YouTube pro-anorexia and anti-pro-anorexia user channels as a starting point, we gathered data on users, their videos, and their commentators. A total of 395 anorexia videos and 12,161 comments were analyzed using positive and negative sentiments and ratings submitted by the viewers of the videos. The emotional information was automatically extracted with an automatic sentiment detection tool whose reliability was tested with human coders. Ordinary least squares regression models were used to estimate the strength of sentiments. The models controlled for the number of video views and comments, number of months the video had been on YouTube, duration of the video, uploader's activity as a video commentator, and uploader's physical location by country.
RESULTS
The 395 videos had more than 6 million views and comments by almost 8000 users. Anti-pro-anorexia video comments expressed more positive sentiments on a scale of 1 to 5 (adjusted prediction [AP] 2.15, 95% CI 2.11-2.19) than did those of pro-anorexia videos (AP 2.02, 95% CI 1.98-2.06). Anti-pro-anorexia videos also received more likes (AP 181.02, 95% CI 155.19-206.85) than pro-anorexia videos (AP 31.22, 95% CI 31.22-37.81). Negative sentiments and video dislikes were equally distributed in responses to both pro-anorexia and anti-pro-anorexia videos.
CONCLUSIONS
Despite pro-anorexia content being widespread on YouTube, videos promoting help for anorexia and opposing the pro-anorexia community were more popular, gaining more positive feedback and comments than pro-anorexia videos. Thus, the anti-pro-anorexia content provided a user-generated counterforce against pro-anorexia content on YouTube. Professionals working with young people should be aware of the social media dynamics and versatility of user-generated eating disorder content online.
Topics: Adolescent; Anorexia; Child; Female; Humans; Internet; Male; Social Media; Video Recording
PubMed: 26563678
DOI: 10.2196/jmir.5007 -
Thoracic Cancer Jan 2019Advanced lung cancer is becoming a chronic disease threatening human life and health. Cachexia has been recognized as the most common problem associated with advanced... (Review)
Review
Advanced lung cancer is becoming a chronic disease threatening human life and health. Cachexia has been recognized as the most common problem associated with advanced lung cancer. Lung cancer-induced cachexia seriously affects patients' quality of life. The present article summarizes the pathogenesis of advanced lung cancer-induced cachexia from three aspects: anorexia, cytokines, and energy and metabolic abnormalities. In addition, the present article proposes corresponding nursing measures based on cachexia pathogenesis to improve the quality of life and survival rate of cachectic patients with advanced lung cancer by combining continuously advancing treatment regimens and effective nursing. The present article also provides references for healthcare professionals when administering related treatments and nursing care.
Topics: Anorexia; Cachexia; Cytokines; Energy Metabolism; Humans; Lung Neoplasms; Quality of Life; Survival Rate
PubMed: 30461213
DOI: 10.1111/1759-7714.12910 -
The Cochrane Database of Systematic... Sep 2022Chronic loss of appetite in cystic fibrosis concerns both individuals and families. Appetite stimulants have been used to help cystic fibrosis patients with chronic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic loss of appetite in cystic fibrosis concerns both individuals and families. Appetite stimulants have been used to help cystic fibrosis patients with chronic anorexia attain optimal body mass index (BMI) and nutritional status. However, these may have adverse effects on clinical status. This is an updated version of the original review.
OBJECTIVES
To systematically search for and evaluate the evidence on the beneficial effects of appetite stimulants in the management of cystic fibrosis-related anorexia and synthesise reports of any side effects.
SEARCH METHODS
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Cystic Fibrosis Trials Register and online trials registries; handsearched reference lists; and contacted local and international experts to identify relevant trials. Last search of the Cystic Fibrosis Trials Register: 23 May 2022. Last search of online trial registries: 10 May 2022.
SELECTION CRITERIA
Randomised and quasi-randomised controlled trials of appetite stimulants compared to placebo, control, no treatment or different appetite stimulants, or to the same appetite stimulants at different doses or regimens for at least one month in adults and children with cystic fibrosis.
DATA COLLECTION AND ANALYSIS
Review authors independently extracted data and assessed risk of bias of the included trials. We used the GRADE approach to assess the certainty of the evidence and performed meta-analyses.
MAIN RESULTS
We included four trials (70 participants) comparing appetite stimulants (cyproheptadine hydrochloride and megestrol acetate) to placebo; the numbers of adults or children within each trial were not always reported. We assessed the certainty of evidence as low due to the small number of participants, incomplete or selective outcome reporting, and unclear risk of selection bias. Regarding our primary outcomes, a meta-analysis of two trials (42 participants) showed that appetite stimulants may produce a larger increase in weight (kg) at three months (mean difference (MD) 1.25 kg, 95% confidence interval (Cl) 0.45 to 2.05), and one trial (17 participants) showed a similar result at six months (MD 3.80 kg, 95% CI 1.27 to 6.33) (both low-certainty evidence). Results also showed that weight z score may increase with appetite stimulants compared to placebo at three months (MD 0.61, 95% CI 0.29 to 0.93; 3 studies; 40 participants; P < 0.001) and at six months (MD 0.74, 95% CI 0.26 to 1.22; 1 trial; 17 participants). There was no evidence of a difference in effect between cyproheptadine hydrochloride and megestrol acetate for either outcome. Only one trial (25 participants) reported analysable data for body composition (BMI), with results favouring cyproheptadine hydrochloride compared to placebo; a further trial (16 participants) narratively agreed with this result. All four trials reported on lung function at durations ranging from two to nine months. Considering analysable data, two trials (42 participants) found that appetite stimulants may make little or no difference in forced expiratory volume at one second (FEV) % predicted at three months, and one trial (17 participants) found similar results at six months. Two further three-month trials narratively agreed with these results. Limited information was reported for secondary outcomes. Two trials (23 participants) reported results showing that appetite stimulants may increase appetite compared to placebo at three months (odds ratio 45.25, 95% CI 3.57 to 573.33; low-certainty evidence). Only one study reported on quality of life, finding that cyproheptadine reduced fatigue in two participants compared with none with placebo. One study (25 participants) found no difference in energy intake between appetite stimulant or placebo at three months. Insufficient reporting of adverse effects prevented a full determination of their impact. Two studies (33 participants) narratively reported similar requirements for additional antibiotics between appetite stimulants and placebo at three months. AUTHORS' CONCLUSIONS: At six months in adults and children, appetite stimulants improved only two of the outcomes of this review: weight (or weight z score) and subjectively reported appetite. Insufficient reporting of side effects prevented a full determination of their impact. Whilst the data may suggest the potential use of appetite stimulants in treating anorexia in adults and children with cystic fibrosis, this is based upon low-certainty evidence from a small number of trials, therefore firm conclusions cannot be drawn. Clinicians need to be aware of the potential adverse effects of appetite stimulants and actively monitor any individuals prescribed these medications accordingly. Research is required to determine meaningful surrogate measures for appetite and to define what constitutes quality weight gain. Future trials of appetite stimulants should use a validated measure of symptoms including a disease-specific instrument for measuring poor appetite. This review highlights the need for multicentred, adequately powered, and well-designed trials to evaluate agents to safely increase appetite in people with cystic fibrosis and to establish the optimal mode of treatment.
Topics: Adult; Anorexia; Anti-Bacterial Agents; Appetite Stimulants; Child; Cyproheptadine; Cystic Fibrosis; Humans; Megestrol Acetate; Quality of Life
PubMed: 36149378
DOI: 10.1002/14651858.CD008190.pub3 -
Journal of Cachexia, Sarcopenia and... Aug 2017The anorexia of aging was first recognized as a physiological syndrome 30 years ago. Its major causes are an alteration in fundal compliance with an increase in antral...
The anorexia of aging was first recognized as a physiological syndrome 30 years ago. Its major causes are an alteration in fundal compliance with an increase in antral stretch and enhanced cholecystokinin activity leading to increased satiation.This anorexia leads to weight loss in aging persons and is one of the component causes of the aging related sarcopenia. This physiological anorexia also increases the risk of more severe anorexia when an older person has an increase in inflammatory cytokines such as occurs when they have an illness. This results in an increase in the anorexia due to cachexia in older persons.
Topics: Aged; Aging; Anorexia; Cachexia; Humans; Sarcopenia; Satiation; Weight Loss
PubMed: 28452130
DOI: 10.1002/jcsm.12192 -
Journal of Cachexia, Sarcopenia and... Oct 2020Malnutrition plays an essential role in the mechanism of pathogenesis for sarcopenia. In late life, both food consumption and energy intakes decline. One of key factors...
BACKGROUND
Malnutrition plays an essential role in the mechanism of pathogenesis for sarcopenia. In late life, both food consumption and energy intakes decline. One of key factors for reduced energy intakes is anorexia of ageing. The aim of this study is to examine the association between anorexia of ageing and sarcopenia among community-dwelling elderly Japanese individuals.
METHODS
This uses population-based, cross-sectional cohort study of elderly Japanese individuals. Anorexia of ageing was assessed via a simplified nutritional appetite questionnaire. Handgrip strength and walking speed were tested, and skeletal muscle mass was assessed using a bio-impedance analysis device. Subjects with sarcopenia were defined as those who met the criteria of the Asian Working Group for Sarcopenia. The association between anorexia of ageing and sarcopenia was then analysed via multiple regression analysis.
RESULTS
In total, 9,496 elderly Japanese individuals were evaluated (mean age 74.1 ± 5.4 years; male, 47.0%). The prevalence of anorexia of ageing was 9.8% (n = 927) in the present study. The prevalence of sarcopenia in men was 1.1%, 1.8%, 6.1%, 10.1%, and 21.2% and was 1.6%, 3.3%, 3.6%, 4.8%, and 7.4% in women aged 65-69, 70-74, 75-79, 80-84, and 85 years and older, respectively. The prevalence of anorexia also showed an age-dependent increase in both sexes (P < 0.001, respectively). The prevalence of anorexia in men was 8.3%, 6.3%, 9.8%, 13.6%, and 12.9% and was 7.9%, 9.4%, 10.5%, 17.6%, and 17.1% in women aged 65-69, 70-74, 75-79, 80-84, and 85 years and older, respectively. In multivariable logistic regression model adjusted for the covariates except for albumin, anorexia of ageing was independently associated with sarcopenia (OR: 1.45, 95% CI: 1.07 to 1.95; P = 0.015). This significant association remained even after adjusting for all covariates including nutritional status (OR: 1.42, 95% CI: 1.06 to 1.92, P = 0.020).
CONCLUSIONS
Anorexia of ageing is associated with sarcopenia among Japanese elderly individuals. Further studies are needed to determine whether a causal association exists between anorexia and sarcopenia.
Topics: Aged; Aged, 80 and over; Aging; Anorexia; Cross-Sectional Studies; Female; Hand Strength; Humans; Japan; Male; Sarcopenia
PubMed: 32190984
DOI: 10.1002/jcsm.12571 -
Medicine Apr 2021Anorexia is a common and frequent disease in clinical pediatrics. It refers to a chronic digestive disorder syndrome with loss of appetite or disappearance and reduced...
BACKGROUND
Anorexia is a common and frequent disease in clinical pediatrics. It refers to a chronic digestive disorder syndrome with loss of appetite or disappearance and reduced food intake. The incidence of anorexia in children is very high, if not timely, safe and effective treatment, will have a huge impact on the growth and development of children. The toxic side effects of related treatment drugs often worry clinicians. Pediatric massage is external therapy, with green, safe and effective characteristics, lack of evidence-based medicine evidence support. A systematic evaluation and meta-analysis of the safety and efficacy of pediatric massage in the treatment of anorexia will be carried out in this paper to provide a powerful evidence.
METHODS
We'll retrieve 8 electronic databases, including the PubMed, Embase, Cochrane Library, Web Of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database (WF), China Science Journal Database (VIP), the retrieval date was established from the database to March 2021. The authors will screen the study independently, Extracting data, and through Coch bias tools to assess the quality hazards of methods. RevmanV.5.3 software will be used for statistical analysis.
RESULTS
The results of this study need to be obtained after the completion of this program.
CONCLUSIONS
The conclusion of this study will confirm the efficacy and safety of pediatric massage in the treatment of anorexia, and provide reliable evidence for clinical selection of pediatric massage in the treatment of anorexia.
ETHICS AND DISSEMINATION
This study does not need to be reviewed by the Ethics Committee, because this paper is not a clinical study or a related experimental study, and this paper is only a literature study.
INPLASY REGISTRATION NUMBER
INPLASY202130050.
Topics: Adolescent; Anorexia; Child; Female; Humans; Male; Massage; Meta-Analysis as Topic; Pediatrics; Randomized Controlled Trials as Topic; Research Design; Systematic Reviews as Topic; Treatment Outcome
PubMed: 33907127
DOI: 10.1097/MD.0000000000025654