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Biomedical subjects

K A Halmi

Publications and source records attributed to K A Halmi.

At least 55 records · Page 3Linked to original sources

Relationship of bone density to estradiol and cortisol in anorexia nervosa and bulimia.

Dual photon absorptiometry was used to assess the risk of developing osteoporosis in patients with anorexia nervosa and patients of normal weight with bulimia nervosa. Anorectic patients had significantly lower vertebral bone mineral densities compared with healthy controls. Bulimic patients had values similar to those of controls, and the differences between bulimics and anorectics narrowly missed significance. No significant difference was found between patient groups in measurements of serum estradiol, but anorectics, compared with bulimics, had significantly higher values of 24-hour urinary free cortisol. Hypercortisolemia, by diminishing bone formation and increasing bone resorption, is likely to contribute to the development of osteoporosis in patients with eating disorders.

Adult↗

Fat aversion in eating disorders.

Patients with eating disorders are reported to show an irrational dislike of starchy foods, sometimes described as a "carbohydrate phobia". In the present study, food-related attitudes and self-reported food preferences of women patients with anorexia nervosa (N = 13), anorexia with bulimia (N = 16) and bulimia (N = 14) were mapped using multidimensional scaling (MDS) procedures and compared to those of normal-weight controls (N = 49). Sixteen common food names were rated along 9-point category scales for their nutritional similarity, perceived macronutrient content, caloric density and overall nutritional value. MDS (SINDSCAL) and property fitting (PROFIT) procedures revealed that eating disorder patients associated calories with fat content to a greater extent than did controls, and tended to dislike high-fat foods. In contrast, no differences in perceptions or preferences for carbohydrate foods were observed. Anorectic restrictor patients showed the most rigid attitude structure, expressing preferences only for the lowest calorie and the most nutritious foods. The present multivariate techniques of mapping perceptual space may help to distinguish between diagnostic subgroups in studies of eating disorders.

Adolescent↗

The endocrinology of anorexia nervosa and bulimia nervosa.

Considerable evidence exists of hypothalamic dysfunction in patients with anorexia nervosa and bulimia nervosa. This dysfunction is reflected in disturbances of endocrine function including abnormalities of gonadotropin, growth hormone, and corticotropin-releasing hormone secretion. Whereas these disturbances are generally reversed with nutritional rehabilitation and weight restoration, it is not evident to what extent nutritional factors are the primary etiology or whether they unmask an otherwise existing but compensated central disturbance. Similarly, endocrine disturbances may be a final common pathway in which disturbances of diet, weight, activity, stress, and mood as well as hypothalamic dysfunction are expressed.

Adrenal Glands↗

The endocrinology of anorexia nervosa and bulimia nervosa.

Considerable evidence exists of hypothalamic dysfunction in patients with anorexia nervosa and bulimia nervosa. This dysfunction is reflected in disturbances of endocrine function including abnormalities of gonadotropin, growth hormone, and corticotropin-releasing hormone secretion. Whereas these disturbances are generally reversed with nutritional rehabilitation and weight restoration, it is not evident to what extent nutritional factors are the primary etiology or whether they unmask an otherwise existing but compensated central disturbance. Similarly, endocrine disturbances may be a final common pathway in which disturbances of diet, weight, activity, stress, and mood as well as hypothalamic dysfunction are expressed.

Anorexia Nervosa↗

Relationship of clinical factors to caloric requirements in subtypes of eating disorders.

Caloric requirements for weight gain in subgroups of anorectic patients (anorectic restrictors, anorectic binge-purgers) and weight maintenance in subgroups of anorectic and bulimic patients (bulimics with and without a prior history of anorexia nervosa) were studied in a total of 36 patients. No significant differences were found between subgroups of anorectic patients either in calories to gain weight or to maintain a normal weight. Bulimic patients, as a group, were found to require significantly fewer [corrected] calories than the group of anorectic patients to maintain a normal weight. Bulimic patients with a prior history of anorexia nervosa were found to require more calories for weight maintenance than bulimics with no such prior history. In the entire eating disorder population, there was a significant negative correlation between highest premorbid body mass index (BMI) and calories required to maintain weight. These findings suggest that differences in energy metabolism may be present in the eating disorder subgroups.

Adolescent↗

Comparison of bulimic and non-bulimic anorexia nervosa patients during treatment.

Bulimic and non-bulimic anorexics were compared on psychological variables during a hospital treatment study. Although before treatment bulimic anorexics displayed more overall psychopathology than non-bulimics, many of the differences disappeared with treatment. There was no difference in severity of depression or body size estimation in these groups both before and with treatment. There was no difference in treatment response as measured by rate of weight gain. More expression of discomfort by bulimic anorexics during the acute phase of illness may in part account for some described differences in these two groups.

Adolescent↗

Taste and eating disorders.

Taste responses to sucrose and fat-containing stimuli were examined in a population of young women with eating disorders. Anorectic-restrictor and anorectic-bulimic patients were compared with normal-weight bulimic patients and with normal-weight control subjects. Sensory estimates of sweetness and fat content of 20 different mixtures of milk, cream, and sugar did not differ among subject groups. In contrast, relative preferences for sugar vs fat as determined by the Response Surface Method differed between patients with eating disorders and control subjects. Normal-weight bulimic patients preferred sweeter stimuli than did control subjects. Anorectic-restrictor and anorectic-bulimic patients liked sweet but disliked high-fat stimuli and showed elevated optimal sugar:fat (S:F) ratios. This pattern of response did not change following weight regain. The stability of preference profiles suggests that taste responsiveness may be independent of diagnostic categories, bulimic behaviors, or acute changes in body weight.

Adolescent↗

Anorexia nervosa and bulimia.

This article is an update on the research and treatment of anorexia nervosa and bulimia. In the past five years, endocrine research has focused on neurotransmitters in anorexia nervosa and treatment research has centered on bulimia.

Adolescent↗

Anorexia nervosa. Treatment efficacy of cyproheptadine and amitriptyline.

Patients with anorexia nervosa have concurrent problems of emaciation and depression. Therefore, treatment with medications affecting both weight gain and depression seemed reasonable. Seventy-two anorectic patients were randomly assigned in a double-blind study to receive cyproheptadine hydrochloride, a weight-inducing drug, amitriptyline hydrochloride, a tricyclic antidepressant, or placebo. Overall, cyproheptadine had a marginal effect on decreasing the number of days necessary to achieve a normal weight. There was a differential drug effect present in the bulimic subgroups of the anorectic patients: cyproheptadine significantly increased treatment efficiency for the nonbulimic patients and significantly impaired treatment efficiency for the bulimic patients when compared with the amitriptyline- and placebo-treated groups. The differential cyproheptadine effect on the anorectic bulimic subgroups is the first pharmacologic evidence of the validity of these subgroups. Cyproheptadine had an anti-depressant effect demonstrated by a significant decrease in the Hamilton depression ratings.

Adolescent↗

Activity measures in anorexia nervosa.

Twenty-four-hour measurements of wrist and ankle kinetic energy expenditures were obtained on 20 hospitalized female anorectics during the first two weeks of their hospitalization. Kinetic energy was examined against measures of weight, depression, and Minnesota Multiphasic Personality Inventory scores in a regression analysis. Effect of cyproheptadine hydrochloride, amitriptyline hydrochloride, and placebo on activity was assessed. The results supported previous studies showing a positive relationship between weight gain and motor activity and challenge the commonly held notion that activity decreases in anorectics as their clinical condition improves. Motor activity was initially significantly suppressed by cyproheptadine and subsequently increased.

Adolescent↗

Satiety responses in eating disorders.

Appetite and satiety responses in a test meal paradigm were studied in six anorexia nervosa patients (four had bingeing and purging behaviors) and in nine normal control women. The anorexic patients were distinguished from normal controls by the amounts of food taken and by the pattern of the hunger and fullness responses to the test meal. Possible explanations for these findings are discussed.

Anorexia Nervosa↗

A comparison of the psychological evaluation of adolescents with anorexia nervosa and of adolescents with conduct disorders.

Cognitive and projective psychological tests were administered to ten inpatient adolescents with anorexia nervosa and ten inpatient adolescents with conduct disorders. All subjects were selected on the basis of race, sex and overall intelligence. Results indicate that there are high numbers of neuropsychological deficits in both groups, but that neuropsychological deficits are especially numerous in the anorexia group. The two groups showed striking similarities in terms of some psychological functions, but results indicate that some aspects of personality style in the two groups are significantly different. A significant finding was that there were far more suicidal indicators on the Rorschach records of the anorectic group as compared with those found on the records of the conduct disorder group.

Adolescent↗