Biomedical subjects

L K George Hsu

Publications and source records attributed to L K George Hsu.

7 recordsLinked to original sources

PubMed2005

Five cases of male eating disorders in Central China.

OBJECTIVE: Despite the recent surge of eating disorders among women in large Asian cities, male eating disorder cases remain rare. The current article described 5 male eating disorder cases that presented within a period of 2 years in Wuhan, a city in central China. METHODS: The authors described 4 cases of anorexia nervosa (2 restrictive, 2 bulimic) and 1 case of normal weight bulimia nervosa. RESULTS: Fear of fat was reported for all 5 cases, and none of the cases reported homosexuality. DISCUSSION: Sociocultural changes and westernization most probably accounted for the increasing incidence of eating disorders among male and female youngsters in China today.

Adolescent↗

PubMed2005

Relationship between control and the intermediate term outcome of anorexia nervosa in Hong Kong.

OBJECTIVE: To examine the relationship between control and the intermediate term outcome of Chinese patients with anorexia nervosa. METHOD: 88 patients who fulfilled the DSM-III-R criteria for typical (fat phobic, n=63) and atypical (non-fat phobic, n=25) anorexia nervosa were contacted 9 years after the onset of illness. They completed the Morgan-Russell Outcome Assessment Schedule, Shapiro Control Inventory, and Eating Disorder Inventory-I. RESULTS: 62.2%, 32.4% and 5.4% of patients had good, intermediate, and poor outcome. Outcome was positively correlated with the overall general and specific sense of control, positive sense of control, and negatively with negative sense of control. Patients with good outcome exhibited the least negative modes of control and had the least desire for control. Typical and atypical patients showed similar but not identical control profiles. CONCLUSION: Healthier control was associated with better outcome of anorexia nervosa but their causal relationship was far from clear because of the cross-sectional nature of the present study. The Shapiro Control Inventory is a potentially useful instrument for studying control in eating disorders.

Adolescent↗

PubMed2004

Energy expenditure is very high in extremely obese women.

To test the hypothesis that total energy expenditure (TEE) and resting energy expenditure (REE) are low in extremely obese individuals, factors that could contribute to maintenance of excess weight, a cross-sectional study was conducted in 30 weight stable, extremely obese women [BMI (mean +/- SEM) 48.9 +/- 1.7 kg/m(2)]. TEE was measured over 14 d using the doubly labeled water method, REE and the thermic effect of feeding (TEF) were measured using indirect calorimetry, and activity energy expenditure (AEE) was calculated as TEE - (REE + TEF). Body composition was determined using a 3-compartment model. Subjects were divided into tertiles of BMI (37.5-45.0; 45.1-52.0; and 52.1-77.0 kg/m(2)) for data analysis. TEE and REE increased with increasing BMI tertile: TEE, 12.80 +/- 0.5, 14.67 +/- 0.5, and 16.10 +/- 0.9 MJ/d (P < 0.01); REE, 7.87 +/- 0.2, 8.78 +/- 0.3, and 9.94 +/- 0.6 MJ/d (P < 0.001), and these values were 29-38% higher than published means of measured TEE in nonobese individuals. No significant differences were observed among BMI tertiles for AEE, TEF, or physical activity level (PAL = TEE/REE, overall mean 1.64 +/- 0.16). The Harris-Benedict and WHO equations provided the closest estimates of REE (within 3%), whereas the obese-specific equations of Ireton-Jones overpredicted (40%) and Bernstein underpredicted (21%) REE. Extremely obese individuals have high absolute values for TEE and REE, indicating that excess energy intake contributes to the maintenance of excess weight. Standard equations developed for nonobese populations provided the most accurate estimates of REE for the obese individuals studied here. REE was not accurately predicted by equations developed in obese populations.

Adult↗

PubMed2004

Eating disorders: practical interventions.

The 4 currently recognized eating disorders are among the most common of psychiatric disorders to affect women in this country and are associated with chronic health impairments, although anorexia nervosa still carries a high mortality rate, including death by suicide. This review will focus primarily on the treatment of anorexia and bulimia nervosa and discuss interventions focused on engaging the patient, normalizing weight and nutritional status, changing dysfunctional attitudes and behaviors, and managing comorbid disorders such as major depression.

Anorexia Nervosa↗

PubMed2003

Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery.

Body composition methods were examined in 20 women [body mass index (BMI) 48.7 +/- 8.8 kg/m(2)] before and after weight loss [-44.8 +/- 14.6 (SD) kg] after gastric bypass (GBP) surgery. The reference method, a three-compartment (3C) model using body density by air displacement plethysmography and total body water (TBW) by H(2)18O dilution (3C-H(2)18O), showed a decrease in percent body fat (%BF) from 51.4 to 34.6%. Fat-free mass hydration was significantly higher than the reference value (0.738) in extreme obesity (0.756; P < 0.001) but not after weight reduction (0.747; P = 0.16). %BF by H(2)18O dilution and air displacement plethysmography differed significantly from %BF by 3C-H(2)18O in extreme obesity (P < 0.05) and 3C models using (2)H(2)O or bioelectrical impedance analysis (BIA) to determine TBW improved mean %BF estimates over most other methods at both time points. BIA results varied with the equation used, but BIA better predicted %BF than did BMI at both time points. All methods except BIA using the Segal equation were comparable to the reference method for determining changes over time. A simple 3C model utilizing air displacement plethysmography and BIA is useful for clinical evaluation in this population.

Adipose Tissue↗

PubMed2003

Long-term changes in energy expenditure and body composition after massive weight loss induced by gastric bypass surgery.

BACKGROUND: Little is known about the determinants of individual variability in body weight and fat loss after gastric bypass surgery or about the effects of massive weight loss induced by this surgery on energy requirements. OBJECTIVES: The objectives were to determine changes in energy expenditure and body composition with weight loss induced by gastric bypass surgery and to identify presurgery predictors of weight loss. DESIGN: Thirty extremely obese women and men with a mean (+/- SD) age of 39.0 +/- 9.6 y and a body mass index (BMI; in kg/m(2)) of 50.1 +/- 9.3 were tested longitudinally under weight-stable conditions before surgery and after weight loss and stabilization (14 +/- 2 mo). Total energy expenditure (TEE), resting energy expenditure (REE), body composition, and fasting leptin were measured. RESULTS: Subjects lost 53.2 +/- 22.2 kg body weight and had significant decreases in REE (-2.4 +/- 1.0 MJ/d; P < 0.001) and TEE (-3.6 +/- 2.5 MJ/d; P < 0.001). Changes in REE were predicted by changes in fat-free mass and fat mass. The average physical activity level (TEE/REE) was 1.61 at both baseline and follow-up (P = 0.98). Weight loss was predicted by baseline fat mass and BMI but not by any energy expenditure variable or leptin. Measured REE at follow-up was not significantly different from predicted REE. CONCLUSIONS: TEE and REE decreased by 25% on average after massive weight loss induced by gastric bypass surgery. REE changes were predicted by loss of body tissue; thus, there was no significant long-term change in energy efficiency that would independently promote weight regain.

Adult↗

PubMed2003

The intermediate-term outcome of Chinese patients with anorexia nervosa in Hong Kong.

OBJECTIVE: The authors determined the intermediate-term outcome of anorexia nervosa for Chinese patients in Hong Kong. METHOD: A consecutive series of 88 patients who fulfilled DSM-III-R criteria for typical (i.e., fat phobic [N=63]) and atypical (i.e., no fat phobia [N=25]) anorexia nervosa were contacted at least 4 years after onset of their illness for semistructured and self-rated assessments of outcome. RESULTS: Three patients (3.4%) died; the mortality ratio for this group against the expected standard for subjects of similar age and gender was 10.5 to 1. Eighty (94.1%) of the remaining 85 patients were successfully traced 9.0 years after onset of their illness. Good, intermediate, and poor outcomes were seen in 61.8%, 32.9%, and 5.3% of the subjects, respectively. Anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified was exhibited by 55.0% of the subjects (N=44). Lifetime depressive (81.6%) and anxiety (27.6%) disorders were common. Older age at onset and the presence of fat phobia independently predicted poor outcome. Patients with atypical anorexia nervosa were symptomatically stable, less likely to demonstrate bulimia, and had a better eating disorder outcome than patients with typical anorexia nervosa. CONCLUSIONS: The outcome profile of Chinese patients supported the cross-cultural disease validity of anorexia nervosa. The cultural fear of fatness not only shaped the manifest content but also added to the chronicity of the illness.

Adolescent↗