Personal Meaning and Eating Disorder Treatment: Comment on Warren Et Al.

Personal Meaning and Eating Disorder Treatment: Comment on Warren et al.

Psychotherapy (Chic). 2013 Jul 29;
Zerbe K

Clinicians who treat eating disorders are reported by Warren and colleagues (Demographic and work-related correlates of job burnout in professional eating disorder treatment providers, Psychotherapy, 50, pp. •••-•••) to have significant levels of burnout, with significant observed relationships to important factors such as experience in the field and recent patient mortality. The levels of burnout among those who persist in treating patients with eating disorders, however, were lower than expected, and clinicians with a personal history of eating disorders reported finding higher levels of meaning in their work. This comment explores the possibility that many eating disorder clinicians find satisfaction and meaning in this work for reasons that may not be immediately obvious. Additionally, it considers the possibility that some of the personal meaning derived from clinicians who report themselves “recovered” may be due to residual, unrecognized, or unreported emotional struggle surrounding eating and exercise that lends additional personal significance to this work. (PsycINFO Database Record (c) 2013 APA, all rights reserved). HubMed – eating

Patterns of diet-related practices and prevalence of gastroesophageal reflux disease.

Neurogastroenterol Motil. 2013 Jul 29;
Esmaillzadeh A, Keshteli AH, Feizi A, Zaribaf F, Feinle-Bisset C, Adibi P

No studies have evaluated associations between patterns of diet-related practices as determined by latent class analysis (LCA) and gastroesophageal reflux disease (GERD). We aimed to assess this relationship in a large sample of Iranian adults.In a cross-sectional study in 4763 adults, diet-related practices were assessed in four domains, ‘meal pattern’, ‘eating rate’, ‘intra-meal fluid intake’, and ‘meal-to-sleep interval’, using a pretested questionnaire. LCA was applied to identify classes of diet-related practices. We defined GERD as the presence of heartburn sometimes, often or always.The prevalence of GERD in the study population was 23.5% (n = 1120). We identified two distinct classes of meal patterns: ‘regular’ and ‘irregular’, three classes of eating rates: ‘moderate’, ‘moderate-to-slow’, and ‘moderate-to-fast’, two major classes of fluid ingestion with meals: ‘moderate’ and ‘much intra-meal drinking’, and two classes regarding the interval between meals and sleeping: ‘short’ and ‘long meal-to-sleep’ interval. After adjustment for potential confounders, subjects with ‘irregular meal pattern’ had higher odds of GERD compared with subjects with ‘regular meal pattern’ (OR: 1.21; 1.00-1.46). However, when taking into account BMI, the association disappeared. ‘Long meal-to-sleep interval’ was inversely associated with GERD compared with ‘short meal-to-sleep interval’ (OR: 0.73; 95% CI: 0.57-0.95). ‘Eating rate’ and ‘intra-meal fluid intake’ were not significantly associated with GERD.Our data suggest certain associations between dietary patterns and GERD. These findings warrant evaluation in prospective studies to establish the potential value of modifications in dietary behaviors for the management of GERD. HubMed – eating

Meal replacements, reduced energy density eating and weight loss maintenance in primary care patients: A randomized controlled trial.

Obesity (Silver Spring). 2013 Jul 26;
Lowe MR, Butryn ML, Thomas JG, Coletta M

Objective: To compare the presence or absence of meal replacements (MRs) and an energy density (ED) intervention to facilitate weight loss maintenance. Design and Methods: 238 overweight primary care patients (mean BMI= 39.5 kg/m(2) ) began the study; 132 completed the 12-week weight loss phase. Participants were randomly assigned to one of four maintenance conditions formed by crossing the presence or absence of MRs (MR+/MR-) and of the ED program (ED+/ED-) during a subsequent 9-month maintenance phase. Follow-ups assessments occurred 1 and 2 years after treatment termination. Results: Participants initially lost 6.1 kg. Analyses of variance based on weight change from the beginning of the maintenance phase to the 2-year follow-up produced a significant interaction. All groups except ED+/MR- regained substantial weight during follow-up; the ED+/MR- group regained significantly less weight than the control group at both follow-up assessments. No significant effects of treatment were found for several variables that were expected to mediate these outcomes. Conclusions: Because weight losses achieved in lifestyle change programs for obesity are rarely maintained, the superior outcome achieved by the ED+/MR- condition is notable. Nonetheless, methodological issues and inability to identify a potential mediator of this outcome makes replication of this finding essential. HubMed – eating

Blocking alpha2A adrenoceptors, but not dopamine receptors, augments bupropion-induced hypophagia in rats.

Obesity (Silver Spring). 2013 Jul 26;
Janhunen SK, la Fleur SE, Adan RA

Objective: Anti-obesity drugs have adverse effects which limit their use, creating a need for novel anti-obesity compounds. We studied effects of dopamine (DA) and norepinephrine (NE) reuptake inhibitor bupropion (BUP), alone and after blocking ?1- or ?2-adrenoceptors (AR), D1/5, D2/3 or D4 receptors, to determine which receptors act downstream of BUP. Design and Methods: Effects on caloric intake, meal patterning and locomotion were assessed, using an automated weighing system and telemetry in male rats with 18-h access to Western Human style diet. Results: BUP (30mg/kg) induced hypophagia by reducing meal size and postponing meal initiation. WB4101 (?1-AR;2mg/kg) and imiloxan (?2B-AR;5mg/kg) attenuated BUP’s effect on meal size, while WB4101 and BRL 44408 (?2A/D-AR;2mg/kg) counteracted effect on meal initiation. Atipamezole (?2-AR;1mg/kg) and imiloxan further postponed initiation of meals. SKF 83566 (D1/5;0.3mg/kg), raclopride (D2/3;0.5mg/kg) and to a lesser extent FAUC 213 (D4;0.5mg/kg), attenuated BUP-induced hypophagia. BUP stimulated locomotion, which was blocked by all antagonists, except FAUC 213 or BRL 44408. Conclusions: Alpha1-, ?2A/D- and ?2B-ARs and DA receptors underlie BUP’s effects on size and initiation of meals, while blocking presynaptic ?2-ARs enhanced BUP-induced hypophagia. An inverse agonist of (presynaptic) ?2A-ARs could enhance BUP-induced anorexia and treat eating disorders and obesity. HubMed – eating