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Abnormalities of the hypothalamus-pituitary-adrenal axis in patients with Anorexia Nervosa are not really reflected by free corticosteroid excretion - Reply [Letter]

Klein, Diane A; Mayer, Laurel E; Schebendach, Janet E; Walsh, BTimothy
ISI:000251698100036
ISSN: 0306-4530
CID: 1822672

Artificial sweetener use among individuals with eating disorders

Klein, Diane A; Boudreau, Gillian S; Devlin, Michael J; Walsh, B Timothy
Women with eating disorders report using large quantities of artificially sweetened products, but this has not been quantified. OBJECTIVE: The authors assessed the use of selected artificially sweetened low-calorie products among women with eating disorders compared with controls. METHOD: Thirty women with anorexia nervosa (18 with the restricting subtype [AN-R] and 12 with the binge/purge subtype [AN-B/P]), 48 women with bulimia nervosa (BN), and 32 healthy control women completed a survey of frequency and amount of consumption of chewing gum, artificially sweetened low-calorie beverages, and packets of artificial sweetener in the previous month. RESULTS: A greater proportion of women with AN-B/P and BN reported use of each product, compared with women with AN-R and control participants. Among product users, patients with eating disorders reported using greater amounts than controls. Among patients who reported binge eating and/or purging, the quantity of each product used was inversely correlated with body mass index (BMI). CONCLUSION: These data suggest an increased drive for sweet orosensory stimulation in women with AN and BN.
PMID: 16523474
ISSN: 0276-3478
CID: 162785

Translational approaches to understanding anorexia nervosa

Klein, Diane A; Walsh, B Timothy
Translational research has fostered significant gains in neuroscience and psychiatry and has been identified by the NIMH as a "priority area" for further funding. As applied to anorexia nervosa (AN), "translational research" describes the application of principles and methodologies employed in related fields to advance the understanding, and ultimately treatment and prevention, of this disorder. Several promising areas of translational research in AN are identified. Such research, particularly when linked to a conceptual framework, offers the potential of lending much-needed novel insight into this challenging and enigmatic disorder.
PMID: 15852311
ISSN: 0276-3478
CID: 162787

Exercise "addiction" in anorexia nervosa: model development and pilot data

Klein, Diane A; Bennett, Andrew S; Schebendach, Janet; Foltin, Richard W; Devlin, Michael J; Walsh, B Timothy
BACKGROUND: Excessive exercise has long been observed to be a problematic behavior of many patients with anorexia nervosa (AN). However, many questions remain as to the exact role exercise plays in this disorder. In particular, it has been suggested that exercise holds "addictive" properties in persons with AN, but that remains to be demonstrated. OBJECTIVE: The aim of this study was to adapt and apply a scale used in addictions research to determine whether symptoms of "dependence" to exercise could be measured in a group of women with AN. RESULTS: Forty-eight percent of individuals assessed endorsed symptoms consistent with exercise dependence in the previous month. The number of criteria met for exercise dependence was directly correlated with a clinical measure of anxiety. CONCLUSION: Results support further investigation into addictive properties for exercise in individuals with AN and its relationship to anxiety
PMID: 15208508
ISSN: 1092-8529
CID: 162789

Eating disorders: clinical features and pathophysiology

Klein, Diane Alix; Walsh, B Timothy
Anorexia nervosa (AN) and bulimia nervosa (BN) are disorders of eating and weight-related behavior that together afflict some 1-3% of women in the United States. One of the remarkable features about each of the eating disorders is how persistent the disordered eating behavior becomes once it has begun. Substantial psychological, social, and physiological disturbances are associated with eating disorders, and it has been very difficult to disentangle those factors that may result from the disturbed behavior from the factors that may have predisposed individuals to, or precipitated the development of, the disorder. This article will briefly review the definitions, phenomenology, and identified risk factors for development of each of the major eating disorders. Pathophysiology will be discussed, with a particular focus on candidate factors that might sustain disordered eating behavior, as informed by clinical and basic science research. Future research directions will be suggested.
PMID: 15159176
ISSN: 0031-9384
CID: 185682

Eating disorders

Klein, D A; Walsh, B T
Eating disorders rank among the most debilitating psychiatric disturbances that affect young women. Knowledge has increased in recent years about the two major eating disorders, anorexia nervosa (AN) and bulimia nervosa (BN); however, much remains unknown. This review article will provide an overview of the epidemiology, proposed risk factors and clinical features of AN, and BN, as well as current recommendations for evaluation and treatment of these disorders.
PMID: 15276960
ISSN: 0954-0261
CID: 174335