INGE ATING A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES
J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS
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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1
Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Binge Eating: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00137-3 1. Binge Eating-Popular works. I. Title.
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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.
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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on binge eating. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.
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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.
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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health
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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON BINGE EATING .......................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Binge Eating ................................................................................. 6 The National Library of Medicine: PubMed ................................................................................ 28 CHAPTER 2. NUTRITION AND BINGE EATING ................................................................................ 71 Overview...................................................................................................................................... 71 Finding Nutrition Studies on Binge Eating ................................................................................ 71 Federal Resources on Nutrition ................................................................................................... 72 Additional Web Resources ........................................................................................................... 72 CHAPTER 3. ALTERNATIVE MEDICINE AND BINGE EATING .......................................................... 75 Overview...................................................................................................................................... 75 National Center for Complementary and Alternative Medicine.................................................. 75 Additional Web Resources ........................................................................................................... 80 General References ....................................................................................................................... 81 CHAPTER 4. DISSERTATIONS ON BINGE EATING ............................................................................ 83 Overview...................................................................................................................................... 83 Dissertations on Binge Eating ..................................................................................................... 83 Keeping Current .......................................................................................................................... 84 CHAPTER 5. BOOKS ON BINGE EATING........................................................................................... 85 Overview...................................................................................................................................... 85 Book Summaries: Federal Agencies.............................................................................................. 85 Chapters on Binge Eating ............................................................................................................ 86 CHAPTER 6. PERIODICALS AND NEWS ON BINGE EATING ............................................................. 89 Overview...................................................................................................................................... 89 News Services and Press Releases................................................................................................ 89 Newsletter Articles ...................................................................................................................... 90 Academic Periodicals covering Binge Eating............................................................................... 91 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 95 Overview...................................................................................................................................... 95 NIH Guidelines............................................................................................................................ 95 NIH Databases............................................................................................................................. 97 Other Commercial Databases....................................................................................................... 99 APPENDIX B. PATIENT RESOURCES ............................................................................................... 101 Overview.................................................................................................................................... 101 Patient Guideline Sources.......................................................................................................... 101 Finding Associations.................................................................................................................. 107 APPENDIX C. FINDING MEDICAL LIBRARIES ................................................................................ 109 Overview.................................................................................................................................... 109 Preparation................................................................................................................................. 109 Finding a Local Medical Library................................................................................................ 109 Medical Libraries in the U.S. and Canada ................................................................................. 109 ONLINE GLOSSARIES................................................................................................................ 115 Online Dictionary Directories ................................................................................................... 116 BINGE EATING DICTIONARY................................................................................................. 117 INDEX .............................................................................................................................................. 145
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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with binge eating is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about binge eating, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to binge eating, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on binge eating. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to binge eating, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on binge eating. The Editors
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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.
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CHAPTER 1. STUDIES ON BINGE EATING Overview In this chapter, we will show you how to locate peer-reviewed references and studies on binge eating.
The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and binge eating, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “binge eating” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •
Binge eating disorder: A review of the literature after publication of DSM-IV Source: Eating and Weight Disorders. September 1999. p. 103- 114. Contact: Editrice Kurtis s.r.l., Via Luigi Zoja, 30, 20153 Milano, Italy. http://www.kurtis.it. Summary: Binge Eating Disorder (BED) is a syndrome marked by recurrent episodes of binge eating, in the absence of the regular use of inappropriate compensatory behaviors. This article reviews research on BED since the publication of Diagnostic and Statistical Manual of Mental Disorders (DSM- IV; 4). Binge eating is a common symptom associated with obesity, however BED may be conceptualized as a psychiatric syndrome or it may be viewed as a behavioral symptom associated with obesity.
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Overcoming Binge Eating Disorder Source: Diabetes Self-Management. 19(2): 13-21. March-April 2002. Contact: Available from R.A. Rapaport Publishing, Inc. 150 West 22nd Street, New York, NY 10011. (800) 234-0923. Website: www.diabetes-self-mgmt.com. Summary: Binge eating disorder affects both men and women, as well as people of all ages and ethnic backgrounds. This article describes binge eating disorder, with a special focus on the implications of eating disorders in people with diabetes. The author differentiates between overeating and binge eating, defining binge eating as an overwhelming urge to eat and consume a larger quantify of food more quickly than usual and in a short period of time. The amount of food consumed is definitely more than most people would eat in that amount of time. The person eats despite the absence of hunger or how full they feel; they may not stop eating until they feel very painfully full. In addition, it is common for a person with binge eating disorder to eat normally or restrictively in front of other people and to binge in secret to avoid embarrassment about the amount of food being consumed. When episodes of binge eating become frequent (at least two times a week) and persist for six months, it is called binge eating disorder. Binge eating disorder is similar to bulimia except that people with binge eating disorder do not attempt to rid themselves of the food they consume during a binge by vomiting, using laxatives, decreasing or omitting insulin doses, or exercising excessively. The author describes the etiology (cause) of binge eating, psychosocial factors, biological factors, learned and family factors, the complications of binge eating, treatment strategies, the role of support groups, nutrition counseling, and self care. One sidebar lists resources organizations that can provide more information about eating disorders and referrals to professionals in this area.
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An Update on Binge Eating Disorder Source: Healthy Weight Journal. 16(2):20-23. March/April 2002. Summary: The author of this article provides an update on binge eating disorder (BED), a term adopted in 1992 at an International Eating Disorders Conference. BED is used to describe and distinguish individuals who binge eat, but do not use severe compensatory weight control behaviors such as fasting or purging, from those with bulimia nervosa. Binge eating causes individuals to feel out of control, isolated, ashamed, and depressed. BED appears to afflict a more diverse group than other eating disorders. Men, women, African Americans, and Caucasians appear to be at equal risk. The age range for those with BED is also broader than usually found in those with the eating disorders anorexia nervosa and bulimia nervosa. BED treatment emphasizes the individual's binge eating; compulsivity with food; inability to control food intake; and use of food to cope with depression, anxiety, or other issues. The author, who treats patients with BED, provides a case study to show how she helps patients develop a healthy relationship with food.
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Binge Eating Disorder Comes Out of the Closet Source: Tufts University Diet and Nutrition Letter. 14(11):4-5, Jan 1997. Contact: Tufts University Diet and Nutrition Letter, 53 Park Place, New York, NY 10007. Summary: This article characterizes Binge Eating Disorder (BED) as uncontrollable food consumption that is not followed by purging behavior (i.e., laxatives, self-induced vomiting). According to this article, BED is not recognized as a disorder separate from anorexia nervosa and bulimia by the American Psychiatric Association, in spite of the differences. One such difference, says Seda Ebrahimi, director of the eating disorders
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treatment program at McLean Hospital in Belmont, Massachusetts, is the discomfort and distress felt after a binge. Others include the lack of purging; eating more rapidly than normal; eating until uncomfortably full; eating large amounts when not actually hungry; eating alone because of embarrassment about how much is eaten; and feelings of disgust, depression, and guilt after a binge. Dr. Ebrahimi says there is a relationship between depression and BED, but no one is sure which is the cause and which is the effect. Treatment is usually directed to the depression first, then to the eating behavior. •
Binge Eating in Obesity: Treatment and Weight Management Issues Source: Healthy Weight Journal. 16(2):24-26. March/April 2002. Summary: This article compares overweight nonbingeing individuals with obese binge eaters. Obese binge eaters are usually more overweight; have lower self- esteem; and have higher levels of perfectionism, anxiety, depression, and body shame. They often feel depressed, disgusted, and/or guilty after a binge. Binge eating disorder (BED) is usually diagnosed when binge eating occurs at least twice a week for a minimum of 6 months, accompanied by feeling out of control and an absence of behavior such as purging or fasting. Treatment for binge eating consists of assessing eating behavior, regulating eating behavior, distinguishing real hunger from emotional hunger, improving control over binge foods, decreasing depression and anxiety, increasing wellbeing, managing high- risk situations, and changing self-defeating food thoughts. Managing binge eating before trying to lose weight is recommended.
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Body Image, Binge Eating, and Obesity in Males Source: Healthy Weight Journal. 16(4):56-58. July/August 2002. Summary: This article provides an overview of body image, binge eating disorder (BED), and obesity in men. Data support the idea that males are experiencing an increased pressure to be slender and muscular. Men's food choices and eating style may present a paradox in relation to body image, as it is culturally acceptable for men to eat heartily, yet less acceptable for them to be overweight. Research suggests that men and women with BED have similar demographics, frequency of interpersonal problems, selfesteem, eating-disordered behaviors, and eating-disordered psychopathology. More than half of adults in the United States are overweight and males have shown more significant increases in obesity than females. The authors conclude that although there is a tendency to believe that eating disorders are more common in women than in men, men are concerned about issues of body shape and weight, overeating, and obesity. Health professionals working with patients who have eating disorders should be aware of the increasing prevalence of weight-related concerns for males and how these concerns differ from females.
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Frequency of Binge Eating Disorder in an Outpatient Weight Loss Clinic Source: J Am Diet Assoc. 102(5):697-699. May 2002. Summary: This study assessed the prevalence of binge eating disorder (BED) in an outpatient weight-loss clinic. Among those who seek nutrition counseling for weight loss, it also determined readiness to start an intervention program. Thirty-six weightloss patients were given diet readiness questionnaires. Fifty-six percent of the group failed the questionnaire, indicating a lack of willingness to initiate lifestyle changes. Frequency of BED was 22 percent. In this small study, there was an association between lack of diet readiness and BED. The authors note that this relationship deserves more
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attention. Patients with BED frequently seek weight-loss counseling, and better patient service includes screening for BED.
Federally Funded Research on Binge Eating The U.S. Government supports a variety of research studies relating to binge eating. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to binge eating. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore binge eating. The following is typical of the type of information found when searching the CRISP database for binge eating: •
Project Title: BINGE EATING IN OBESE VS NORMAL WEIGHT INDIVIDUALS Principal Investigator & Institution: Mcduffie, Jennifer; University of North Carolina Chapel Hill Aob 104 Airport Drive Cb#1350 Chapel Hill, Nc 27599 Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: BINGE CORRELATES
EATING:
CLINICAL
PATTERNS
&
BIOLOGICAL
Principal Investigator & Institution: Keel, Pamela K.; Associate Professor; Psychology; Harvard University Holyoke Center 727 Cambridge, Ma 02138 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: The long term objectives of this study are to explore the utility of defining binge-eating episodes in bulimia nervosa by the amount of food consumed and to reveal factors that contribute to the development or maintenance of bulimic symptoms. An additional objective is to improve the recognition of an alternative symptom cluster that resembles bulimia nervosa-purging subtype, except that perceived binge episodes do not involve objectively large amounts of food. Recent research indicates that a substantial number of young women suffer from this alternative symptom cluster (subjective bulimia nervosa-SBN) suggesting that SBN represents a significant public health concern. One specific aim of this study is to test the hypothesis that, like women with DSM-IV bulimia nervosa, women with SBN demonstrate clinically significant levels of distress and impairment. A second aim is to demonstrate that SBN is distinct from DSM-IV bulimia nervosa and thus should not be combined with this syndrome 2
Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).
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within one diagnostic category. The study proposes to extend preliminary data suggesting that women with bulimia nervosa have higher levels of impulsiveness compared to women with SBN. In addition, this study proposes a novel examination of whether, compared to women with SBN, women with bulimia nervosa demonstrate lower levels of satiety and blunted cholecystokin (CCK) release following a rest meal. The study will include 30 women with DSM-IV bulimia nervosa-purging subtype, 30 women with SBNm and 30 non-eating disordered control females. Subjects will complete psychological assessments including structured clinical interviews and standardized questionnaire assessments of depression, anxiety, impulsiveness, and social and occupational functioning. Subjects will also participate in assessments of postprandial satiety and CCK release. This study will test a model of bulimia nervosa in which deficient satiety signals fail to decrease the impulse to eat which, combined with poor impulse control, increases the liability to experience objectively large binge-eating episodes by the amount of food consumed and reveal etiologic or maintaining factors for objectively large bing episodes in bulimia nervosa. Further, this study has the potential to identify a new subtype of eating disorder that is worthy of study, treatment, and inclusion in nosological schemes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COGNITIVE THERAPY VIA CD ROM FOR BINGE EATING DISORDER Principal Investigator & Institution: Bulik, Cynthia M.; Professor; Psychiatry; Virginia Commonwealth University Richmond, Va 232980568 Timing: Fiscal Year 2002; Project Start 01-APR-2001; Project End 31-MAR-2004 Summary: Although eating and weight-related disorders are treatable, most afflicted individuals never receive proper treatment. Despite the existence of excellent prototype cognitive-behavioral programs for the treatment of binge-eating disorder (BED) and other eating disorders, we face a crisis of dissemination. The goal of this project is to join cognitive-behavioral therapy (CBT) with novel information technology to develop an interactive CBT program that will allow individuals to experience the basics of CBT in the privacy of their own homes. This Exploratory/Development Grant for Mental Health Intervention (R21) proposes a four stage project to develop a CD-ROM-based program for the effective delivery of cognitive-behavioral therapy (CBT) to obese individuals with binge-eating disorder (OBED) and other unhealthy eating behaviors. In Phase 1 of the project, we will continue development of a CD-ROM program that we began in 1998. The program will be a rich, vivid, and interactive approach to CBT that provides helpful psychoeducation on unhealthy eating and weight-related practices; clearly introduces the basic concepts and techniques of CBT; provides rich and vivid examples of techniques; provides individualized and interactive exercises for practicing CBT principles; and enables users to contact the central web site and staff with questions. This program will be applicable to a broad range of adult women and men of all races and backgrounds. In Phase 2, we will implement a rigorous four-stage betatesting procedure that includes: group testing sessions followed by individual and focus group debriefing for feedback; peer review by experts in the field of CBT for eating disorders; and in-home beta testing prior to final production. Phase III of the project will be a small feasibility and pilot study comparing the efficacy of the CD-ROM-based delivery of CBT to traditional manual-based group therapy for individuals with OBED and a wait list control. Data from this pilot study will be used to support Phase IV, which will develop a proposal for a large-scale clinical trial comparing CD-ROM-based intervention with traditional group therapy. We anticipate that a CD-ROM-based
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program will be an efficacious and cost-effective intervention. For some, this program may suffice for treating their eating and weight-related problems. For others, it may be a useful adjunct to traditional psychotherapy or an introductory step to treatment which will familiarize them with the principles and techniques of CBT and increase their comfort and motivation to seek additional professional care. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: COMPARISON OF DBT AND SUPPORTIVE THERAPY FOR BED Principal Investigator & Institution: Safer, Debra L.; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2003; Project Start 11-APR-2003; Project End 29-FEB-2008 Summary: (provided by applicant): The overarching objective of the candidate's application for an individual Research Career Award (K23) is to train the candidate to become an independent clinical researcher in an academic setting in order to develop an expertise in the treatment of individuals with eating disorders. Binge Eating Disorder (BED), a proposed diagnostic category in DSM-IV, is associated with impairments in physical, psychological, and social functioning. Cognitive behavioral therapy (CBT), based on the restraint model, has been the most studied treatment for BED. Given that the average rate of abstinence from binge eating at the end of CBT treatment approximates 50% across multiple studies, potentially more effective treatment interventions merit consideration. Dialectical Behavior Therapy (DBT), based on the affect regulation model linking binge eating with emotional distress, is one such treatment approach. Preliminary studies indicate that abstinence rates at the end of 20 weeks of manualized DBT adapted for BED in a group format range from 82-89%. At the same time that new and more efficacious treatments for BED are being developed, current BED research has not as yet demonstrated consistently significant outcome differences among existing therapies. This suggests that nonspecific therapeutic factors (e.g. therapist-patient interactions) and/or baseline factors (e.g. patient expectations) may account for much if not all of BED treatment outcome. As no studies to date have compared the outcome of a specific psychotherapeutic treatment for BED with a therapy controlling for nonspecific factors, the candidate will conduct a randomized clinical trial comparing the outcome of manualized DBT to a manualized Supportive Group Therapy for adults. Assessed will be the short (post-treatment), medium (3 mo, 6 mo) and longer term (12 mo) outcomes of these treatments as well as mediators and moderators of abstinence. The candidate's specific aims for this K23 award are: 1) to obtain training in research design, statistical analysis, and the theory and process of research through an individualized program of coursework at the Stanford University School of Medicine, with a focus on health outcomes and emotion regulation research and theory; 2) to contribute meaningfully to the understanding of efficacious treatments for BED by conducting a randomized clinical trial and 3) to expand the candidate's skills so that she can develop into a successful and independent investigator capable of obtaining future support for patient-oriented research, such as an R01. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EATING BEHAVIOR AFTER GASTRIC BYPASS Principal Investigator & Institution: Hsu, L. K. George.; Professor; New England Medical Center Hospitals 750 Washington St Boston, Ma 021111533 Timing: Fiscal Year 2002 Summary: This abstract is not available.
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Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENT FOR BED Principal Investigator & Institution: Wilfley, Denise E.; Professor; Psychiatry; Washington University Lindell and Skinker Blvd St. Louis, Mo 63130 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007 Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: EFFECTIVENESS OF PSYCHOLOGICAL TREATMENTS FOR BED Principal Investigator & Institution: Agras, William Stewart.; Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 31-MAR-2007
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Description (provided by applicant): Binge Eating Disorder (BED) is characterized by frequent and persistent episodes of binge eating and associated eating disorder psychopathology as well as general psychiatric comorbidity, psychosocial impairment, and obesity. Although a distinct clinical syndrome, BED is indistinguishable from bulimia nervosa on core eating disorder features such as eating, weight, and shape concerns. To date there is no definitive answer as to what constitutes the most efficacious treatment of BED. Specialty treatments (e.g., interpersonal psychotherapy [IPT]) have demonstrated significant short- and long-term reductions in binge eating and associated psychopathology, but not body weight. Behavioral weight loss (BWL) interventions produce clinically significant short-tem weight loss and reductions in binge eating among obese BED individuals, but the long-term impact on binge eating and other outcomes remains unclear. Guided self-help (GSH) has also demonstrated efficacy for BED in the short-term. The overall aim of this study is to compare the longterm effectiveness of three conceptually and procedurally distinct BED treatments: IPT, BWL, and GSH. A primary question posed is whether BED participants require a specialty treatment (i.e., IM, or whether BWL by itself is sufficient. BWL has the potential advantages of producing weight loss, at least in the short term and being more disseminable as a non-specialty treatment widely administered to obese individuals. Previous tests of BWL for BED have lacked adequate sample sizes, valid measurement of binge eating, and sufficient long-term follow-up. The proposed study remedies these methodological shortcomings, while also evaluating whether IPT or BWL have specific effects beyond that of a credible, minimal treatment (GSH) that is briefer, less costly, and more broadly disseminable than the professionally administered therapies of IPT and BWL. Further, the proposed study tests the differential effectiveness of these BED treatments across levels of negative affect, a dimension along which BED participants reliably subtype. Because IPT targets negative affect, we predict that IPT will prove more effective than either BWL or GSH for the subset of participants with high negative affect. 210 overweight BED participants will be recruited and divided into low negative affect and high negative affect subtypes. Participants will be stratified by negative affect sub-type and randomized to receive one of the three 24-week interventions: IPT, BWL, or GSH. Two treatment sites are required to recruit the large sample needed and to establish generalizability of findings. A third site will serve the function of data coordination and assessment/treatment oversight. Binge eating and associated outcomes will be assessed pre-treatment, post-treatment, and at 6-, 12-, and 24-month follow-up. In addition, likely mediators of change will be assessed during treatment. This study promises to not only clarify the most efficacious overall treatment for individuals with BED, but also to identify sub-groups for whom specific treatments are indicated. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: ENERGY INTAKE IN OBESE BINGE EATING DISORDER INDIVIDUALS Principal Investigator & Institution: Raymond, Nancy C.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 15-AUG-2001; Project End 31-JUL-2004 Summary: (investigator's abstract): Over the last decade there has been increased recognition that a subset of obese patients report binge eating episodes similar to those seen in patients with bulimia nervosa. However, individuals with binge eating disorder (BED) do not engage in compensatory behavior and therefore tend to become obese.
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These individuals with BED have the increased health risk associated with obesity, are at increased risk of developing psychiatric disorders, and have high rates of treatment failure making this an important disorder to study. While certain aspects of the eating behavior of individuals with BED have been studied, important questions about energy intake patterns, nutrient composition and food selection remain unanswered. Additionally, some of the best methods that are available for the study of human energy intake have not yet been applied to this population. We propose to use a comparison of results from several methods to develop a detailed understanding of total energy intake, meal patterning, and nutrient and food selection in obese individuals with BED compared to body mass index (BMI, kg/m2) matched individuals with no history of binge eating. The specific aims of this study are to determine: (1) whether individuals with BED have a higher daily energy intake on average than their non-BED counterparts, (2) how the patterns of energy intake, food selection and nutrient composition differ between individuals with and without a BED diagnosis during meals and overeating episodes, determine the nature of binge eating episodes in the BED population. We hypothesize that: (1) there will be a significant elevation in the total energy intake per day in individuals with BED compared to non-BED individuals; (2) patterns of energy intake will be significantly different between the two groups and; (3) nutrient selection and food selections will differ between individuals with BED and individuals who do not have current or past binge eating episodes. We propose to add to the current body of knowledge in this area with the use of the doubly labeled water (DLW) technique to validate the accuracy of self-reported energy intake records. This study will provide the first direct evidence of the relationship between energy expenditure and self-reported energy intake in individuals with BED. We propose the use of random 24-hour dietary recall interviews to collect dietary intake data in individuals with and without a BED diagnosis. This method has not previously been applied to the study of this disorder. We propose to compare energy intake data collected during binge eating episodes and normal meals in a laboratory setting with comparable data collected during the random dietary recall interviews and the DLW study. A thorough understanding of the energy intake patterns in BED and non-BED individuals will lead to a better understanding of the descriptive nature of the disorder. It will also help to guide treatment priorities and aid researchers in prioritizing which biological systems to study gain insight into the underlying pathophysiology of this disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: FAMILIAL TRANSMISSION OF EATING PATHOLOGY & SEX HORMONES Principal Investigator & Institution: Klump, Kelly L.; Assistant Professor; Psychology; Michigan State University 301 Administration Bldg East Lansing, Mi 48824 Timing: Fiscal Year 2002; Project Start 01-APR-2002; Project End 31-MAR-2005 Summary: Anorexia and bulimia nervosa are often chronic disorders with some of the highest mortality rates (.10%) of any psychiatric illness. Greater understanding of the etiology of disordered eating attitudes and behaviors that underlie these sometimes fatal disorders will inform intervention and prevention efforts aimed at their amelioration. The primary purpose of the proposed study is to examine the etiology significance of ovarian hormones in the development of eating attitudes and behaviors by examining phenotypic and genetic relationships between eating pathology and basal estrogen and progesterone levels in a community-based sample of twins. A secondary aim is to examine phenotypic and genetic relationships between the stress hormone cortisol and
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Binge Eating
disordered eating variables. Estrogen is expected to show positive relationships with dietary restraint, weight preoccupation, and eating/weight./body concerns, and negative associations with binge eating and compensatory behaviors. Progesterone is expected to attenuate these relationships, such that lower estrogen: progesterone ratios will be associated with increased binge eating and compensatory behaviors, and decreased dietary restraint and associated attitudes. Cortisol is expected to show significant positive relationships with all forms of disordered eating. Common genetic factors are expected to contribute significantly to all of these hormone/disordered eating phenotypic relationships. Participants will include 50 female dizygotic twins recruited from the campus of Michigan State University and surrounding metropolitan areas who will complete self-report questionnaires assessing body dissatisfaction, weight preoccupation, binge eating, compensatory behaviors, eating concerns, and dietary restraint. Early follicular phase salivary hormone concentrations of estradiol, progesterone, and cortisol will be obtained between the hours of 0800 and 0900. Phenotypic associations between eating variables and hormone concentrations will be examined using within-person correlations whereas genetic associations will be examined via cross- twin, cross-trait correlations (i.e., Twin 1,s eating attitudes with Twin 2's hormone levels) and Cholesky Decomposition and model fitting analyses. Understanding the magnitude and nature of genetic associations will increase understanding of the etiology of eating disorders and lead to the potential identification of endogenous risk factors to be explored in genetic and neurobiological research. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GUIDED SELF-HELP FOR EATING DISORDERS Principal Investigator & Institution: Striegel-Moore, Ruth H.; Professor; Kaiser Foundation Research Institute 1800 Harrison St, 16Th Fl Oakland, Ca 946123433 Timing: Fiscal Year 2003; Project Start 15-SEP-2003; Project End 31-JUL-2008 Summary: (provided by applicant): Bulimia nervosa (BN) and related eating disorders involving binge eating (e.g., Eating Disorder not Otherwise Specified, EDNOS; Binge Eating Disorder, BED) are serious mental health problems, particularly among young adult women but increasingly also among men. BN and its spectrum variants are associated with adverse long-term health and mental health outcomes. These disorders also are associated with elevated health services utilization, yet these services rarely target the eating disorder (ED) specifically. Cognitive- Behavioral Therapy (CBT), offered by trained professionals with specific expertise, is considered the treatment of choice f or BN and has also been shown to be effective in treating BED. Studies have found, however, that this evidence-based treatment reaches only a minority of individuals with an ED: few individuals receive care specifically for an ED, and when they do, most therapists use treatments other than CBT. Experts have called for the development of a more disseminable form of CBT as an important step within a model of treatment that progresses from minimal interventions to increasingly complex treatments. Several studies have reported the successful use of CBT-based Guided SelfHelp (GSH) treatments for BN and BED, but the data are limited by small sample sizes, a restricted range of patients, and very brief follow-up. Finally, in light of the low rates of treatment seeking, the stepped care approach should include a proactive attempt to reach ED patients. The overall aim of t he proposed study is to determine the acceptability and effectiveness of CBT-GSH when delivered to a community population of women and men with a severe binge eating disorder following a large-scale outreach (screening) effort. Specifically, the study aims to determine the clinical effectiveness of CBT-GSH in the treatment of BN, BED and related EDNOS; subsidiary aims are to
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examine the acceptability of the CBT-GSH intervention t o potential participants and the cost-effectiveness of CBT-GSH relative to usual clinical care in a health maintenance organization. We propose to screen a random sample of 30,000 adults (ages 18 to 35) for binge eating disorders, and enroll an estimated sample of 285 of those women and men with BN, BED or EDNOS in a randomized clinical trial of CBT-GSH. The primary outcome will be change in binge eating. Secondary outcomes will include changes in associated eating pathology (e.g., body image disturbance), associated psychopathology (e.g., depression), functional impairment, body mass index, and health services use. The proposed study will answer the question whether CBT- GSH is an effective early step intervention for the treatment of binge eating disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: GUSTATORY REWARD AND DOPAMINE IN THE NUCLEUS ACCUMBENS Principal Investigator & Institution: Hajnal, Andras; Neural and Behavioral Science; Pennsylvania State Univ Hershey Med Ctr 500 University Drive Hershey, Pa 170332390 Timing: Fiscal Year 2002; Project Start 01-JAN-2001; Project End 31-DEC-2003 Summary: (from applicant's abstract): Gustatory stimuli, particularly those that taste sweet to humans, initiate and maintain ingestive behavior. They also provide reward sufficient to support the learned behavior used by most animals to locate food. Reward mechanisms related to feeding (and other biological drives) have been linked to the mesolimbic dopamine (DA) system in general, and to the nucleus accumbens, specifically. Nevertheless, the function of accumbens DA in reward remains unclear. Taste provides a logical tool for examining central reward mechanisms. Sapid chemicals are quantified easily, they are transduced via a single, well-described sensory channel, and they can be disassociated from their nutritional consequences. Conversely, such testing of the central reward systems can shed light on a central conundrum of gustatory physiology -how the hedonic qualities of tastes can be reconciled with their purely sensory characteristics. Despite the substantial overlap between taste and reward, relatively little experimental attention has been focused on the interaction of these systems at the neural level. The present experiments are designed to: 1) investigate whether sapid sucrose activates the mesoaccumbens DA neurons in a concentration dependent manner during sham feeding; 2) evaluate the effect sucrose licking on NAc DA during chronic weight reduction, as a model of reward sensitization; and 3) examine the contributions of DI and D2 dopaminergic mechanisms of the NAc in the mediation of both the behavioral and neurochemical activation related to sucrose ingestion in both normal and underweight rats. Unlike previous sham-feeding studies that used systemic injections, dopaminergic drugs will be perfused locally in the NAc through reverse microdialysis. The long-term objective of such an investigation is to understand how food-related oral stimuli produce reward. This knowledge is directly relevant to understanding the control of normal ingestive behavior and to the maladies related to this essential behavior, such as obesity, anorexia nervosa, bulimia nervosa, and binge eating disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: HORMONAL AND METABOLIC IMPACT OF BINGE EATING IN WOMEN Principal Investigator & Institution: Taylor, Ann E.; Massachusetts General Hospital 55 Fruit St Boston, Ma 02114
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Binge Eating
Timing: Fiscal Year 2002 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: INTERVENTIONS TO REDUCE EATING DISORDER RISK FACTORS Principal Investigator & Institution: Taylor, Craig B.; Professor; Psychiatry and Behavioral Sci; Stanford University Stanford, Ca 94305 Timing: Fiscal Year 2002; Project Start 12-FEB-2001; Project End 31-JAN-2005 Summary: Description (adapted from the investigator's abstract): Unhealthy weight control methods and body image concerns, which may predispose to clinical and subclinical eating disorders, are widespread among college students. The primary aim of this application is to determine if reducing eating disorders risk-factors (excessive weight/shape concerns and/or bingeing) in female college students reduces the incidence of these disorders. Secondary aims are to evaluate the long-term effects, of a moderated, interactive, multimedia intervention to: reduce potential risk factors for eating disorders, determine the importance of weight gain, evaluate the role of upsetting events, detect new onset of other psychiatric disorders or alcohol and drug abuse on precipitating subclinical/clinical eating disorders. Six hundred sixty students at high risk of developing eating disorders from 3 different colleges/universities will be selected for the project. Students will be selected as being at risk based on high scores on the weight concerns scale. High-risk students will then be randomized into a multimedia risk-reduction program or to no-intervention and followed for up to twoand-a-half years. We expect that 10 percent of the students in the high-risk untreated group will develop eating disorders in one year and that the intervention will reduce this rate by 50 percent (a 5 percent difference). The multimedia risk-reduction program was chosen for the intervention because it was proven effective in a series of pilot studies and can be provided to students at relatively low cost. The intervention is a structured 9-week program which includes sections on reducing body image and weight/shape concerns, the risks of eating disorders, and increasing healthy weight regulation practices. The program also includes weekly readings and writing assignments and participation in a moderated electronic discussion group. The program automatically monitors adherence. Quarterly booster sessions will be provided to help ensure maintenance of risk factor reduction. The primary outcome measure will be oneyear incidence of eating disorders determined by a diagnostic interview. Secondary outcome measures will include weight concerns, eating disorder symptoms, body shape and eating disorder attitudes, distress and treatment seeking. Changes in BMI, the occurrence of major stressors and psychiatric events will also be assessed to determine their impact on the incidence of eating disorders. Incidence rates will be compared using a chi-square statistic. Survival analyses and other multivariate statistics will be used to examine secondary hypotheses and exploratory analyses. The application focuses on issues relevant to recently described NIMH priorities in prevention. Developing and evaluating interventions to reduce eating disorders in this high-risk population is of extreme public health importance. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: DISORDER
MEDITATION-BASED
TREATMENT
FOR
BINGE
EATING
Principal Investigator & Institution: Kristeller, Jean L.; Psychology; Indiana State University 217 N 6Th St Terre Haute, in 47809
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Timing: Fiscal Year 2002; Project Start 01-FEB-2002; Project End 30-JUN-2003 Summary: As many as 30% of individuals seeking treatment for obesity meet DSM-IV criteria for binge eating disorder (BED) (1). BED is marked by recurrent episodes of bingeing, accompanied by feelings of loss of control, and involves chronic disregulation of physiological, emotional and behavioral systems (2). Meditation-based interventions have been used successfully to treat disorders with similar addictive and disregulatory characteristics (3), but have not been applied to treating BED. Data from an uncontrolled pilot study (4) suggests that such an intervention can have marked immediate impact on decreasing episodes of binge eating and other associated characteristics in obese women. Therefore, this study incorporates appropriate comparison conditions to further investigate the efficacy of a mindfulness meditation-based intervention as a treatment component for treating BED symptoms. Exploratory aspects include further development of a manual, establishment of effect size (in comparisof'to appropriate comparison groups), inclusion of a more diverse population, and of measures that address: 1) individual differences in treatment response, 2) possible mechanisms, 3) time course of response, and 3) impact on medical/health variables. Women (approximate N=162) from two communities will be randomly assigned to 3 conditions: 1) an 8-week manualized meditation-based group intervention, 2) a psychoeducational comparison condition, or 3) a waiting-list control. Primary outcome variables will be changes in binge eating behaviors, and associated measures of depression, anxiety, self-esteem, and diet; secondary variables include medical variables sensitive to dietary change (i.e., weight; blood pressure; lipid profile; blood glucose levels), and process variables related to meditation practice, such as the Tellegen Absorption Scale, perceived value and use of the meditation practice, and experiences of increased control and awareness. Participants will be evaluated pre- and post-treatment, and at 1, 3, and 6 months followup. This data would then support the further investigation of a meditation-based intervention as part of a more comprehensive treatment program for BED. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: MELANOCORTIN SIGNALING IN FEEDING BEHAVIOR Principal Investigator & Institution: Cone, Roger D.; Senior Scientist; None; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2009 Summary: Obesity is a leading cause of morbidity and mortality as a risk factor for diabetes, cardiovascular disease, and cancer. The central melanocortin system is a critical circuit in the regulation of body weight and composition, with haploinsufficiency of the melanocortin-4 receptor (MC4-R) in humans the most common monogenic cause of severe obesity, accounting for up to 5% of cases. Consequently, a thorough understanding of the central melanocortin system will increase our understanding of obesity, improve differential diagnosis of obesity syndromes, and ultimately identify potential targets for drug development for the treatment of disorders of energy homeostasis. Much of the research in the field has been focused on the regulation of the arcuate proopiomelanocortin (POMC) neurons by leptin, and their role in mediating the long-term adipostatic leptin signal. Work from the first funding period of this grant also demonstrated an important role of the melanocortin system in satiety, and sensing of nutrient intake. Using an electrophysiological system developed in this laboratory for recording from arcuate POMC and NPY neurons, as well as neuroanatomical methods, we have discovered that these neurons not only respond to leptin, but are also regulated by acute hunger and satiety factors such as PYY3-36, insulin, CCK, and ghrelin. Likewise, in preliminary data provided here we show that MC4-R signaling also has an
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impact on gastric emptying, identifying a novel efferent pathway for regulation of satiety by this system. Indeed, data just published on MC4-R haploinsufficient humans documents a profound hyperphagia, and perhaps even binge eating in these individuals. These findings raise two intriguing hypotheses. First, most hunger and satiety signals are transmitted to the CNS via vagal afferents and humoral inputs to the brainstem. POMC is also expressed in a poorly characterized set of neurons in the nucleus of the solitary tract (NTS) in the brainstem, and the dorsal motor nucleus of the vagus, a key site of motor neurons regulating GI function, is a dense site of MC4-R expression. Thus, the central melanocortin system may be an important pathway for sensing and responding to hunger and satiety siqnals acting through vaqa! and humoral inputs to the brainstem melanocortin system, and perhaps, in the case of some humoral factors even acting directly on arcuate POMC neurons. Secondly, arcuate and brainstem POMC neurons send projections to a number of MC4-R-containing sites involved in autonomic outflow, like the PVN, DMH, IML, PBL, and DMV, and stereotaxic injection of melanocortJn compounds into the PVN can profoundly impact feeding behavior. Thus, the regulation of autonomic outflow to the gut by the melanocortin system may be an important pathway by which this system participates in the regulation of energy intake. In this next funding period, we will continue to characterize regulatory inputs to the central melanocortin system, and effector output pathways, with a focus on the role of the system in sensing and responding to acute hunger and satiety signals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROBIOLOGY OF BINGE-TYPE BEHAVIOR Principal Investigator & Institution: Corwin, Rebecca L.; Nutritional Sciences; Pennsylvania State University-Univ Park 110 Technology Center University Park, Pa 16802 Timing: Fiscal Year 2004; Project Start 12-MAY-2004; Project End 29-FEB-2008 Summary: (provided by applicant): Neurological mechanisms relevant to intermittent episodes of behavioral excess are not well understood, but bear investigation due to the contribution of this kind of behavior to health problems such as disordered eating, obesity and substance abuse. We have developed a unique rat bingeing protocol, which we have been using to examine the neurobiology associated with repeated intermittent excessive fat intake that is maintained over extended periods of time. Peptides that regulate fat intake under non-binge conditions are without effect when rats binge on fat. In contrast, recent results from my laboratory show that the GABA-B agonist baclofen reduces fat intake in our protocol, while having no effect in non-bingeing protocols. Others have reported that baclofen reduces self-administration of abused drugs. This suggests that the neurobiology of bingeing is different from that of non-binge behavior, but may share similarities with the neurobiology of substance abuse. Therefore, we will use baclofen to test the overall hypothesis guiding this research, i.e. that GABA-B receptors have a role in binge-type eating. The following Specific Aims will be addressed: AIM 1: To test the hypothesis that GABA-B ligands will differentially affect fat consumption in bingeing and non-bingeing rats. Hypotheses: a) Lower dosages of baclofen will reduce food intake to a greater extent in bingeing rats than in non-bingeing rats; Lower dosages of baclofen will reduce food intake to a greater extent in females than in males; b) Baclofen-induced reductions in binge intake will be mediated centrally; GABA-B receptor blockade will stimulate binge intake; c) Dosages of GABA-B ligands that affect food intake will not affect general behavioral activity in the bingeing rats. AIM 2: To test the hypothesis that baclofen-induced reductions in fat intake are enhanced with repeated bingeing. Hypothesis: Lower dosages of baclofen will reduce
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food intake to a greater extent in rats that have repeatedly binged than in rats that have engaged in fewer binge episodes. AIM 3: To test the hypothesis that the VTA is a sensitive site of action for baclofen-induced reductions in bingeing. Hypothesis: Lower doses of baclofen will reduce bingeing when infused into the VTA than when infused into the striatum or substantia nigra. These studies are the first to examine the contribution of GABA-B receptors to bingeing and will provide new insight into the neurobiology of bingeing-related disorders Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: NEUROCHEMISTRY OF STRESS-INDUCED BINGE EATING Principal Investigator & Institution: Hagan, Mary M.; Psychology; University of Alabama at Birmingham UAB Station Birmingham, Al 35294 Timing: Fiscal Year 2004; Project Start 01-FEB-2004; Project End 30-NOV-2006 Summary: (provided by applicant): Binge-eating is a central feature of bulimia nervosa and binge-eating disorder, which affect millions and renders many more susceptible to obesity and related diseases. Dieting and stress are well-known etiological factors of these disorders, and dieting is the strongest predictor of overeating in response to stress. However, the exact physiological mechanisms by which dieting and stress stimulate eating are not known. We have found that in rats, a history of cyclic food restriction (cFR), i.e. 'dieiting' alone or of stress from foot shock alone, does not alter food intake, but in rats with a history of cFR, stress produces powerful hyperphagia that is characteristic of binge-eating. This intake is marked by a strong preference for highly palatable (HP) food but can occur with regular food if triggered by a bite of HP food, it occurs in a discrete period of time, and while rats are sated. Using this model we propose to describe the physiology by which dieting and stress promote binge-eating. Our hypothesis is that cFR increases susceptibility to binge-eating by increasing two key orexigenic peptides, peptide YY (PYY) and opioids, and by suppressing key reward and satiety signals, namely dopamine receptors (R) in the nucleus accumbens and serotonin in the hypothalamus, respectively. These neuroadaptations to binge-eating develop in the course of repeated cFR. Stress then potentiates PYY and opioid signaling, possibly via corticosterone (CORT) modulation of these peptides, and magnifies an anhedonic state from desensitized dopamine-Rs. The animal binge-eats in response to unopposed orexigenic signals and as an attempt to restore normal levels of reward. To test this hypothesis we will measure hindbrain and hypothalamic concentrations of PYY and opioids and their modulation by CORT via radioimmunoassay. Gene expression of hypothalamic and accumbens opioid and dopamine-Rs will be quantified by RT-PCR, and extracellular levels of limbic dopamine and hypothalamic serotonin will be determined via high performance liquid chromatography. These measures will be determined in rats with a history of cFR after stress and compared to rats with a history of cFR alone, stress alone, or neither to understand how each of these factors contribute to the neurochemical adaptations that cause binge-eating. Finally we will test the effect of CORT, PYY-, and opioid-R blockade to reduce binge-eating and will manipulate access to HP food to evaluate its exact role in altering reward signaling. These experiments are critical to a complete understanding of the brain's control of food intake. By defining the neural substrates that mediate bingelike eating in this model, novel strategies that prevent, arrest, and reverse the disorder in humans can be tested. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Binge Eating
Project Title: NOCICEPTION IN BULIMIA NERVOSA Principal Investigator & Institution: Faris, Patricia L.; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-AUG-1993; Project End 30-JUN-2005 Summary: (provided by applicant): This application for renewal of R01 DK 052291-05 proposes to further study the role of vagal afferents in the perpetuation of binge-eating and vomiting. We previously proposed that the pathophysiology of bulimia nervosa involves dysregulation of the afferent vagus nerve. During the last funding period, this hypothesis was tested using two main strategies: (1) the use of somatic pain detection as a physiological marker of vagal afferent activity; and (2) the use of ondansetron (a 5 HT3 antagonist known to reduce vagal neurotransmission) as a pharmacological challenge test of vagal modulation of both the bulimic behaviors and on elevated pain detection thresholds. The principle findings from these studies are: 1) pain detection thresholds rise dynamically across the interval between bulimic binge/vomit episodes, apparently reaching their zenith as the next bulimic episode is approached and dropping to their nadir in close temporal association with having recently engaged in a bulimic episode; and (3) ondansetron treatment was associated with a significant moderation in both the cyclic fluctuations in pain detection thresholds and the primary disorder symptom of binge/vomit episodes per week in a group of patients with severe and chronic bulimia nervosa under randomized, placebo controlled, double-blind condition. Collectively, the above summarized physiological and clinical data have led to the refined hypothesis that the pathophysiology of bulimia nervosa involves a cyclic hyperactivity in vagal afferent nerves. This overall hypothesis will be tested through an interactive combination of clinical pharmacology and psychophysiological approaches. Specific Aim I will investigate the association between disorder severity as indicated by binge/vomit frequencies and dynamic changes in pain detection thresholds. The approach of this Aim is based on the idea that if dynamic increases in vagal activity drive bulimic episodes, then the rate of cyclic changes in vagal activity should be a significant statistical predictor of the frequency of bulimic behaviors. Specific Aim II will investigate the effect of psychotherapeutic intervention on physiological indices of vagal activity, namely thresholds for pain detection and induction of satiety. The approach of the Aim is based on the idea that if vagal hyperactivity represents the critical factor involved in symptom production, then any therapeutic method resulting in a decrease in symptoms would be predicted to be accompanied by a demonstrable correction in vagal function. In addition to generating important basic science information on vagus nerve function in bulimia nervosa, these studies will also provide insight into the utility of ondansetron in the clinical treatment of this debilitating disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: OPTIMIZING LIFESTYLE ADJUSTMENT IN WEIGHT LOSS SURGERY Principal Investigator & Institution: Kalarchian, Melissa A.; Assistant Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JUL-2007 Summary: (provided by applicant): Although surgery is the treatment of choice for severe obesity, very little is known about the relationship of lifestyle factors to patient outcomes after operation. This Mentored Patient-Oriented Research Career Development Award (K23) describes integrated training and research plans designed to
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prepare the candidate to pursue research on helping patients achieve optimal weight loss and lifestyle adjustment after bariatric surgery. A model of treatment is presented in which an intervention targeting behavioral (eating, activity, and compliance) and psychosocial factors (e.g., symptoms of binge eating and personality style) is expected to impact weight loss, health-related quality of life, and overall well-being. Advanced training in genetic and environmental influences on severe obesity, an expanded working knowledge of how surgeons treat severely obese patients, and consolidation of skills in longitudinal research methodology will assist in refining and developing this model. The research plan involves prospectively tracking weight-related variables, eating and activity, compliance and satisfaction, and psychosocial factors over time among a group severely obese patients undergoing surgery for weight loss (Study 1), and using the data to inform the development and evaluation of a lifestyle intervention geared to optimizing outcomes after operation (Study 2). The comprehensive lifestyle intervention will encompass 1) encouraging healthy eating habits, 2) increasing physical activity, 3) enhancing psychosocial adjustment. Adaptations to treatment will accommodate the unique needs of bariatric surgery patients. Specifically, a modular treatment format will address patients' changing needs in the preoperative, postoperative, and longer-term adjustment phases. Additionally, the intervention will be developed for delivery one-on-one at routine clinic visits with supplemental contact via the Internet. The data collected will contribute to the preparation of an R01 application that will involve conducting a full-scale randomized clinical trial to evaluate the modular, computer-aided lifestyle intervention. Future work may focus on adding adjunctive treatment components such as weight loss medication, the effects of which have not been adequately studied in bariatric surgery patients. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: OVARIAN HORMONAL CONTROL OF MEAL SIZE Principal Investigator & Institution: Geary, Norcross D.; Professor; Psychiatry; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2003; Project Start 01-MAY-1994; Project End 28-FEB-2009 Summary: (provided by applicant): This application proposes investigations of the role of the ovarian hormone estradiol in feeding and bodyweight in female rats. Sexual differentiation in the physiological controls of eating may contribute to the increased vulnerability of women to anorexia nervosa, bulimia nervosa, and some forms of obesity or exacerbate the course of these disorders. Furthermore, disordered meal size is the crucial behavioral change in eating disorders, including the binge eating of obesity, and estradiol potently controls meal size in animals by tonically and phasically increasing the satiating potency of food. Therefore, this application proposes to determine the peripheral and central mechanisms through which estradiol modulates the satiating potencies of gastric and intestinal food stimuli that are known physiological controls of meal size. State-of-the-art behavioral, physiological, and molecular techniques are used. There are eight specific aims: (1) Determine whether estradiol tonically or phasically increases gastric satiation, using rats with inflatable pyloric cuffs. (2) Determine whether estradiol tonically or phasically increases intestinal satiation using duodenal nutrient infusions. (3) Determine whether estradiol receptors in the nucleus tractus solitarius and adjacent caudal brainstem are sufficient for the estrogenic control of feeding by testing the effects of microinjecitons of estradiol directly into the caudal brainstem; (4) Identify brain areas in which increases in neuronal activity, as measured by quantitative c-Fos immunocytochemistry, accompany tonic or phasic estrogenic increases in gastric or intestinal satiation. (5) Determine cellular sites of initiation of the tonic and phasic
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estrogenic controls of meal size by identifying cellular co-localization of feeding-elicited c-Fos expression and estradiol receptor-alpha expression. (6) Determine the necessity of abdominal vagal and splanchnic afferents in the tonic and phasic estrogenic controls of meal size in rats with selective abdominal afferent denervations. (7) Determine the tonic and phasic effects of estradiol on the neurophysiological responses of single vagal afferent fibers to meal-related food stimuli. (8) Determine the tonic and phasic effects of estradiol on glutamate synaptogenesis in the brainstem by using immunocytochemical detection of synaptic proteins. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: PEER ENHANCED INTERVENTION TO SUPPORT TEEN WEIGHT LOSS Principal Investigator & Institution: Jelalian, Elissa; Assistant Professor; Miriam Hospital Providence, Ri 029062853 Timing: Fiscal Year 2003; Project Start 15-MAY-2003; Project End 30-APR-2007 Summary: (provided by applicant): The prevalence of overweight children and adolescents has increased significantly during the last two decades. While there are empirically supported weight management interventions for school age children, treatment findings with overweight adolescents are not as consistent. A potential limitation of weight control interventions for adolescents is the minimal attention given to the peer group as an active component of treatment. We have promising findings from a pilot study that involves adding an innovative peer-based intervention (peerbased skills training; PBST) to cognitive behavioral weight management treatment for adolescents. The purpose of the proposed study is to expand the pilot by: 1) increasing our sample size, 2) assessing weight loss over a longer time period, and 3) evaluating the role of psychosocial variables, as well as physical activity and diet, in mediating treatment outcome. It is hypothesized that overweight adolescents randomized to cognitive-behavioral treatment with peer enhancement will demonstrate greater weight loss at long term follow-up than adolescents randomized to cognitive-behavioral treatment with exercise. One hundred and fifty adolescents between the ages of 13 and 16 years and 20% and 80% overweight will be randomized to one of two treatment conditions: 1) Cognitive-Behavioral Weight Loss Treatment with Peer-Based Skills Training (CBT + PBST) or 2) Cognitive-Behavioral Weight Loss Treatment with Exercise (CBT+EXER). Measures of height, weight, physical activity, diet, and psychosocial functioning will be obtained at baseline, end of treatment, 12 months, and 24 months after randomization. A between-groups t-test will be conducted to evaluate group differences in change in percent overweight between baseline and 24 month follow-up. Hierarchical linear modeling will be used to assess the pattern of weight loss for the two treatment groups across four time points: baseline, end of treatment, 12 month, and 24 month follow-up. Effects of treatment of psychosocial measures will be analyzed using mixed analysis of variance with treatment condition as the between subjects factor and a within subject factor of time. Finally, a series of regression analyses will be conducted to evaluate the role of psychosocial variables, physical activity, and diet, as mediators of treatment outcome. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: PROBLEM DRINKING IN WOMEN--A 20-YEAR NATIONAL STUDY Principal Investigator & Institution: Wilsnack, Sharon C.; Professor; Neuroscience; University of North Dakota 264 Centennial Drive Grand Forks, Nd 58202
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Timing: Fiscal Year 2002; Project Start 01-SEP-1980; Project End 31-JAN-2004 Summary: This application proposes a national survey of 1,550 women in 2001 to increase knowledge about longitudinal patterns of women's drinking. The survey will include 700 women interviewed in 1981 and 1991, 350 women first interviewed in 1991, and a new sample of 500 women age 21-30 in 2001. (Subsamples of women were also interviewed in 1986 and 1996). Combining the 2001 survey with preceding surveys will produce 20-year cross-sectional data for all age groups, 20-year multiwave longitudinal data from women over age 40 in 2001, and 10-year longitudinal data from women age 31-40 in 2001. Specific aims of the proposed research are to evaluate (1) 20-year trends and age, period, and cohort effects in women's drinking behavior; (2) predictors of 5-, 10- and 20-year age-specific changes in women's drinking behavior; (3) effects on and from women's drinking trajectories across the adult life span; (4) correlates and predictors of heavier drinking among older women, and among women of childbearing age; (5) effects of question formats and interview modes on women's drinking selfreports; (6) links of women's drinking patterns with disordered eating behavior and with use of prescribed psychoactive drugs; and (7) cross-national variations in women's drinking behavior and its antecedents and consequences, using data from an international collaborative project coordinated by our research group. In the 2001 survey, professional female interviewers will conduct 75- minute face-to-face interviews using many questions from previous surveys about drinking patterns, drinking-related problems, changes in work and family roles, depressive symptoms, sexual and reproductive experience, and relationships with significant others. New questions will include a measure of trait impulsivity and additional questions about binge eating, estrogen replacement therapy, antidepressant use, and health problems of older age. Data analysis will include cross- tabular, correlational, and regression analyses; analysis of variance; cluster analysis (of drinking partnerships and drinking trajectories); structural equation modeling (for longitudinal prediction of 2001 drinking patterns); and generalized estimating equations, random regression models, latent transition analysis, and survival analysis (for comparing trends and trajectories and for predicting trajectories). The 2001 survey, combined with data from the 1981, 1986, 1991, and 1996 surveys, will yield the largest, longest-term, and most detailed set of longitudinal and life-historical data yet available about U.S. women's drinking and its antecedents and consequences. Together with findings from the international collaborative gender and alcohol project, issues addressed by the proposed analyses of these data should provide a strong foundation for efforts to improve the prevention and treatment of women's problem drinking in the 21st century. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: DISORDERS
PSYCHOBIOLOGY
OF
EATING
BEHAVIOR
IN
EATING
Principal Investigator & Institution: Walsh, B T.; Professor; Psychiatry; Columbia University Health Sciences Po Box 49 New York, Ny 10032 Timing: Fiscal Year 2004; Project Start 01-JAN-1997; Project End 31-DEC-2008 Summary: (provided by investigator): Bulimia Nervosa (BN) is a serious eating disorder characterized by frequent uncontrolled eating binges. Binge Eating Disorder (BED) is a more recently described disorder which occurs primarily in obese individuals and which is associated with significant morbidity. While much is known about the characteristics and treatment of these disorders, particularly BN, there is as yet a limited understanding of their pathophysiology. The aim of this ongoing research program is to describe objectively the eating behavior of individuals with disorders of binge eating
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and, using this information, to generate and test hypotheses concerning their pathophysiology. Work to date has focused on the inhibitory controls of eating, i.e., the development of satiety during a meal, and considerable evidence has been obtained suggesting that binge eating in BN and BED reflects a disturbance in these controls. Studies of gastrointestinal function in BN demonstrated abnormalities in gastric emptying, postprandial gastric relaxation, and cholecystokinin (CCK) release, and suggested a physiological model of altered satiety in BN. Other findings suggested a disturbance in the excitatory controls of eating in BN and BED. The proposed project will critically test, both in the laboratory and the clinic, the hypothesis that disturbances in the inhibitory and excitatory controls of eating contribute to behavioral symptoms in BN and BED. Experiments in patients with BN will determine whether the administration of CCK reduces binge eating in a laboratory setting, and whether treatment with erythromycin, an agent that accelerates gastric emptying, enhances CCK release and reduces the frequency of binge eating. Other experiments focusing on BN will determine whether an increased rate of eating is necessary to produce the increased caloric intake characteristic of binge eating. Experiments focusing on BED will determine whether individuals with this disorder have disturbances in the release of CCK and in gastric emptying similar to those of individuals with BN. Additional experiments will examine whether excitatory controls of eating, as reflected by sham feeding (i.e., consumption of non-caloric food) and by cue reactivity, are increased in patients with BN and BED. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SEROTONIN REGULATION IN EATING DISORDERS Principal Investigator & Institution: Wolfe, Barbara E.; Assistant Professor; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2000; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: (Applicant's Abstract): This project investigates the contribution of altered central nervous system (CNS) serotonin function to the abnormal eating patterns characteristic of bulimia nervosa. This serious psychiatric disorder leads to severe psychosocial distress and potentially serious medical consequences in approximately two percent of young women, the population at greatest risk for eating disorders. Binge eating in bulimia nervosa is thought to result in part from a deficiency in the satiety response that normally leads to meal termination. Hypo thalamic serotonin is important in meal-related satiety. Patients with bulimia nervosa have abnormalities in serotoninmediated release of neuroendocrine hormones. The primary goal of this project is to test the hypothesis that serotonin-mediated satiety responses are abnormal in bulimia nervosa. To evaluate serotonin-mediated satiety responses, this project measures the decrease in food intake during a single-item test-meal following administration of a single oral dose of the serotonin-agonist medication m-chlorophenylpiperazine (mCPP) (0.4 mg/kg). During the three year project, serotonin-mediated satiety and neuroendocrine responses will be compared in 18 medication-free women who meet DSM-IV criteria for bulimia nervosa and 18 health female volunteers. Although dieting behaviors per se can influence serotonin function, alterations in CNS serotonin regulation in bulimia nervosa are postulated to occur independently of the effects of dieting. To test this hypothesis, this project includes a second comparison group of 18 healthy female volunteers studied while following a reduced calorie diet. This project will also assess whether stable recovery in a group of 18 women with a history of bulimia nervosa is associated with a normal pattern of decreased food intake following mCPP administration. Behavioral and neuroendocrine responses to mCPP will be
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evaluated using a placebo-controlled, randomized design. Subject groups will be matched for age and height-adjusted weight, with studies scheduled during the follicular phase of the menstrual cycle. Further exploratory analyses will evaluate the relationship of serotonergic responses in bulimia patients to associated psychiatric symptoms, including depressed mood and impulsive and aggressive behaviors. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: SEROTONIN-A TRAIT DISTURBANCE IN ANOREXIA NERVOSA? Principal Investigator & Institution: Kaye, Walter H.; Professor; Psychiatry; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-AUG-1990; Project End 31-MAR-2004 Summary: Indirect evidence suggests that brain serotonin (5-HT) alterations occur in women with anorexia nervosa (AN) when they are underweight and after recovery. This competitive renewal will use new technologies that offer the potential of direct characterization of dynamic relationships between 5-HT receptor function and human behavior. We will assess 5-HT1A and 5-HT2A receptors. A defect in either may contribute to trait-related increased 5-HT neurotransmission associated with core AN symptoms, such as restricted feeding, obsessions with order and perfectionism, harm avoidance and negative affect. Our last funding period supports the possibility that starvation-induced changes may reduce 5-HT neuronal activity, which in turn reduces dysphoric affective states. Such receptor changes may also shed light on failure to respond to SSRIs. Over 4 years 3 groups of women (18 to 45 years old) will be studied: 1) 30 AN women who are underweight; 2) 30 women who are recovered (greater than 1 year normal menses, no bingeing and purging, and healthy and stable weight) from AN; 3) 30 healthy control women (CW). Each AN cohort will consist of 15 restrictingsubtypes and 15 binge- eating/purging subtypes. In Aim 1 Positron Emission Tomography (PET) imaging and [18F]altanserin will assess 5-HT2A postreceptor binding. Preliminary data support the possibility that recovered AN women will have a reduction of orbitofrontal 5-HT2A receptor binding associated with evidence of increased extracellular 5-HT. In comparison, underweight AN should have opposite findings. In Aim 2 PET imaging and [11C]WAY100635 will assess 5-HT1A receptor binding. Knockout gene studies in mice support the hypothesis that a malfunction of pre-synaptic raphe autoreceptors could contribute to increased 5-HT activity and behavioral symptoms in AN. Thus 1A binding may not change with state of the illness. Our last funding period found that a polymorphism (-1438G/A) in the promoter region of the 5-HT2A receptor gene was associated with AN. Aim 3 is a pilot study that will explore whether this or other 5-HT related polymorphisms, are associated with altered binding on PET or with behavioral symptoms. Aim 4 will test whether core AN symptoms or impulse control are related to 5-HT neuronal activity. The understanding of whether a biologic vulnerability, such as a 5-HT disturbance, occurs in AN may contribute to developing new treatment interventions for this often chronic and deadly disorder. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: STOMACH CAPACITY AND EMPTYING IN OBESITY Principal Investigator & Institution: Geliebter, Allan; St. Luke's-Roosevelt Inst for Hlth Scis Health Sciences New York, Ny 100191102 Timing: Fiscal Year 2001; Project Start 01-SEP-1999; Project End 31-AUG-2004
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Binge Eating
Summary: (Adapted From The Applicant's Abstract): Obesity, which can lead to a variety of chronic diseases and reduced life span, continues to increase in prevalence in the US. A subset of obese subjects (30 percent of those entering medical weight-loss programs) has the recently characterized binge-eating disorder (BED), ingestion of very large meals without purging as occurs in bulimia nervosa. We have shown that stomach capacity is greater in obese than lean subjects, but this may be due mainly to the BED subset. We hypothesize that stomach capacity is larger in obese BED subjects than in obese non-BED subjects and lean subjects. Stomach capacity will be estimated by filling a gastric balloon in 24 obese BED and 24 non-obese subjects and 24 lean controls, each group divided equally by sex. Gastric capacity will be estimated from a) maximum volume tolerated and b) volume required to induce a given rise in intragastric pressure. Gastric capacity will be correlated with laboratory test-meal intake. Gastric emptying of a liquid meal will also be determined and related to gastric capacity. From out previous work, we would predict slower emptying, especially in the early phase, from a stomach with a large capacity. During the gastric emptying test, blood will be sampled for plasma cholecystokinin (CCK), a satiety peptide, shown to be lower in bulimics postprandially. The reduced CCK in bulimics may be the result of slower gastric emptying and larger gastric capacity and is predicted to be reduced in BED. The extent to which gastric capacity and emptying, test meal intake, and CCK change after restrictive dieting in obese subjects will then be determined. The obese BED and nonBED subjects will be randomized for 3 mo. of a) cognitive-behavior modification with a recommended intake of 5016 kJ/day (1200 kcal/day) or b) ad-lib intake. Gastric capacity may not decline in BED subjects if it is a primary factor in the disorder. Body composition, including underwater weighing wil be assessed before and after this period. Afterwards, a double-blind, dose-response study of a gastric emptying accelerant (cisapride) will be conducted in 12 non-dieting subjects of each group. Especially for the BED group, cisapride may speed emptying, enhance CCK release, and increase satiety. The lowest effective dose will then be used in a double-blind, 2 month crossover clinical trial of 12 obese non-BED subjects. Body weight and composition will be assessed at the start and monthly. The studies may enhance knowledge of the etiology, pathophysiology, and treatment of BED. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE PREVALENCE OF TWO EATING DISORDERS Principal Investigator & Institution: Stunkard, Albert J.; Professor Emeritus of Psychiatry; Psychiatry; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2002; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Two eating disorders, binge eating disorder (BED) and the night eating syndrome (NES), have been associated with obesity. There is reason to believe that they contribute to the obesity and that controlling them might contribute to the control of obesity. The prevalence of these disorders is not known. We hope that this proposed study will help to determine this prevalence and the extent to which the disorders are associated with the severity of obesity. Binge eating disorder is characterized by a subjective feeling of loss of control over what is being consumed and an objective consumption of an amount of food "definitely larger than most people would eat." Night eating syndrome consists of morning anorexia, evening hyperphagia, lowering of mood late in the day, and nighttime awakenings, during which time foodusually high in carbohydrates is consumed. Our proposed study seeks to delineate how common each of these eating disorders is among the Look AHEAD population and, if
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possible, the stability of the diagnosis in the course of the first year of treatment. One thousand randomly selected subjects from five Look AHEAD sites, including both men and women and irrespective of race or ethnicity, will be administered screening questionnaires that assess both the BED and NES criteria. From those screening questionnaires, 20 percent of persons with the highest scores for NES and those scoring above a cutoff (20 percent +/-5 percent) for BED will be contacted for follow-up clinical phone interviews to reduce the number of subjects who are falsely self-identified. This information will be gathered upon subjects' entry into the Look AHEAD trial and again at six months and one year into treatment to assess the stability of the diagnosis. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: THE ROLE OF ATTENTION IN SELF-REGULATION. Principal Investigator & Institution: Mann, Traci L.; Sociology; University of California Los Angeles 10920 Wilshire Blvd., Suite 1200 Los Angeles, Ca 90024 Timing: Fiscal Year 2002; Project Start 01-JUN-2002; Project End 31-MAY-2007 Summary: (provided by applicant): This project explores the interacting role played by situational factors and individual mental processes in the self-regulation of emotions and behavior. From binge eating to excessive anger, many sources of adverse physical and mental health outcomes revolve around a common theme: the inability of individuals to control their own behavior. The goal of this research is to explain why individuals often fail at self-regulation and how they succeed. According to the analysis presented here, self-regulation typically demands a significant expenditure of mental resources. When those resources are limited in some fashion, the result is a state of affairs we term "attentional myopia," in which individuals can focus on only the most salient internal and external cues, to the neglect of more distal stimuli. Their subsequent behavior is then likely to be under the near-exclusive motivational influence of those "central" cues. This state of attentional narrowing is predicted to lead to disinhibited behavior when salient internal or situational cues serve to promote the behavior in question, and enhanced behavioral inhibition when those cues instead suggest restraint. The specific aims include 1) demonstrating the predictions of the attentional myopia model in studies of the self-regulation of smoking, anger, aggression, and other behaviors, 2) addressing two alternative explanations for phenomena explained by the model, 3) clarifying the specific cognitive processes through which attentional narrowing affects self-regulation, 4) examining whether attentional narrowing serves as the primary mediator between mental/physical fatigue and poor behavioral regulation , and 5) exploring the implications of the model for significant self-regulatory challenges. In a series of laboratory and field studies, cognitive load manipulations are crossed with manipulations of person and/or situational factors, and relevant behaviors are assessed. An enhanced understanding of the personal and situational sources of maladaptive selfregulation will contribute to the promotion of mental health and well-being among at-risk individuals. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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Project Title: THE TREATMENT OF BINGE EATING DISORDER Principal Investigator & Institution: Crow, Scott J.; Associate Professor; Psychiatry; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 15-FEB-2002; Project End 31-JAN-2005 Summary: (provided by applicant): Research over the last few decades has shown that a sub-group of overweight individuals have an abnormal eating pattern best
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Binge Eating
characterized by discrete binge eating episodes. The presence of binge eating episodes in obese individuals is associated with increased rates of psychopathology, social dysfunction, early onset obesity, and greater severity of obesity. However, recent research suggests that binge eating can be effectively treated in obese individuals using certain forms of psychotherapy such as cognitive behavioral techniques, and certain antidepressant drugs, strategies that have also been shown to be useful in suppressing binge eating in individuals of normal weight with bulimia nervosa. Certain self-help techniques have also been shown to be quite useful in improving binge eating symptoms and in encouraging healthy eating behavior in individuals with disordered eating. Our research groups have demonstrated the utility of a self-help manual in working with individuals with bulimia nervosa and most recently the utility of a group self-help approach in targeting binge eating behavior in overweight individuals with binge eating. Therefore, as an extension of our prior research, and given the preliminary data that will be reported in the application, we propose to study the utility of treatments targeting binge eating in obese individuals who binge eat through a random assignment, parallel study wherein subjects who satisfy inclusion criteria will be assigned to one of 6 conditions: 1) manual-based self-help targeting binge eating without therapist involvement; 2) supervised manual-based self-help; 3) group self-help therapy, without contact with a psychotherapist; 4) group therapy delivered partially through videotapes and partially with therapist leadership; 5) a traditional therapist-led group psychotherapy, and 6) a wait list control to control for the effects of time and the non-specific effects of being involved in the protocol. Of note, the materials presented in the five treatment arms will be essentially identical, but are written for self-help vs. audio-visual vs. therapy presentation based on the treatment assignment. This protocol is not designed to test a weight loss strategy, but instead to focus on strategies for bingeeating. Such strategies could then be administered in combination with, or sequentially with, various weight loss strategies (e.g., behavioral, pharmacologic) in those who are overweight. Treatments for weight loss are currently undergoing significant evolution with the introduction of two new pharmacologic agents in the last 18 months. We believe that to attempt to address both strategies for binge eating and strategies for weight loss in this study would make it overly complex. The result of this study could inform the design of trials to treat both binge-eating and promote weight loss. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: TREATMENT FOR OBESITY AND BINGE EATING DISORDER Principal Investigator & Institution: Grilo, Carlos M.; Associate Professor; Psychiatry; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2002; Project Start 01-AUG-1996; Project End 31-JUL-2007 Summary: (provided by applicant): This application seeks funds to conduct a study of cognitive behavioral and behavioral weight loss treatments for obese patients with binge eating disorder (BED). The proposed study builds directly upon the findings of the initial project that examined the efficacy of fluoxetine treatment and cognitive behavioral therapy (CBT) and the relative efficacy of the treatments alone and in combination for patients with BED (balanced 2 x 2 factorial design). CBT produced significant and clinically meaningful improvements in the behavioral (binge eating), cognitive (attitudinal features of eating disorders), and associated psychological (depression) features of BED, but not for the physical problem of obesity. In the 2 x 2 factorial design: (1) CBT was superior to treatment without CBT, treatment with fluoxetine was not superior to treatment without fluoxetine, and no interaction between treatments occurred; (2) Specific comparisons among specifc treatments revealed that
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fluoxetine was not superior to placebo, CBT + Placebo and CBT + Fluoxetine were similar, and CBT + Placebo and CBT + Fluoxetine were superior to Fluoxetine-only and Placebo-only. Findings suggest that CBT has efficacy for the behavioral, cognitive, associated psychological features of BED. The strong association between BED and obesity, and the major health risks associated with obesity highlight the need for developing interventions that also reduce weight. It remains uncertain whether behavioral weight loss (BWL) has efficacy for producing weight loss in BED or for reducing binge eating and its associated features. The proposed study involves a comparison of three treatment conditions: (1) CBT; (2) BWL, and (3) a sequential (twopart) treatment consisting of CBT followed by BWL. Assessments will occur at baseline, bimonthly during treatment, and 6-and 12-months post-treatment. The primary specific aim is to test the relative efficacy of CBT, BWL, and a sequential treatment consisting of CBT followed by BWL. Secondary aims are to (1) explore predictors and processes of change during the acute treatment and follow-up period, and (2) examine whether (a) BWL ("dieting") after the CBT produces weight loss, and (b) weight regain (if it occurs following BWL) is accompanied/followed by reoccurrence of binge eating, attitudinal features of eating disorders, psychological distress, or psychiatric disturbances. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •
Project Title: URGENCY IN PROBLEM DRINKING AND BINGE EATING Principal Investigator & Institution: Fischer, Sarah F.; Psychology; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2003; Project Start 30-SEP-2003; Project End 29-SEP-2005 Summary: (provided by applicant): The long term goal of this program of research is to test a model for the development of behavioral addiction incorporating trait based risk factors with psychosocial learning risk factors. The model is that trait urgency, the tendency to act rashly to relieve distress, is a broad, distal risk factor for maladaptive addictive behaviors such as problem drinking and binge eating, while specific, psychosocial learning based risk factors such as expectancies influence the specific behaviors that one chooses to engage in. Cross-sectional, correlational support for this model has been found in a college student sample. The specific goal of this project is to replicate the findings supporting this model in a clinical sample of individuals with alcohol use disorders and binge eating disorder. A sample of patients with alcohol use disorders, a sample of patients with binge eating disorder, and a comparison community sample of adults will be given structured interviews for alcohol use disorders and eating disorders, and complete self-report measures assessing urgency, sensation seeking, and other forms of impulsivity, as well as expectancies for alcohol use and eating. We predict that, as in the college student sample, urgency will correlate with both alcohol use and binge eating, and that urgency will positively correlate with positive expectancies for alcohol use and positive expectancies for eating. However, we predict that the specific expectancies for alcohol use will correlate with drinking, but not binge eating or eating expectancies. Similarly, specific expectancies for eating will correlate with binge eating, but not with either drinking or drinking expectancies. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen
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The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with binge eating, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “binge eating” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for binge eating (hyperlinks lead to article summaries): •
A comparison of black and white women with binge eating disorder. Author(s): Pike KM, Dohm FA, Striegel-Moore RH, Wilfley DE, Fairburn CG. Source: The American Journal of Psychiatry. 2001 September; 158(9): 1455-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11532731
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A comparison of different methods for assessing the features of eating disorders in patients with binge eating disorder. Author(s): Grilo CM, Masheb RM, Wilson GT. Source: Journal of Consulting and Clinical Psychology. 2001 April; 69(2): 317-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11393608
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A comparison of onset of binge eating versus dieting in the development of bulimia nervosa. Author(s): Pederson Mussell M, Mitchell JE, Fenna CJ, Crosby RD, Miller JP, Hoberman HM. Source: The International Journal of Eating Disorders. 1997 May; 21(4): 353-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9138047
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A comparison of two approaches to the assessment of binge eating in obesity. Author(s): Gladis MM, Wadden TA, Foster GD, Vogt RA, Wingate BJ. Source: The International Journal of Eating Disorders. 1998 January; 23(1): 17-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9429915
3
PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.
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A descriptive analysis of factors contributing to binge eating. Author(s): Stickney MI, Miltenberger RG, Wolff G. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1999 September; 30(3): 177-89. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10619542
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A double-blind, placebo-controlled trial of fluvoxamine in binge eating disorder: a high placebo response. Author(s): Pearlstein T, Spurell E, Hohlstein LA, Gurney V, Read J, Fuchs C, Keller MB. Source: Archives of Women's Mental Health. 2003 April; 6(2): 147-51. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12720065
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A learning model of binge eating: cue reactivity and cue exposure. Author(s): Jansen A. Source: Behaviour Research and Therapy. 1998 March; 36(3): 257-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9642846
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A new animal model of binge eating. Author(s): Geary N. Source: The International Journal of Eating Disorders. 2003 September; 34(2): 198-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12898555
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A test of the continuity perspective across bulimic and binge eating pathology. Author(s): Fitzgibbon ML, Sanchez-Johnsen LA, Martinovich Z. Source: The International Journal of Eating Disorders. 2003 July; 34(1): 83-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12772173
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Abuse, bullying, and discrimination as risk factors for binge eating disorder. Author(s): Striegel-Moore RH, Dohm FA, Pike KM, Wilfley DE, Fairburn CG. Source: The American Journal of Psychiatry. 2002 November; 159(11): 1902-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12411226
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Accuracy of self-reported weight in patients with binge eating disorder. Author(s): Masheb RM, Grilo CM. Source: The International Journal of Eating Disorders. 2001 January; 29(1): 29-36. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11135330
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Addition of naltrexone to fluoxetine in the treatment of binge eating disorder. Author(s): Neumeister A, Winkler A, Wober-Bingol C. Source: The American Journal of Psychiatry. 1999 May; 156(5): 797. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10327921
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Age of onset for binge eating and purging during late adolescence: a 4-year survival analysis. Author(s): Stice E, Killen JD, Hayward C, Taylor CB. Source: Journal of Abnormal Psychology. 1998 November; 107(4): 671-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9830254
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Age of onset for binge eating: are there different pathways to binge eating? Author(s): Spurrell EB, Wilfley DE, Tanofsky MB, Brownell KD. Source: The International Journal of Eating Disorders. 1997 January; 21(1): 55-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986518
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Alcohol and drug-related negative consequences in college students with bulimia nervosa and binge eating disorder. Author(s): Dunn EC, Larimer ME, Neighbors C. Source: The International Journal of Eating Disorders. 2002 September; 32(2): 171-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12210659
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Alexithymia, obesity, and binge eating disorder. Author(s): de Zwaan M, Bach M, Mitchell JE, Ackard D, Specker SM, Pyle RL, Pakesch G. Source: The International Journal of Eating Disorders. 1995 March; 17(2): 135-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7757093
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Allelic variation of the 5-HT2C receptor (HTR2C) in bulimia nervosa and binge eating disorder. Author(s): Burnet PW, Smith KA, Cowen PJ, Fairburn CG, Harrison PJ. Source: Psychiatric Genetics. 1999 June; 9(2): 101-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10412190
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Amount of calories retained after binge eating and vomiting. Author(s): Kaye WH, Weltzin TE, Hsu LK, McConaha CW, Bolton B. Source: The American Journal of Psychiatry. 1993 June; 150(6): 969-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8494080
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An age-matched comparison of subjects with binge eating disorder and bulimia nervosa. Author(s): Raymond NC, Mussell MP, Mitchell JE, de Zwaan M, Crosby RD. Source: The International Journal of Eating Disorders. 1995 September; 18(2): 135-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7581415
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An evaluation of affect and binge eating. Author(s): Deaver CM, Miltenberger RG, Smyth J, Meidinger A, Crosby R. Source: Behavior Modification. 2003 September; 27(4): 578-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12971129
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An evaluation of the relationship between mood and binge eating in the natural environment using ecological momentary assessment. Author(s): Wegner KE, Smyth JM, Crosby RD, Wittrock D, Wonderlich SA, Mitchell JE. Source: The International Journal of Eating Disorders. 2002 November; 32(3): 352-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12210650
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Assessing the specific psychopathology of binge eating disorder patients: interview or self-report? Author(s): Wilfley DE, Schwartz MB, Spurrell EB, Fairburn CG. Source: Behaviour Research and Therapy. 1997 December; 35(12): 1151-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9465449
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Assessment of binge eating in obese patients. Author(s): Wilson GT, Nonas CA, Rosenblum GD. Source: The International Journal of Eating Disorders. 1993 January; 13(1): 25-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8477274
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Associated factors for self-reported binge eating among male and female adolescents. Author(s): Ledoux S, Choquet M, Manfredi R. Source: Journal of Adolescence. 1993 March; 16(1): 75-91. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8496470
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Association of binge eating disorder and psychiatric comorbidity in obese subjects. Author(s): Yanovski SZ, Nelson JE, Dubbert BK, Spitzer RL. Source: The American Journal of Psychiatry. 1993 October; 150(10): 1472-9. Erratum In: Am J Psychiatry 1993 December; 150(12): 1910. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8379549
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Attitudes and health behavior in diverse populations: drunk driving. Alcohol use, binge eating, marijuana use, and cigarette use. Author(s): Stacy AW, Bentler PM, Flay BR. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 1994 January; 13(1): 73-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8168474
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Avoidance coping, binge eating, and depression: an examination of the escape theory of binge eating. Author(s): Paxton SJ, Diggens J. Source: The International Journal of Eating Disorders. 1997 July; 22(1): 83-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9140740
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Binge antecedents in obese women with and without binge eating disorder. Author(s): Greeno CG, Wing RR, Shiffman S. Source: Journal of Consulting and Clinical Psychology. 2000 February; 68(1): 95-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10710844
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Binge eating among gastric bypass patients at long-term follow-up. Author(s): Kalarchian MA, Marcus MD, Wilson GT, Labouvie EW, Brolin RE, LaMarca LB. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2002 April; 12(2): 270-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11975227
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Binge eating among the overweight population: a serious and prevalent problem. Author(s): Bruce B, Wilfley D. Source: Journal of the American Dietetic Association. 1996 January; 96(1): 58-61. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8537571
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Binge eating and eating attitudes among Nazi concentration camp survivors. Author(s): Favaro A, Rodella FC, Santonastaso P. Source: Psychological Medicine. 2000 March; 30(2): 463-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10824666
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Binge eating and eating-related cognitions and behavior in ethnically diverse obese women. Author(s): Sanchez-Johnsen LA, Dymek M, Alverdy J, le Grange D. Source: Obesity Research. 2003 August; 11(8): 1002-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12917506
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Binge eating and its relationship to multiple weight control program attendance and alternative methods of weight control. Author(s): DiGioacchino R, Sargent RG. Source: Eat Weight Disord. 1998 December; 3(4): 173-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728168
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Binge eating and psychopathology in severely obese adolescents. Author(s): Isnard P, Michel G, Frelut ML, Vila G, Falissard B, Naja W, Navarro J, Mouren-Simeoni MC. Source: The International Journal of Eating Disorders. 2003 September; 34(2): 235-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12898560
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Binge eating antecedents in normal-weight nonpurging females: is there consistency? Author(s): Grilo CM, Shiffman S, Carter-Campbell JT. Source: The International Journal of Eating Disorders. 1994 November; 16(3): 239-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7833957
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Binge eating as a major phenotype of melanocortin 4 receptor gene mutations. Author(s): Branson R, Potoczna N, Kral JG, Lentes KU, Hoehe MR, Horber FF. Source: The New England Journal of Medicine. 2003 March 20; 348(12): 1096-103. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12646666
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Binge eating as a phenotype of melanocortin 4 receptor gene mutations. Author(s): Farooqi IS, Yeo GS, O'Rahilly S. Source: The New England Journal of Medicine. 2003 August 7; 349(6): 606-9; Author Reply 606-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12908459
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Binge eating as a phenotype of melanocortin 4 receptor gene mutations. Author(s): Herpertz S, Siffert W, Hebebrand J. Source: The New England Journal of Medicine. 2003 August 7; 349(6): 606-9; Author Reply 606-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12908458
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Binge eating as a phenotype of melanocortin 4 receptor gene mutations. Author(s): Gotoda T. Source: The New England Journal of Medicine. 2003 August 7; 349(6): 606-9; Author Reply 606-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12904527
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Binge eating behaviours, depression and weight control strategies. Author(s): Speranza M, Corcos M, Atger F, Paterniti S, Jeammet P. Source: Eat Weight Disord. 2003 September; 8(3): 201-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14649783
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Binge eating disorder and night eating syndrome: psychological and behavioral characteristics. Author(s): Napolitano MA, Head S, Babyak MA, Blumenthal JA. Source: The International Journal of Eating Disorders. 2001 September; 30(2): 193-203. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11449453
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Binge eating disorder and obesity in 2003: could treating an eating disorder have a positive effect on the obesity epidemic? Author(s): Yanovski SZ. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S117-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900992
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Binge eating disorder and the dietitian's role. Author(s): Raynor H, Zemel P. Source: Journal of the American Dietetic Association. 1996 September; 96(9): 854. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8784328
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Binge eating disorder and the night-eating syndrome. Author(s): Stunkard A, Berkowitz R, Wadden T, Tanrikut C, Reiss E, Young L. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1996 January; 20(1): 1-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8788315
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Binge eating disorder and the proposed DSM-IV criteria: psychometric analysis of the Questionnaire of Eating and Weight Patterns. Author(s): Nangle DW, Johnson WG, Carr-Nangle RE, Engler LB. Source: The International Journal of Eating Disorders. 1994 September; 16(2): 147-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7987349
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Binge eating disorder in a community-based sample of successful and unsuccessful dieters. Author(s): Ferguson KJ, Spitzer RL. Source: The International Journal of Eating Disorders. 1995 September; 18(2): 167-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7581419
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Binge eating disorder in extreme obesity. Author(s): Hsu LK, Mulliken B, McDonagh B, Krupa Das S, Rand W, Fairburn CG, Rolls B, McCrory MA, Saltzman E, Shikora S, Dwyer J, Roberts S. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 October; 26(10): 1398-403. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12355338
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Binge eating disorder in males: a population-based investigation. Author(s): Kinzl JF, Traweger C, Trefalt E, Mangweth B, Biebl W. Source: Eat Weight Disord. 1999 December; 4(4): 169-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728177
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Binge eating disorder onset by unusual parasitic intestinal disease: a case-report. Author(s): Fernandez-Aranda F, Solano R, Badia A, Jimenez-Murcia S. Source: The International Journal of Eating Disorders. 2001 July; 30(1): 107-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11439415
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Binge eating disorder should be included in DSM-IV: a reply to Fairburn et al.'s "the classification of recurrent overeating: the binge eating disorder proposal". Author(s): Spitzer RL, Stunkard A, Yanovski S, Marcus MD, Wadden T, Wing R, Mitchell J, Hasin D. Source: The International Journal of Eating Disorders. 1993 March; 13(2): 161-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8477285
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Binge eating disorder versus overeating: a failure to replicate and common factors in severely obese treatment seeking women. Author(s): Antoniou M, Tasca GA, Wood J, Bissada H. Source: Eat Weight Disord. 2003 June; 8(2): 145-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12880192
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Binge eating disorder with and without a history of purging symptoms. Author(s): Peterson CB, Mitchell JE, Engbloom S, Nugent S, Mussell MP, Crow SJ, Miller JP. Source: The International Journal of Eating Disorders. 1998 November; 24(3): 251-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9741035
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Binge eating disorder, retention, and dropout in an adult obesity program. Author(s): Ho KS, Nichaman MZ, Taylor WC, Lee ES, Foreyt JP. Source: The International Journal of Eating Disorders. 1995 November; 18(3): 291-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8556026
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Binge eating disorder, weight control self-efficacy, and depression in overweight men and women. Author(s): Linde JA, Jeffery RW, Levy RL, Sherwood NE, Utter J, Pronk NP, Boyle RG. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2004 March; 28(3): 418-25. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14724662
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Binge eating disorder, weight cycling, and psychopathology. Author(s): Kuehnel RH, Wadden TA. Source: The International Journal of Eating Disorders. 1994 May; 15(4): 321-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8032347
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Binge eating disorder: a need for additional diagnostic criteria. Author(s): Masheb RM, Grilo CM. Source: Comprehensive Psychiatry. 2000 May-June; 41(3): 159-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10834622
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Binge eating disorder: a review of the literature after publication of DSM-IV. Author(s): Williamson DA, Martin CK. Source: Eat Weight Disord. 1999 September; 4(3): 103-14. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11234238
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Binge eating disorder: clinical features and treatment of a new diagnosis. Author(s): de Zwaan M, Mitchell JE, Raymond NC, Spitzer RL. Source: Harvard Review of Psychiatry. 1994 March-April; 1(6): 310-25. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9384866
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Binge eating disorder: disorder or marker? Author(s): Stunkard AJ, Allison KC. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S107-16. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900991
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Binge eating disorder: its further validation in a multisite study. Author(s): Spitzer RL, Yanovski S, Wadden T, Wing R, Marcus MD, Stunkard A, Devlin M, Mitchell J, Hasin D, Horne RL. Source: The International Journal of Eating Disorders. 1993 March; 13(2): 137-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8477283
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Binge eating disorder: reliability and validity of a new diagnostic category. Author(s): Brody ML, Walsh BT, Devlin MJ. Source: Journal of Consulting and Clinical Psychology. 1994 April; 62(2): 381-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8201077
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Binge eating disorder: response to naltrexone. Author(s): Marrazzi MA, Markham KM, Kinzie J, Luby ED. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1995 February; 19(2): 143-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7735342
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Binge eating disorder: treatment outcome over a 6-year course. Author(s): Fichter MM, Quadflieg N, Gnutzmann A. Source: Journal of Psychosomatic Research. 1998 March-April; 44(3-4): 385-405. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9587882
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Binge eating following biliopancreatic diversion for obesity. Author(s): Adami GF, Gandolfo P, Cocchi FH, Bauer B, Petti AR, Scopinaro N. Source: Appetite. 1995 October; 25(2): 177-88. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8561489
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Binge eating in an obese community sample. Author(s): Striegel-Moore RH, Wilson GT, Wilfley DE, Elder KA, Brownell KD. Source: The International Journal of Eating Disorders. 1998 January; 23(1): 27-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9429916
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Binge eating in bariatric surgery patients. Author(s): Kalarchian MA, Wilson GT, Brolin RE, Bradley L. Source: The International Journal of Eating Disorders. 1998 January; 23(1): 89-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9429923
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Binge eating in children and adolescents. Author(s): Marcus MD, Kalarchian MA. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S47-57. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900986
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Binge eating in ethnic minority groups. Author(s): Smith DE. Source: Addictive Behaviors. 1995 November-December; 20(6): 695-703. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8820522
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Binge eating in massively obese patients undergoing bariatric surgery. Author(s): Adami GF, Gandolfo P, Bauer B, Scopinaro N. Source: The International Journal of Eating Disorders. 1995 January; 17(1): 45-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7894452
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Binge eating in obese children and adolescents. Author(s): Decaluwe V, Braet C, Fairburn CG. Source: The International Journal of Eating Disorders. 2003 January; 33(1): 78-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12474202
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Binge eating in obesity. Author(s): Adami GF, Gandolfo P, Scopinaro N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1996 August; 20(8): 793-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8856406
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Binge eating in obesity: a longitudinal study following biliopancreatic diversion. Author(s): Adami GF, Gandolfo P, Meneghelli A, Scopinaro N. Source: The International Journal of Eating Disorders. 1996 December; 20(4): 405-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8953328
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Binge eating onset in obese patients with binge eating disorder. Author(s): Marcus MD, Moulton MM, Greeno CG. Source: Addictive Behaviors. 1995 November-December; 20(6): 747-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8820527
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Binge eating versus nonpurged eating in bulimics: is there a carbohydrate craving after all? Author(s): van der Ster Wallin G, Norring C, Holmgren S. Source: Acta Psychiatrica Scandinavica. 1994 June; 89(6): 376-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8085466
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Binge eating, quality of life and physical activity improve after Roux-en-Y gastric bypass for morbid obesity. Author(s): Boan J, Kolotkin RL, Westman EC, McMahon RL, Grant JP. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 2004 March; 14(3): 341-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15072655
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Binge eating. Author(s): Waller D. Source: Bmj (Clinical Research Ed.). 2001 February 10; 322(7282): 343. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11159659
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Biological correlates of binge eating. Author(s): Yanovski SZ. Source: Addictive Behaviors. 1995 November-December; 20(6): 705-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8820523
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Body image alterations in binge eating disorder. Author(s): Adami GF, Bressani A, Marini P. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1998 December; 43(10): 1052-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9868575
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Body image in binge eating disorder. Author(s): Adami GF, Marinari GM, Bressani A, Testa S, Scopinaro N. Source: Obesity Surgery : the Official Journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand. 1998 October; 8(5): 517-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9819082
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Case report: treatment of a woman with alcohol and binge eating problems. Author(s): Dawe S, Staiger P. Source: Journal of Behavior Therapy and Experimental Psychiatry. 1998 September; 29(3): 249-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9847044
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Childhood maltreatment and personality disorders in adult patients with binge eating disorder. Author(s): Grilo CM, Masheb RM. Source: Acta Psychiatrica Scandinavica. 2002 September; 106(3): 183-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12197855
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Childhood psychological, physical, and sexual maltreatment in outpatients with binge eating disorder: frequency and associations with gender, obesity, and eatingrelated psychopathology. Author(s): Grilo CM, Masheb RM. Source: Obesity Research. 2001 May; 9(5): 320-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11346674
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Childhood sexual abuse and precursors of binge eating in an adolescent female population. Author(s): Moyer DM, DiPietro L, Berkowitz RI, Stunkard AJ. Source: The International Journal of Eating Disorders. 1997 January; 21(1): 23-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986514
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Circulating levels of neuroactive steroids in patients with binge eating disorder: a comparison with nonobese healthy controls and non-binge eating obese subjects. Author(s): Monteleone P, Luisi M, De Filippis G, Colurcio B, Monteleone P, Genazzani AR, Maj M. Source: The International Journal of Eating Disorders. 2003 December; 34(4): 432-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566930
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Clinical characteristics associated with binge eating in obese females: a descriptive study. Author(s): Mussell MP, Mitchell JE, de Zwaan M, Crosby RD, Seim HC, Crow SJ. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 1996 April; 20(4): 324-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8680459
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Clinical features of binge eating disorder in type I diabetes: a case report. Author(s): Mannucci E, Ricca V, Rotella CM. Source: The International Journal of Eating Disorders. 1997 January; 21(1): 99-102. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986524
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Comorbid psychopathology in binge eating disorder: relation to eating disorder severity at baseline and following treatment. Author(s): Wilfley DE, Friedman MA, Dounchis JZ, Stein RI, Welch RR, Ball SA. Source: Journal of Consulting and Clinical Psychology. 2000 August; 68(4): 641-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965639
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Comorbidity of binge eating disorder and the partial binge eating syndrome with bipolar disorder. Author(s): Kruger S, Shugar G, Cooke RG. Source: The International Journal of Eating Disorders. 1996 January; 19(1): 45-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8640201
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Comparison of binge eating disorder and bulimia nervosa in a community sample. Author(s): Striegel-Moore RH, Cachelin FM, Dohm FA, Pike KM, Wilfley DE, Fairburn CG. Source: The International Journal of Eating Disorders. 2001 March; 29(2): 157-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11429978
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Comparison of men and women with binge eating disorder. Author(s): Tanofsky MB, Wilfley DE, Spurrell EB, Welch R, Brownell KD. Source: The International Journal of Eating Disorders. 1997 January; 21(1): 49-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8986517
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Comparison of patients with bulimia nervosa, obese patients with binge eating disorder, and nonobese patients with binge eating disorder. Author(s): Barry DT, Grilo CM, Masheb RM. Source: The Journal of Nervous and Mental Disease. 2003 September; 191(9): 589-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504568
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Conditioned insulin and blood sugar responses in humans in relation to binge eating. Author(s): Overduin J, Jansen A. Source: Physiology & Behavior. 1997 April; 61(4): 569-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9108577
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Convergent and discriminant validity of DSM-IV axis II personality disorder criteria in adult outpatients with binge eating disorder. Author(s): Grilo CM, McGlashan TH. Source: Comprehensive Psychiatry. 2000 May-June; 41(3): 163-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10834623
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Correlates of subjective and objective binge eating in binge-purge syndromes. Author(s): Kerzhnerman I, Lowe MR. Source: The International Journal of Eating Disorders. 2002 March; 31(2): 220-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11920983
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Critical differences between binge eating and overeating. Author(s): Pincus HA, First M. Source: Archives of General Psychiatry. 1999 October; 56(10): 951. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10530639
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Daily variations in cortisol levels and binge eating disorder. Author(s): Sitton S, Porn PM, Shaeffer S. Source: Psychological Reports. 2002 December; 91(3 Pt 1): 846-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12530732
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Depression, dietary restraint, and binge eating in female runners. Author(s): Prussin RA, Harvey PD. Source: Addictive Behaviors. 1991; 16(5): 295-301. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1776545
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Development and construct validation of a self-report measure of binge eating tendencies. Author(s): Hawkins RC 2nd, Clement PF. Source: Addictive Behaviors. 1980; 5(3): 219-26. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6933827
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d-fenfluramine treatment of binge eating disorder. Author(s): Stunkard A, Berkowitz R, Tanrikut C, Reiss E, Young L. Source: The American Journal of Psychiatry. 1996 November; 153(11): 1455-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8890680
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Diagnosis of binge eating disorder: discrepancies between a questionnaire and clinical interview. Author(s): Greeno CG, Marcus MD, Wing RR. Source: The International Journal of Eating Disorders. 1995 March; 17(2): 153-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7757096
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Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder. Author(s): Grilo CM. Source: Behaviour Research and Therapy. 2004 January; 42(1): 57-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14744523
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Dialectical behavior therapy for binge eating disorder. Author(s): Telch CF, Agras WS, Linehan MM. Source: Journal of Consulting and Clinical Psychology. 2001 December; 69(6): 1061-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777110
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Dietary restraint and binge eating: pseudo-quantitative anthropology for a medicalised problem habit? Author(s): Booth DA, Lewis VJ, Blair AJ. Source: Appetite. 1990 April; 14(2): 116-9; Discussion 142-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2337334
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Dietary restraint and binge eating: response to Charnock. Author(s): Polivy J, Herman CP. Source: The British Journal of Clinical Psychology / the British Psychological Society. 1989 November; 28 ( Pt 4): 341-3; Discussion 343-6. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2690993
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Dieting and binge eating among adolescents: what do they really mean? Author(s): Neumark-Sztainer D, Story M. Source: Journal of the American Dietetic Association. 1998 April; 98(4): 446-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9550169
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Dieting and binge eating: which dieters are at risk? Author(s): Neumark-Sztainer D, Butler R, Palti H. Source: Journal of the American Dietetic Association. 1995 May; 95(5): 586-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7722196
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Dieting, binge eating, and some of their correlates among secondary school girls. Author(s): Huon GF. Source: The International Journal of Eating Disorders. 1994 March; 15(2): 159-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8173561
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Differences between binge eating disorder and nonpurging bulimia nervosa. Author(s): Santonastaso P, Ferrara S, Favaro A. Source: The International Journal of Eating Disorders. 1999 March; 25(2): 215-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10065398
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Differences in body image and depression among obese women with and without binge eating disorder. Author(s): Mussell MP, Peterson CB, Weller CL, Crosby RD, de Zwaan M, Mitchell JE. Source: Obesity Research. 1996 September; 4(5): 431-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8885207
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Differences in daily stress, mood, coping, and eating behavior in binge eating and nonbinge eating college women. Author(s): Wolff GE, Crosby RD, Roberts JA, Wittrock DA. Source: Addictive Behaviors. 2000 March-April; 25(2): 205-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10795945
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Different methods for assessing the features of eating disorders in patients with binge eating disorder: a replication. Author(s): Grilo CM, Masheb RM, Wilson GT. Source: Obesity Research. 2001 July; 9(7): 418-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11445665
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Discriminant function analysis of depressive symptoms in binge eating disorder, bulimia nervosa, and major depression. Author(s): Crow SJ, Zander KM, Crosby RD, Mitchell JE. Source: The International Journal of Eating Disorders. 1996 May; 19(4): 399-404. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8859398
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Do emotional states influence binge eating in the obese? Author(s): Telch CF, Agras WS. Source: The International Journal of Eating Disorders. 1996 November; 20(3): 271-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8912039
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Does binge eating play a role in the self-regulation of moods? Author(s): Lynch WC, Everingham A, Dubitzky J, Hartman M, Kasser T. Source: Integrative Physiological and Behavioral Science : the Official Journal of the Pavlovian Society. 2000 October-December; 35(4): 298-313. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11330493
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Does interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral therapy? Author(s): Agras WS, Telch CF, Arnow B, Eldredge K, Detzer MJ, Henderson J, Marnell M. Source: Journal of Consulting and Clinical Psychology. 1995 June; 63(3): 356-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7608347
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Eating behavior in binge eating disorder. Author(s): Goldfein JA, Walsh BT, LaChaussee JL, Kissileff HR, Devlin MJ. Source: The International Journal of Eating Disorders. 1993 December; 14(4): 427-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8293024
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Eating disorders and psychiatric disorders in the first-degree relatives of obese probands with binge eating disorder and obese non-binge eating disorder controls. Author(s): Lee YH, Abbott DW, Seim H, Crosby RD, Monson N, Burgard M, Mitchell JE. Source: The International Journal of Eating Disorders. 1999 November; 26(3): 322-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10441248
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Eating related and general psychopathology in obese females with binge eating disorder. Author(s): de Zwaan M, Mitchell JE, Seim HC, Specker SM, Pyle RL, Raymond NC, Crosby RB. Source: The International Journal of Eating Disorders. 1994 January; 15(1): 43-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8124326
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Effect of a very low calorie diet on the diagnostic category of individuals with binge eating disorder. Author(s): Raymond NC, de Zwaan M, Mitchell JE, Ackard D, Thuras P. Source: The International Journal of Eating Disorders. 2002 January; 31(1): 49-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11835297
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Effect of binge eating on the prediction of weight loss in obese women. Author(s): Smith MC, Sondhaus E, Porzelius LK. Source: Journal of Behavioral Medicine. 1995 April; 18(2): 161-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7563044
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Effect of inositol on bulimia nervosa and binge eating. Author(s): Gelber D, Levine J, Belmaker RH. Source: The International Journal of Eating Disorders. 2001 April; 29(3): 345-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11262515
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Effectiveness of spouse involvement in cognitive behavioral therapy for binge eating disorder. Author(s): Gorin AA, Le Grange D, Stone AA. Source: The International Journal of Eating Disorders. 2003 May; 33(4): 421-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658672
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Effects of bariatric surgery on binge eating and related psychopathology. Author(s): Kalarchian MA, Wilson GT, Brolin RE, Bradley L. Source: Eat Weight Disord. 1999 March; 4(1): 1-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728171
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Effects of cognitive-behavioural therapy on health-related quality of life in obese subjects with and without binge eating disorder. Author(s): Marchesini G, Natale S, Chierici S, Manini R, Besteghi L, Di Domizio S, Sartini A, Pasqui F, Baraldi L, Forlani G, Melchionda N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 September; 26(9): 1261-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12187405
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Effects of sibutramine on binge eating, hunger, and fullness in a laboratory human feeding paradigm. Author(s): Mitchell JE, Gosnell BA, Roerig JL, de Zwaan M, Wonderlich SA, Crosby RD, Burgard MA, Wambach BN. Source: Obesity Research. 2003 May; 11(5): 599-602. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12740447
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Elevated plasma lipids in patients with binge eating disorders are found only in those who are anorexic. Author(s): Case T, Lemieux S, Kennedy SH, Lewis GF. Source: The International Journal of Eating Disorders. 1999 March; 25(2): 187-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10065396
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Energy intake patterns in obese women with binge eating disorder. Author(s): Raymond NC, Neumeyer B, Warren CS, Lee SS, Peterson CB. Source: Obesity Research. 2003 July; 11(7): 869-79. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12855757
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Epidemiology of binge eating disorder. Author(s): Striegel-Moore RH, Franko DL. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S19-29. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900983
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Ethnic differences in psychosocial and health behavior correlates of dieting, purging, and binge eating in a population-based sample of adolescent females. Author(s): French SA, Story M, Neumark-Sztainer D, Downes B, Resnick M, Blum R. Source: The International Journal of Eating Disorders. 1997 November; 22(3): 315-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9285269
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Evaluating direct and indirect measures for the functional assessment of binge eating. Author(s): Stickney MI, Miltenberger RG. Source: The International Journal of Eating Disorders. 1999 September; 26(2): 195-204. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10422609
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Exercise augments the effects of cognitive-behavioral therapy in the treatment of binge eating. Author(s): Pendleton VR, Goodrick GK, Poston WS, Reeves RS, Foreyt JP. Source: The International Journal of Eating Disorders. 2002 March; 31(2): 172-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11920978
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Exercise in the treatment of binge eating disorder. Author(s): Levine MD, Marcus MD, Moulton P. Source: The International Journal of Eating Disorders. 1996 March; 19(2): 171-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8932555
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Factor structure of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder. Author(s): Grilo CM. Source: Acta Psychiatrica Scandinavica. 2004 January; 109(1): 64-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14674960
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Fluoxetine and fluvoxamine combined with individual cognitive-behaviour therapy in binge eating disorder: a one-year follow-up study. Author(s): Ricca V, Mannucci E, Mezzani B, Moretti S, Di Bernardo M, Bertelli M, Rotella CM, Faravelli C. Source: Psychotherapy and Psychosomatics. 2001 November-December; 70(6): 298-306. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11598429
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Food presentation and energy intake in a feeding laboratory study of subjects with binge eating disorder. Author(s): Gosnell BA, Mitchell JE, Lancaster KL, Burgard MA, Wonderlich SA, Crosby RD. Source: The International Journal of Eating Disorders. 2001 December; 30(4): 441-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11746305
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Food restriction and binge eating: a study of former prisoners of war. Author(s): Polivy J, Zeitlin SB, Herman CP, Beal AL. Source: Journal of Abnormal Psychology. 1994 May; 103(2): 409-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8040513
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Frequency of binge eating disorder in an outpatient weight loss clinic. Author(s): Kalman D, Cascarano H, Krieger DR, Incledon T, Woolsey M. Source: Journal of the American Dietetic Association. 2002 May; 102(5): 697-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12008996
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Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls. Author(s): Paxton SJ, Schutz HK, Wertheim EH, Muir SL. Source: Journal of Abnormal Psychology. 1999 May; 108(2): 255-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10369035
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From dietary restraint to binge eating: attaching causes to effects. Author(s): Herman CP, Polivy J. Source: Appetite. 1990 April; 14(2): 123-5; Discussion 142-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2337336
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Full syndromal versus subthreshold anorexia nervosa, bulimia nervosa, and binge eating disorder: a multicenter study. Author(s): Crow SJ, Stewart Agras W, Halmi K, Mitchell JE, Kraemer HC. Source: The International Journal of Eating Disorders. 2002 November; 32(3): 309-18. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12210645
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Group therapy for binge eating in Type 2 diabetes: a randomized trial. Author(s): Kenardy J, Mensch M, Bowen K, Green B, Walton J. Source: Diabetic Medicine : a Journal of the British Diabetic Association. 2002 March; 19(3): 234-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12162246
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Questions & answers. I'm overweight and have a problem with binge eating, although I never purge. I am working with a nutritionist and have started an exercise program, but I'd like to know if there are any medications that can help. Author(s): Miller MC. Source: The Harvard Mental Health Letter / from Harvard Medical School. 2004 February; 20(8): 8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14980873
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Recurrent overeating: an empirical comparison of binge eating disorder, bulimia nervosa, and obesity. Author(s): Fichter MM, Quadflieg N, Brandl B. Source: The International Journal of Eating Disorders. 1993 July; 14(1): 1-16. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8339091
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Reduced serotonin transporter binding in binge eating women. Author(s): Kuikka JT, Tammela L, Karhunen L, Rissanen A, Bergstrom KA, Naukkarinen H, Vanninen E, Karhu J, Lappalainen R, Repo-Tiihonen E, Tiihonen J, Uusitupa M. Source: Psychopharmacology. 2001 May; 155(3): 310-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11432694
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Refining the definition of binge eating disorder and nonpurging bulimia nervosa. Author(s): Cooper Z, Fairburn CG. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S89-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900989
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Regional cerebral blood flow during exposure to food in obese binge eating women. Author(s): Karhunen LJ, Vanninen EJ, Kuikka JT, Lappalainen RI, Tiihonen J, Uusitupa MI. Source: Psychiatry Research. 2000 July 10; 99(1): 29-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10891647
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Relation of dieting and voluntary weight loss to psychological functioning and binge eating. Author(s): Wilson GT. Source: Annals of Internal Medicine. 1993 October 1; 119(7 Pt 2): 727-30. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8363206
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Relationship between dietary restraint, binge eating, and leptin in obese women. Author(s): d'Amore A, Massignan C, Montera P, Moles A, De Lorenzo A, Scucchi S. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2001 March; 25(3): 373-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11319635
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Reliability of the Eating Disorder Examination in patients with binge eating disorder. Author(s): Grilo CM, Masheb RM, Lozano-Blanco C, Barry DT. Source: The International Journal of Eating Disorders. 2004 January; 35(1): 80-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14705160
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Risk factors for binge eating disorder: a community-based, case-control study. Author(s): Fairburn CG, Doll HA, Welch SL, Hay PJ, Davies BA, O'Connor ME. Source: Archives of General Psychiatry. 1998 May; 55(5): 425-32. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9596045
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Risk factors for binge eating onset in adolescent girls: a 2-year prospective investigation. Author(s): Stice E, Presnell K, Spangler D. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2002 March; 21(2): 131-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11950103
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Schema-level cognitions in patients with binge eating disorder: a case control study. Author(s): Waller G. Source: The International Journal of Eating Disorders. 2003 May; 33(4): 458-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12658675
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Screening for binge eating disorder in obese outpatients. Author(s): Ricca V, Mannucci E, Moretti S, Di Bernardo M, Zucchi T, Cabras PL, Rotella CM. Source: Comprehensive Psychiatry. 2000 March-April; 41(2): 111-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10741889
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Self-efficacy in overweight individuals with binge eating disorder. Author(s): Miller PM, Watkins JA, Sargent RG, Rickert EJ. Source: Obesity Research. 1999 November; 7(6): 552-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10574513
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Self-harm and substance use in a community sample of Black and White women with binge eating disorder or bulimia nervosa. Author(s): Dohm FA, Striegel-Moore RH, Wilfley DE, Pike KM, Hook J, Fairburn CG. Source: The International Journal of Eating Disorders. 2002 December; 32(4): 389-400. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12386904
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Sertraline in underweight binge eating/purging-type eating disorders: five case reports. Author(s): Frank GK, Kaye WH, Marcus MD. Source: The International Journal of Eating Disorders. 2001 May; 29(4): 495-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11285589
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Serum leptin concentration in obese patients with binge eating disorder. Author(s): Adami GF, Campostano A, Cella F, Scopinaro N. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2002 August; 26(8): 1125-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12119579
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Severe hypophosphataemia during binge eating in anorexia nervosa. Author(s): Kaysar N, Kronenberg J, Polliack M, Gaoni B. Source: Archives of Disease in Childhood. 1991 January; 66(1): 138-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1899785
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Sexual orientation as a factor in risk for binge eating and bulimia nervosa: a review. Author(s): Heffernan K. Source: The International Journal of Eating Disorders. 1994 December; 16(4): 335-47. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7866413
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Shame and its psychopathologic correlates in two women's health problems: binge eating disorder and vulvodynia. Author(s): Masheb RM, Grilo CM, Brondolo E. Source: Eat Weight Disord. 1999 December; 4(4): 187-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10728180
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Six-month follow-up of in-patient experiential cognitive therapy for binge eating disorders. Author(s): Riva G, Bacchetta M, Cesa G, Conti S, Molinari E. Source: Cyberpsychology & Behavior : the Impact of the Internet, Multimedia and Virtual Reality on Behavior and Society. 2003 June; 6(3): 251-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12855080
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Sleep-wake cycles in women with binge eating disorder. Author(s): Tzischinsky O, Latzer Y, Epstein R, Tov N. Source: The International Journal of Eating Disorders. 2000 January; 27(1): 43-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10590448
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Social contagion of binge eating. Author(s): Crandall CS. Source: Journal of Personality and Social Psychology. 1988 October; 55(4): 588-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3193348
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Spectrum of binge eating symptomatology in patients treated with clozapine and olanzapine. Author(s): Theisen FM, Linden A, Konig IR, Martin M, Remschmidt H, Hebebrand J. Source: Journal of Neural Transmission (Vienna, Austria : 1996). 2003 January; 110(1): 111-21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12541016
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Subthreshold binge eating disorder. Author(s): Striegel-Moore RH, Dohm FA, Solomon EE, Fairburn CG, Pike KM, Wilfley DE. Source: The International Journal of Eating Disorders. 2000 April; 27(3): 270-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10694712
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Subtyping binge eating disorder. Author(s): Grilo CM, Masheb RM, Wilson GT. Source: Journal of Consulting and Clinical Psychology. 2001 December; 69(6): 1066-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11777111
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Subtyping binge eating-disordered women along dieting and negative affect dimensions. Author(s): Stice E, Agras WS, Telch CF, Halmi KA, Mitchell JE, Wilson T. Source: The International Journal of Eating Disorders. 2001 July; 30(1): 11-27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11439405
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Sugar, opioids and binge eating. Author(s): Fullerton DT, Getto CJ, Swift WJ, Carlson IH. Source: Brain Research Bulletin. 1985 June; 14(6): 673-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3161588
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Teasing history, onset of obesity, current eating disorder psychopathology, body dissatisfaction, and psychological functioning in binge eating disorder. Author(s): Jackson TD, Grilo CM, Masheb RM. Source: Obesity Research. 2000 September; 8(6): 451-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11011912
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Telephone-based guided self-help for binge eating disorder: a feasibility study. Author(s): Wells AM, Garvin V, Dohm FA, Striegel-Moore RH. Source: The International Journal of Eating Disorders. 1997 May; 21(4): 341-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9138045
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Temperament and character in obese women with and without binge eating disorder. Author(s): Fassino S, Leombruni P, Piero A, Daga GA, Amianto F, Rovera G, Rovera GG. Source: Comprehensive Psychiatry. 2002 November-December; 43(6): 431-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12439829
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The assessment of binge eating severity among obese persons. Author(s): Gormally J, Black S, Daston S, Rardin D. Source: Addictive Behaviors. 1982; 7(1): 47-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7080884
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The binge eating and emotional change in a patient with postinfectious encephalomyelitis. Author(s): Yen CF, Lee PW, Chen CC, Lin SF, Chong YY. Source: Kaohsiung J Med Sci. 1997 February; 13(2): 123-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9099051
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The chicken or the egg: binge eating disorder and dietary restraint. Author(s): Yanovski SZ. Source: Appetite. 1995 June; 24(3): 258. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7574573
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The classification of recurrent overeating: the "binge eating disorder" proposal. Author(s): Fairburn CG, Welch SL, Hay PJ. Source: The International Journal of Eating Disorders. 1993 March; 13(2): 155-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8477284
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The clinical significance of binge eating disorder. Author(s): Wilfley DE, Wilson GT, Agras WS. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S96-106. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900990
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The clinical significance of binge eating in an obese population: support for bed and questions regarding its criteria. Author(s): Grissett NI, Fitzgibbon ML. Source: Addictive Behaviors. 1996 January-February; 21(1): 57-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8729708
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The correlates of binge eating in two nonpatient samples. Author(s): O'Mahony JF, Hollwey S. Source: Addictive Behaviors. 1995 July-August; 20(4): 471-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7484328
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The effects of extending cognitive-behavioral therapy for binge eating disorder among initial treatment nonresponders. Author(s): Eldredge KL, Stewart Agras W, Arnow B, Telch CF, Bell S, Castonguay L, Marnell M. Source: The International Journal of Eating Disorders. 1997 May; 21(4): 347-52. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9138046
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The effects of meal composition on subsequent craving and binge eating. Author(s): Gendall KA, Joyce PR, Abbott RM. Source: Addictive Behaviors. 1999 May-June; 24(3): 305-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10400271
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The gender specificity of emotional, situational, and behavioral indicators of binge eating in a diet-seeking obese population. Author(s): Costanzo PR, Musante GJ, Friedman KE, Kern LS, Tomlinson K. Source: The International Journal of Eating Disorders. 1999 September; 26(2): 205-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10422610
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The natural course of bulimia nervosa and binge eating disorder in young women. Author(s): Fairburn CG, Cooper Z, Doll HA, Norman P, O'Connor M. Source: Archives of General Psychiatry. 2000 July; 57(7): 659-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10891036
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The nature of body image disturbance in patients with binge eating disorder. Author(s): Masheb RM, Grilo CM. Source: The International Journal of Eating Disorders. 2003 April; 33(3): 333-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12655630
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The prediction of binge eating over time. Author(s): Greenberg BR, Harvey PD. Source: Addictive Behaviors. 1986; 11(4): 383-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3468776
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The prevalence and correlates of binge eating in a British community sample of women with a history of obesity. Author(s): Robertson DN, Palmer RL. Source: The International Journal of Eating Disorders. 1997 November; 22(3): 323-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9285270
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The prevalence of DSM-IV personality pathology among individuals with bulimia nervosa, binge eating disorder and obesity. Author(s): van Hanswijck de Jonge P, Van Furth EF, Lacey JH, Waller G. Source: Psychological Medicine. 2003 October; 33(7): 1311-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14580084
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The relation between risk factors for binge eating and bulimia nervosa: a populationbased female twin study. Author(s): Wade TD, Bulik CM, Sullivan PF, Neale MC, Kendler KS. Source: Health Psychology : Official Journal of the Division of Health Psychology, American Psychological Association. 2000 March; 19(2): 115-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10762095
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The relationship between binge eating severity and body fat in nonpurge binge eating women. Author(s): Timmerman GM, Stevenson JS. Source: Research in Nursing & Health. 1996 October; 19(5): 389-98. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8848623
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The relationship between perceived evaluation of weight and treatment outcome among individuals with binge eating disorder. Author(s): Eldredge KL, Agras WS. Source: The International Journal of Eating Disorders. 1997 July; 22(1): 43-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9140734
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The role of daily hassles in binge eating. Author(s): Crowther JH, Sanftner J, Bonifazi DZ, Shepherd KL. Source: The International Journal of Eating Disorders. 2001 May; 29(4): 449-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11285582
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The role of dieting in binge eating disorder: etiology and treatment implications. Author(s): Howard CE, Porzelius LK. Source: Clinical Psychology Review. 1999 January; 19(1): 25-44. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9987582
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The role of palatable food and hunger as trigger factors in an animal model of stress induced binge eating. Author(s): Hagan MM, Chandler PC, Wauford PK, Rybak RJ, Oswald KD. Source: The International Journal of Eating Disorders. 2003 September; 34(2): 183-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12898554
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The topography of binge eating. Author(s): Crowther JH, Lingswiler VM, Stephens MA. Source: Addictive Behaviors. 1984; 9(3): 299-303. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6594034
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Three studies on the factorial distinctiveness of binge eating and bulimic symptoms among nonclinical men and women. Author(s): Joiner TE Jr, Vohs KD, Heatherton TF. Source: The International Journal of Eating Disorders. 2000 March; 27(2): 198-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10657893
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Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial. Author(s): McElroy SL, Arnold LM, Shapira NA, Keck PE Jr, Rosenthal NR, Karim MR, Kamin M, Hudson JI. Source: The American Journal of Psychiatry. 2003 February; 160(2): 255-61. Erratum In: Am J Psychiatry. 2003 March; 160(3): 612. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12562571
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Topiramate use in obese patients with binge eating disorder: an open study. Author(s): Appolinario JC, Fontenelle LF, Papelbaum M, Bueno JR, Coutinho W. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 April; 47(3): 271-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11987480
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Treating binge eating problems in primary care. Author(s): Carter JC, Fairburn CG. Source: Addictive Behaviors. 1995 November-December; 20(6): 765-72. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8820529
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Treatment improves serotonin transporter binding and reduces binge eating. Author(s): Tammela LI, Rissanen A, Kuikka JT, Karhunen LJ, Bergstrom KA, RepoTiihonen E, Naukkarinen H, Vanninen E, Tiihonen J, Uusitupa M. Source: Psychopharmacology. 2003 October; 170(1): 89-93. Epub 2003 May 27. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12768277
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Two eating disorders: binge eating disorder and the night eating syndrome. Author(s): Stunkard A. Source: Appetite. 2000 June; 34(3): 333-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10888297
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Two forms of disordered eating in obesity: binge eating and night eating. Author(s): Stunkard AJ, Allison KC. Source: International Journal of Obesity and Related Metabolic Disorders : Journal of the International Association for the Study of Obesity. 2003 January; 27(1): 1-12. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12532147
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Using interactive voice response technology and timeline follow-back methodology in studying binge eating and drinking behavior: different answers to different forms of the same question? Author(s): Bardone AM, Krahn DD, Goodman BM, Searles JS. Source: Addictive Behaviors. 2000 January-February; 25(1): 1-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10708315
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Using the eating disorder examination to identify the specific psychopathology of binge eating disorder. Author(s): Wilfley DE, Schwartz MB, Spurrell EB, Fairburn CG. Source: The International Journal of Eating Disorders. 2000 April; 27(3): 259-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10694711
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Virtual-reality-based multidimensional therapy for the treatment of body image disturbances in binge eating disorders: a preliminary controlled study. Author(s): Riva G, Bacchetta M, Baruffi M, Molinari E. Source: Ieee Transactions on Information Technology in Biomedicine : a Publication of the Ieee Engineering in Medicine and Biology Society. 2002 September; 6(3): 224-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12381039
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Weight and shape overconcern and emotional eating in binge eating disorder. Author(s): Eldredge KL, Agras WS. Source: The International Journal of Eating Disorders. 1996 January; 19(1): 73-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8640205
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Weight cycling, psychological health, and binge eating in obese women. Author(s): Venditti EM, Wing RR, Jakicic JM, Butler BA, Marcus MD. Source: Journal of Consulting and Clinical Psychology. 1996 April; 64(2): 400-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8871424
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What is a binge? The influence of amount, duration, and loss of control criteria on judgments of binge eating. Author(s): Johnson WG, Boutelle KN, Torgrud L, Davig JP, Turner S. Source: The International Journal of Eating Disorders. 2000 May; 27(4): 471-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10744855
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What is binge eating? A comparison of binge eater, peer, and professional judgments of eating episodes. Author(s): Johnson WG, Carr-Nangle RE, Nangle DW, Antony MM, Zayfert C. Source: Addictive Behaviors. 1997 September-October; 22(5): 631-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9347065
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What is this thing called BED? Current status of binge eating disorder nosology. Author(s): Devlin MJ, Goldfein JA, Dobrow I. Source: The International Journal of Eating Disorders. 2003; 34 Suppl: S2-18. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12900982
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CHAPTER 2. NUTRITION AND BINGE EATING Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and binge eating.
Finding Nutrition Studies on Binge Eating The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail:
[email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “binge eating” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.
4
Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.
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The following information is typical of that found when using the “Full IBIDS Database” to search for “binge eating” (or a synonym): •
Binge eating disorder and bulimia nervosa: differences in the quality and quantity of binge eating episodes. Source: Fitzgibbon, M.L. Blackman, L.R. Int-j-eat-disord. New York, N.Y. : John Wiley & Sons, Inc. March 2000. volume 27 (2) page 238-243. 0276-3478
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Dietary and binge eating among adolescents: what do they really mean. Source: Newumark Sztainer, D. Story, M. J-Am-Diet-Assoc. Chicago, IL : The American Dietetic Association. April 1998. volume 98 (4) page 446-450. 0002-8223
Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •
healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0
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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov
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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov
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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/
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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/
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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/
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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/
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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/
Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html
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Google: http://directory.google.com/Top/Health/Nutrition/
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Healthnotes: http://www.healthnotes.com/
Nutrition
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Open Directory Project: http://dmoz.org/Health/Nutrition/
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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/
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WebMDHealth: http://my.webmd.com/nutrition
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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The following is a specific Web list relating to binge eating; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
Food and Diet Weight Loss and Obesity Source: Healthnotes, Inc.; www.healthnotes.com
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CHAPTER 3. ALTERNATIVE MEDICINE AND BINGE EATING Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to binge eating. At the conclusion of this chapter, we will provide additional sources.
National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to binge eating and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “binge eating” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to binge eating: •
“Recovered memory” therapy for eating disorders: implications of the Ramona verdict. Author(s): Pope HG Jr, Hudson JI. Source: The International Journal of Eating Disorders. 1996 March; 19(2): 139-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8932552
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“Spiritual starvation?”: a case series concerning christianity and eating disorders. Author(s): Morgan JF, Marsden P, Lacey JH. Source: The International Journal of Eating Disorders. 2000 December; 28(4): 476-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11054798
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5-Hydroxytryptophan: a clinically-effective serotonin precursor. Author(s): Birdsall TC.
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Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 1998 August; 3(4): 271-80. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9727088 •
A comparison between women seeking self-help and psychiatric treatment in anorexia nervosa and bulimia. Author(s): Deeble EA, Crisp AH, Lacey JH, Bhat AV. Source: The British Journal of Medical Psychology. 1990 March; 63 ( Pt 1): 65-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2331454
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A comparison of nutritional management with stress management in the treatment of bulimia nervosa. Author(s): Laessle RG, Beumont PJ, Butow P, Lennerts W, O'Connor M, Pirke KM, Touyz SW, Waadt S. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1991 August; 159: 250-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1773242
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A prescription of vomiting: historical footnotes. Author(s): Nasser M. Source: The International Journal of Eating Disorders. 1993 January; 13(1): 129-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8386579
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A randomized controlled trial of guided imagery in bulimia nervosa. Author(s): Esplen MJ, Garfinkel PE, Olmsted M, Gallop RM, Kennedy S. Source: Psychological Medicine. 1998 November; 28(6): 1347-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9854276
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Abnormal eating attitudes and behaviours in two ethnic groups from a female British urban population. Author(s): Reiss D. Source: Psychological Medicine. 1996 March; 26(2): 289-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8685285
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Accounts of experiences of bulimia: a discourse analytic study. Author(s): Brooks A, LeCouteur A, Hepworth J. Source: The International Journal of Eating Disorders. 1998 September; 24(2): 193-205. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9697018
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Adolescent vegetarians. A behavioral profile of a school-based population in Minnesota. Author(s): Neumark-Sztainer D, Story M, Resnick MD, Blum RW.
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Source: Archives of Pediatrics & Adolescent Medicine. 1997 August; 151(8): 833-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9265888 •
An educational group treatment program for bulimia. Author(s): Connor-Greene PA. Source: Journal of American College Health : J of Ach. 1987 March; 35(5): 229-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3584705
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An unusual case of pica. Author(s): Solyom C, Solyom L, Freeman R. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1991 February; 36(1): 50-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2029685
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Anorexia nervosa in Hong Kong: a Chinese perspective. Author(s): Lee S. Source: Psychological Medicine. 1991 August; 21(3): 703-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1946859
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Art therapy, psychodrama, and verbal therapy. An integrative model of group therapy in the treatment of adolescents with anorexia nervosa and bulimia nervosa. Author(s): Diamond-Raab L, Orrell-Valente JK. Source: Child Adolesc Psychiatr Clin N Am. 2002 April; 11(2): 343-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12109325
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Binge eating and binge eating disorder in a small-scale, indigenous society: the view from Fiji. Author(s): Becker AE, Burwell RA, Navara K, Gilman SE. Source: The International Journal of Eating Disorders. 2003 December; 34(4): 423-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14566929
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Binge eating and weight concerns among young adults. Results from the Zurich cohort study. Author(s): Vollrath M, Koch R, Angst J. Source: The British Journal of Psychiatry; the Journal of Mental Science. 1992 April; 160: 498-503. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1571749
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Binge eating disorder: prevalence and psychopathological features in a clinical sample of obese people in Italy. Author(s): Ramacciotti CE, Coli E, Passaglia C, Lacorte M, Pea E, Dell'Osso L.
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Source: Psychiatry Research. 2000 May 15; 94(2): 131-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10808038 •
Body dissatisfaction and its interrelations with other risk factors for bulimia nervosa in 12 countries. Author(s): Jaeger B, Ruggiero GM, Edlund B, Gomez-Perretta C, Lang F, Mohammadkhani P, Sahleen-Veasey C, Schomer H, Lamprecht F. Source: Psychotherapy and Psychosomatics. 2002 January-February; 71(1): 54-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11740169
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Body image disturbance in obese outpatients before and after weight loss in relation to race, gender, binge eating, and age of onset of obesity. Author(s): Sorbara M, Geliebter A. Source: The International Journal of Eating Disorders. 2002 May; 31(4): 416-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11948646
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Body-oriented therapy for anorexia nervosa patients. Author(s): Vandereycken W, Depreitere L, Probst M. Source: American Journal of Psychotherapy. 1987 April; 41(2): 252-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3605458
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Bulimia in children and adolescents. Author(s): Brewerton TD. Source: Child Adolesc Psychiatr Clin N Am. 2002 April; 11(2): 237-56, Viii. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12109320
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Bulimia nervosa in the Chinese. Author(s): Schmidt U. Source: The International Journal of Eating Disorders. 1993 December; 14(4): 505-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8293034
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Bulimia nervosa in two cultures: a comparison of Austrian and American college students. Author(s): Mangweth B, Pope HG, Hudson JI. Source: The International Journal of Eating Disorders. 1995 May; 17(4): 403-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7620481
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Bulimia nervosa: a 5-year follow-up study. Author(s): Johnson-Sabine E, Reiss D, Dayson D. Source: Psychological Medicine. 1992 November; 22(4): 951-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1488490
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Bulimia. A review of nutritional and health behaviors. Author(s): Laraia MT, Stuart GW. Source: J Child Adolesc Psychiatr Ment Health Nurs. 1990 July-September; 3(3): 91-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2195155
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Bulimic adolescents benefit from massage therapy. Author(s): Field T, Schanberg S, Kuhn C, Field T, Fierro K, Henteleff T, Mueller C, Yando R, Shaw S, Burman I. Source: Adolescence. 1998 Fall; 33(131): 555-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9831872
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Chewing and spitting associated with a protein sparing modified fast and psychosocial stressors. Author(s): Smith GR Jr, Ross RL. Source: Psychosomatics. 1989 Spring; 30(2): 224-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2710922
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Clinical implications of psychosocial research on bulimia nervosa and binge-eating disorder. Author(s): Stice E. Source: Journal of Clinical Psychology. 1999 June; 55(6): 675-83. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10445859
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Cognitive behavior therapy for eating disorders: progress and problems. Author(s): Wilson GT. Source: Behaviour Research and Therapy. 1999 July; 37 Suppl 1: S79-95. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10402697
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Cognitive-behavioral self-help for binge eating disorder: a controlled effectiveness study. Author(s): Carter JC, Fairburn CG. Source: Journal of Consulting and Clinical Psychology. 1998 August; 66(4): 616-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9735577
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Comparison of alternative treatment techniques in bulimia: the chemical dependency approach. Author(s): Giannini AJ, Keller M, Colapietro G, Melemis SM, Leskovac N, Timcisko T. Source: Psychological Reports. 1998 April; 82(2): 451-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9621718
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Self-help versus therapist-led group cognitive-behavioral treatment of binge eating disorder at follow-up.
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Author(s): Peterson CB, Mitchell JE, Engbloom S, Nugent S, Pederson Mussell M, Crow SJ, Thuras P. Source: The International Journal of Eating Disorders. 2001 December; 30(4): 363-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11746298 •
Short-term oral sensory deprivation: possible cause of binge eating in sham-feeding dogs. Author(s): Lawson DC, Schiffman SS, Pappas TN. Source: Physiology & Behavior. 1993 June; 53(6): 1231-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8346312
Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •
Alternative Medicine Foundation, Inc.: http://www.herbmed.org/
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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats
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Chinese Medicine: http://www.newcenturynutrition.com/
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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html
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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm
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Google: http://directory.google.com/Top/Health/Alternative/
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Healthnotes: http://www.healthnotes.com/
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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine
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Open Directory Project: http://dmoz.org/Health/Alternative/
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HealthGate: http://www.tnp.com/
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WebMDHealth: http://my.webmd.com/drugs_and_herbs
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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html
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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/
The following is a specific Web list relating to binge eating; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •
General Overview Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com
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Eating Disorders Source: Healthnotes, Inc.; www.healthnotes.com Obesity Source: Integrative Medicine Communications; www.drkoop.com
General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.
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CHAPTER 4. DISSERTATIONS ON BINGE EATING Overview In this chapter, we will give you a bibliography on recent dissertations relating to binge eating. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “binge eating” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on binge eating, we have not necessarily excluded non-medical dissertations in this bibliography.
Dissertations on Binge Eating ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to binge eating. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •
A path analysis of binge eating and obesity in African-Americans: Acculturation, racism, emotional distress, binge eating, body dissatisfaction, attitudes towards obesity, dietary restraint, dietary fat intake, and physical activity by Kohlmaier, Joy Rose; PhD from Louisiana State University and Agricultural & Mechanical College, 2003, 119 pages http://wwwlib.umi.com/dissertations/fullcit/3098076
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Appetite-focused cognitive behavioral therapy for the early intervention of binge eating disorder by Elder, Katherine Alicia; PhD from University of Colorado at Boulder, 2003, 84 pages http://wwwlib.umi.com/dissertations/fullcit/3113085
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Comparison of binge eating syndromes and comorbid features in a clinic sample by Seel, Rachel Ann; PhD from Wayne State University, 2003, 148 pages http://wwwlib.umi.com/dissertations/fullcit/3086471
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EXAMINATION OF RESTRAINED AND BINGE EATING IN RELATIONSHIP TO PERSONALITY VARIABLES IN COLLEGE WOMEN by RIDEOUT, CHRISTINA ANN, PHD from Michigan State University, 1983, 248 pages http://wwwlib.umi.com/dissertations/fullcit/8400617
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Functional analysis of binge eating in the obese by Henderson, Kathryn Elizabeth; PhD from Queen's University at Kingston (Canada), 2003, 230 pages http://wwwlib.umi.com/dissertations/fullcit/NQ80998
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IRRESISTIBLE URGES: THE SOCIAL PSYCHOLOGY OF BINGE EATING (EATING DISORDERS) by MELOY, HELEN ANN, PHD from University of California, Santa Barbara, 1993, 213 pages http://wwwlib.umi.com/dissertations/fullcit/9334877
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Predictors of relapse in binge eating disorder following dialectical behavior therapy by Lively, Teresa Jean; PhD from Pacific Graduate School of Psychology, 2003, 100 pages http://wwwlib.umi.com/dissertations/fullcit/3055185
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The effects of binge eating disorder and weight on the Eating Disorder Inventory - 2: An exploratory study by Jackson, Cara Lee, PhD from State University of New York at Buffalo, 1996, 90 pages http://wwwlib.umi.com/dissertations/fullcit/9704890
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The prevalence of sexual abuse, binge eating disorder, and perception of social support in a morbidly obese population by Hunter, Krys Doreen; PsyD from Fuller Theological Seminary, School of Psychology, 2003, 54 pages http://wwwlib.umi.com/dissertations/fullcit/3095332
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THE RELATIONSHIP OF RESTRICTIVE EATING, PERCEIVED BODY SPACE, AND BODY SATISFACTION TO BINGE EATING SEVERITY IN SELFDESIGNATED FEMALE BINGE EATERS by ELLIAS, MARCIA SUSAN, PHD from New York University, 1987, 188 pages http://wwwlib.umi.com/dissertations/fullcit/8720114
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THE ROLE OF BLOOD GLUCOSE IN BINGE EATING BEHAVIOR (EATING DISORDERS) by TOTTEN, DEBORAH PALCZEWSKI, PHD from University of Virginia, 1990, 241 pages http://wwwlib.umi.com/dissertations/fullcit/9023486
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Women's experience of binge eating disorder by Owens, Pamela Crant; EdD from University of Cincinnati, 2003, 278 pages http://wwwlib.umi.com/dissertations/fullcit/3103339
Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.
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CHAPTER 5. BOOKS ON BINGE EATING Overview This chapter provides bibliographic book references relating to binge eating. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on binge eating include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.
Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “binge eating” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on binge eating: •
The New Maximize Your Body Potential: Lifetime Skills for Successful Weight Management Source: Palo Alto, CA: Bull Publishing, 607 p., 1997. Contact: Bull Publishing, P.O. Box 208, Palo Alto, CA 94302- 0208. (415) 322-2855. Summary: Nash discusses the process of weight management comprehensively. She examines the issue of the social importance of physical appearance and how to overcome the pitfall of equating health and thinness. She describes a process for beginning a weight management program, including readiness for change, how to create and maintain motivation, determining long-term weight goals, tracking progress, and social support. A special section covers nutrition in depth, discussing topics such as the relationship between nutrition and health, dietary supplements, food composition, food labels, and vegetarianism. Nash also analyzes how to change behavior patterns, and explains how to begin an exercise program. A final section looks at psychological
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factors such as motivation, depression, anxiety, anger, loneliness, binge eating, and backsliding. Appendixes cover body measurements, dietary allowances, and vitamins and minerals. A glossary and bibliography are also included. •
Now That You've Lost It: How to Maintain Your Best Weight Source: Palo Alto, CA: Bull Publishing Company, 350 p., N.D. Contact: Bull Publishing Company, PO Box 208, Palo Alto, CA 94302- 0208. (800) 6762855. Summary: This book discusses how to maintain weight loss, once you have reached the desired weight. Topics include self-esteem, dealing with binge eating, coping with social events, preventing backsliding, coping with success, and reaching out.
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What You Can Do to Prevent Diabetes: Simple Changes to Improve Your Life Source: Somerset, NJ: John Wiley and Sons, Inc. 2000. 146 p. Contact: Available from John Wiley and Sons. One Wiley Drive, Somerset, NJ 08875. (800) 225-5945 or (732) 469-4400. Fax (732) 302-2300. E-mail:
[email protected]. Website: www.wiley.com. PRICE: $12.95 plus shipping and handling. ISBN: 0471347965. Summary: This book outlines lifestyle changes that people can make to prevent diabetes. Steps that people can take to reduce their chance of getting type 2 diabetes include managing body weight, becoming active, and establishing healthier eating habits. In part one, readers rate their risk for developing diabetes and learn how diabetes develops. Part two provides guidelines and encouragement for helping people make lasting lifestyle changes. Part three focuses on managing body weight. Topics include understanding the connection between diabetes and excess body weight, using body mass index and body shape to determine if one's current weight is healthy, avoiding the use of over the counter appetite suppressants, and dealing with binge eating. Part four provides nutrition guidelines that people can use to achieve better health, including following the 80/20 rule that advocates making healthful food choices 80 percent of the time and allowing less desirable choices on holidays, vacations, and special occasions; getting less than 30 percent of each day's calories from fat; establishing consistent eating habits; keeping calories in check; monitoring portion size; assessing one's hunger; eating intuitively; learning one's food triggers; and eating five servings of fruits and vegetables throughout the day. Part five stresses the importance of exercise and offers suggestions for incorporating more physical activity into daily living. Topics include performing aerobic exercises, adding strength training to an exercise program, and balancing a fitness routine with both aerobic exercise and strength training. Part six focuses on balancing one's lifestyle by monitoring and managing stress, finding support, thinking positively, and visualizing success. The final two parts discuss the advantages of getting the entire family involved in making positive lifestyle changes and offer guidelines for staying on track with a diabetes prevention plan. The book concludes with an index. 30 references.
Chapters on Binge Eating In order to find chapters that specifically relate to binge eating, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and binge eating using the “Detailed Search” option. Go to the following
Books
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hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “binge eating” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on binge eating: •
Solving Coping Problems Source: in Touchette, N. Diabetes Problem Solver. Alexandria, VA: American Diabetes Association. 1999. p. 415-439. Contact: Available from American Diabetes Association (ADA). Order Fulfillment Department, P.O. Box 930850, Atlanta, GA 31193-0850. (800) 232-6733. Fax (770) 4429742. Website: www.diabetes.org. PRICE: $19.95 for members; plus shipping and handling. ISBN: 1570400091. Summary: This chapter deals with solving coping problems in people who have diabetes. Although being diagnosed with diabetes raises conflicting emotions, the best way to cope with diabetes is to deal with both the physical symptoms and the emotional feelings. Once feelings are recognized and confronted, they can be resolved. This in turn allows the person who has diabetes to move on with his or her life and begin to integrate diabetes management into his or her day-to-day living. The chapter discusses the issue of coping with diabetes in terms of adjusting to diabetes by dealing with feelings of denial and anger; dealing with stress; handling depression and anxiety; maintaining the motivation to manage diabetes; dealing with alcohol abuse; and handling eating disorders such as anorexia nervosa, bulimia nervosa, and binge eating disorder. The chapter presents the symptoms of these feelings and conditions and explains how to deal with them.
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CHAPTER 6. PERIODICALS AND NEWS ON BINGE EATING Overview In this chapter, we suggest a number of news sources and present various periodicals that cover binge eating.
News Services and Press Releases One of the simplest ways of tracking press releases on binge eating is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “binge eating” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to binge eating. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “binge eating” (or synonyms). The following was recently listed in this archive for binge eating: •
Study links teen binge eating to suicide attempt Source: Reuters Health eLine Date: January 06, 2003
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The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “binge eating” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “binge eating” (or synonyms). If you know the name of a company that is relevant to binge eating, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “binge eating” (or synonyms).
Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly
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to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “binge eating” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on binge eating: •
Genetic Mutation Associated With Binge Eating Source: WIN Notes. p. 4, 10. Summer/Fall 2003. Contact: Weight-control Information Network, 1 WIN Way, Bethesda, MD 20892-3665. (202) 828-1025.
[email protected]. Summary: A multinational study published in the March 20, 2003 'New England Journal of Medicine' linked irregularities in the melanocortin 4 receptor (MC4R) to binge eating disorder. This disorder is described as rapidly consuming of a large amount of food and feeling a loss of control over eating. A person would need to experience such binges at least twice a week for 6 months or longer to meet the diagnosis for binge eating disorder. An estimated 4 million Americans meet the diagnosis for binge eating, and most, but not all, are obese. In this study of 469 severely obese subjects and 25 normal weight controls, 100 percent of people identified with variations in MC4R met the criteria for binge eating, compared to 14.2 percent of other obese subjects, and none of the normal-weight subjects without the MC4R variants. In other animal and human studies, MC4R played an important role in the regulation of body weight. It manufactures a protein that stimulates appetite in the hypothalamus. MC4R mutations have been linked to increased food intake and extreme and early onset obesity.
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Medication Treatments for Binge Eating Disorder Source: Weight Control Digest. 7(4):633, 636-639; July/Aug 1997. Contact: Weight Control Digest, 1555 W. Mockingbird Lane, Suite 203, Dallas, TX 75235. (800) 736-7323. Summary: This article examines the use of medications in treating overweight individuals with binge eating disorder. The authors first describe what binge eating disorder (BED) is, and how it differs from the bingeing and purging syndrome. They then review studies done with antidepressants, appetite suppressants, combinations of these medications and psychotherapy, and behavior modification. The authors then offer guidelines for the use of medications in the treatment of BED and suggest what the future treatment of BED might be. They conclude that any treatment plan for BED should include medication, behavior modification, and diet and lifestyle changes.
Academic Periodicals covering Binge Eating Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to binge eating. In addition to these sources, you can search for articles covering binge eating that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.”
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If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”
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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.
NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute5: •
Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm
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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/
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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html
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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25
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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm
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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm
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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375
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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/
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These publications are typically written by one or more of the various NIH Institutes.
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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm
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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/
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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm
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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm
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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/
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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm
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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html
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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm
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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm
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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm
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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html
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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm
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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp
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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/
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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp
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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html
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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm
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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.6 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:7 •
Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html
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HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html
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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html
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Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/
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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html
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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html
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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/
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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html
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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html
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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html
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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html
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Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 7 See http://www.nlm.nih.gov/databases/databases.html.
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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html
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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html
The NLM Gateway8 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.9 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “binge eating” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total
Items Found 4056 178 905 10 11 5160
HSTAT10 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.11 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.12 Simply search by “binge eating” (or synonyms) at the following Web site: http://text.nlm.nih.gov.
8
Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.
9
The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 10 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 11 12
The HSTAT URL is http://hstat.nlm.nih.gov/.
Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.
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Coffee Break: Tutorials for Biologists13 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.14 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.15 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.
Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •
CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.
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Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.
13 Adapted 14
from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.
The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 15 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.
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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on binge eating can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.
Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to binge eating. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to binge eating. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “binge eating”:
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Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Eating Disorders http://www.nlm.nih.gov/medlineplus/eatingdisorders.html Mental Health http://www.nlm.nih.gov/medlineplus/mentalhealth.html
Within the health topic page dedicated to binge eating, the following was listed: •
General/Overviews Eating Disorders Source: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration http://www.mentalhealth.org/publications/allpubs/ken98-0047/default.asp Eating Disorders: An Overview For Parents Source: Nemours Foundation http://kidshealth.org/parent/emotions/feelings/eating_disorders.html
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Diagnosis/Symptoms What's Going On With Me?: Evaluating Eating and Exercise Habits Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 55
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Treatment Eating Disorders: Psychotherapy's Role in Effective Treatment Source: American Psychological Association http://helping.apa.org/therapy/eating.html Helpful Questions When Considering Treatment Options Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 51 Questions to Ask Your Treatment Provider Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 81 Treatment of Eating Disorders Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 39
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Coping Sharing with EEEase Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411
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56 What Should I Say?: Tips for Talking with a Friend Who May Be Struggling with an Eating Disorder Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 74 •
Specific Conditions/Aspects Anorexia Nervosa http://www.4woman.gov/faq/Easyread/anorexia-etr.htm Anorexia Nervosa Source: American Academy of Family Physicians http://familydoctor.org/063.xml Binge Eating Disorders Source: NIDDK Weight-control Information Network http://www.niddk.nih.gov/health/nutrit/pubs/binge.htm Body Image Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 57 Bulimia Nervosa http://www.4woman.gov/faq/Easyread/bulnervosa-etr.htm Compulsive Exercise (for Parents) Source: Nemours Foundation http://kidshealth.org/parent/emotions/behavior/compulsive_exercise.html Health Consequences of Eating Disorders Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 43 Pica Source: Nemours Foundation http://kidshealth.org/parent/emotions/behavior/pica.html What Causes Eating Disorders? Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 44 What People with Anorexia Nervosa Need to Know about Osteoporosis Source: Osteoporosis and Related Bone Diseases-National Resource Center http://www.osteo.org/newfile.asp?doc=r803i&doctitle=What%2BPeople%2Bwith %2BAnorexia%2BNervosa%2BNeed%2Bto%2BKnow%2BAbout%2BOsteoporosis& doctype=HTML%2BFact%2BSheet
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Children Kids and Eating Disorders Source: Nemours Foundation http://kidshealth.org/kid/health_problems/learning_problem/eatdisorder.html
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From the National Institutes of Health Eating Disorders: Facts about Eating Disorders and the Search for Solutions Source: National Institute of Mental Health http://www.nimh.nih.gov/publicat/eatingdisorders.cfm
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Latest News Abused Girls at Risk of Later Eating Disorders Source: 05/27/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_18010 .html Binging And Purging Linked to Suicide Risk Source: 05/21/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_17879 .html More News on Eating Disorders http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/alphanews_e.html#Ea tingDisorders Women Snack When Noise Frustrates Source: 06/04/2004, Reuters Health http://www.nlm.nih.gov//www.nlm.nih.gov/medlineplus/news/fullstory_18175 .html
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Men Anorexia Nervosa in Males Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 46 Binge Eating Disorder in Males Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=316&Profile_ID=411 82 Bulimia Nervosa in Males Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 47 Enhancing Male Body Image Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 61
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Men Less Likely To Seek Help for Eating Disorders Source: American Psychiatric Association http://www.medem.com/MedLB/article_detaillb.cfm?article_ID=ZZZ0626R6LC& sub_cat=624 Strategies for Prevention and Early Intervention of Male Eating Disorders Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 72 •
Organizations American Academy of Child and Adolescent Psychiatry http://www.aacap.org/ National Eating Disorders Association http://www.nationaleatingdisorders.org/ National Institute of Mental Health http://www.nimh.nih.gov/
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Prevention/Screening Eating Disorders Can Be Prevented! Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 69 Ten Things Parents Can Do to Prevent Eating Disorders Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 71
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Statistics Statistics: Eating Disorders and Their Precursors Source: National Eating Disorders Association http://www.nationaleatingdisorders.org/p.asp?WebPage_ID=286&Profile_ID=411 38
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Teenagers Binge Eating Disorder Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/problems/binge_eating.html Compulsive Exercise (for Teens) Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/exercise/compulsive_exercise.html Eating Disorders: Anorexia and Bulimia Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/problems/eat_disorder.html
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I Think My Friend May Have an Eating Disorder. What Should I Do? Source: Nemours Foundation http://kidshealth.org/teen/food_fitness/problems/friend_eating_disorder.html •
Women Eating Disorders at Midlife Source: Mayo Foundation for Medical Education and Research http://www.mayoclinic.com/invoke.cfm?id=HQ00596
You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on binge eating. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •
Binge Eating Disorder Source: Binge Eating Disorder. 6 p. NIH Publication No. 99-3589, Revised May 2000. Contact: Weight-control Information Network. 1 WIN Way, Bethesda, MD 20892-3665. 1-877-WIN-4627. Summary: This fact sheet on binge eating disorder provides information and an overview of the condition. It reviews the symptoms of binge eating disorder, the prevalence, and those at risk for developing it. The causes of binge eating disorder are unknown, although as many as half of all people with the disorder have been depressed in the past. The risks of binge eating disorder are discussed as well as whether people with binge eating disorder should attempt to diet. The factsheet provides a list of centers and programs, with addresses and telephone numbers, that can help treat people with binge eating disorder. Additional reading resources as well as information about the Weight-control Information Network (WIN) are included. The NIH Search Utility
The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to binge eating. The drawbacks of this approach are that the information is not
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organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •
AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats
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Family Village: http://www.familyvillage.wisc.edu/specific.htm
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Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/
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Med Help International: http://www.medhelp.org/HealthTopics/A.html
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Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/
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Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/
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WebMDHealth: http://my.webmd.com/health_topics
Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to binge eating. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with binge eating. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about binge eating. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/.
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Simply type in “binge eating” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “binge eating”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “binge eating” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “binge eating” (or a synonym) into the search box, and click “Submit Query.”
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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.
Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.16
Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.
Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of
16
Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.
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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)17: •
Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/
•
Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)
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Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm
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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html
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California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html
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California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html
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California: Gateway Health Library (Sutter Gould Medical Foundation)
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California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/
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California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp
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California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html
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California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/
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California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/
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California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/
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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html
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California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/
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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/
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Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/
•
Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/
17
Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.
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•
Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml
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Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm
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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html
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Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm
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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp
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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/
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Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm
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Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html
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Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/
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Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm
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Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/
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Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/
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Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/
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Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm
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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html
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Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm
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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/
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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/
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Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10
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Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/
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•
Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html
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Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp
•
Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp
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Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/
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Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html
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Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm
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Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp
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Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/
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Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html
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Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/
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Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm
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Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/
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Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html
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Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm
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Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330
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Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)
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National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html
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National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/
•
National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/
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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm
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New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/
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New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm
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New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm
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New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/
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New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html
•
New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/
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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html
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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/
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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm
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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp
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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/
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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/
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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml
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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html
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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html
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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml
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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp
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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm
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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/
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•
South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp
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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/
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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/
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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72
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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •
ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html
•
MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp
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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/
•
Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html
•
On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/
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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp
•
Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm
Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on binge eating: •
Basic Guidelines for Binge Eating Binge eating Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003265.htm
•
Signs & Symptoms for Binge Eating Constipation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003125.htm Depression Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003213.htm Gastric dilatation Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003124.htm Hunger Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003134.htm
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Stress Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003211.htm Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •
Background Topics for Binge Eating Biofeedback Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002241.htm Electrolyte Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002350.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Pulmonary (lung) aspiration Web site: http://www.nlm.nih.gov/medlineplus/ency/article/000036.htm
Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •
Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical
•
MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html
•
Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/
•
Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine
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BINGE EATING DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Aberrant: Wandering or deviating from the usual or normal course. [EU] Accommodation: Adjustment, especially that of the eye for various distances. [EU] Acting Out: Expressing unconscious emotional conflicts or feelings, often of hostility or love, through overt behavior. [NIH] Adipocytes: Fat-storing cells found mostly in the abdominal cavity and subcutaneous tissue. Fat is usually stored in the form of tryglycerides. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Cortex: The outer layer of the adrenal gland. It secretes mineralocorticoids, androgens, and glucocorticoids. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Aerobic Exercise: A type of physical activity that includes walking, jogging, running, and dancing. Aerobic training improves the efficiency of the aerobic energy-producing systems that can improve cardiorespiratory endurance. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and
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older (aged, 80 and over). [NIH] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] A-HA: First enzyme in the biosynthetic pathway of branched-chain amino acids. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amnestic: Nominal aphasia; a difficulty in finding the right name for an object. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]
Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anastomosis: A procedure to connect healthy sections of tubular structures in the body after the diseased portion has been surgically removed. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anorexia: Lack or loss of appetite for food. Appetite is psychologic, dependent on memory and associations. Anorexia can be brought about by unattractive food, surroundings, or
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company. [NIH] Anorexia Nervosa: The chief symptoms are inability to eat, weight loss, and amenorrhea. [NIH]
Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anthropology: The science devoted to the comparative study of man. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]
Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antrectomy: An operation to remove the upper portion of the stomach, called the antrum. This operation helps reduce the amount of stomach acid. It is used when a person has complications from ulcers. [NIH] Anus: The opening of the rectum to the outside of the body. [NIH] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Anxiolytic: An anxiolytic or antianxiety agent. [EU] Approximate: Approximal [EU]
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Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspiration: The act of inhaling. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autoreceptors: Transmitter receptors on or near presynaptic terminals (or varicosities) which are sensitive to the transmitter(s) released by the terminal itself. Receptors for the hormones released by hormone-releasing cells are also included. [NIH] Baclofen: A GABA derivative that is a specific agonist at GABA-B receptors. It is used in the treatment of spasticity, especially that due to spinal cord damage. Its therapeutic effects result from actions at spinal and supraspinal sites, generally the reduction of excitatory transmission. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavior Therapy: The application of modern theories of learning and conditioning in the treatment of behavior disorders. [NIH] Behavioral Symptoms: Observable manifestions of impaired psychological functioning. [NIH]
Biliopancreatic Diversion: A surgical procedure which diverts pancreatobiliary secretions via the duodenum and the jejunum into the colon, the remaining small intestine being anastomosed to the stomach after antrectomy. The procedure produces less diarrhea than does jejunoileal bypass. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological Factors: Compounds made by living organisms that contribute to or influence a phenomenon or process. They have biological or physiological activities. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH]
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Bladder: The organ that stores urine. [NIH] Blood Glucose: Glucose in blood. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Body Mass Index: One of the anthropometric measures of body mass; it has the highest correlation with skinfold thickness or body density. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bulimia: Episodic binge eating. The episodes may be associated with the fear of not being able to stop eating, depressed mood, or self-deprecating thoughts (binge-eating disorder) and may frequently be terminated by self-induced vomiting (bulimia nervosa). [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Cardiorespiratory: Relating to the heart and lungs and their function. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Carrier Proteins: Transport proteins that carry specific substances in the blood or across cell membranes. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU]
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Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Causal: Pertaining to a cause; directed against a cause. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Cholecystokinin: A 33-amino acid peptide secreted by the upper intestinal mucosa and also found in the central nervous system. It causes gallbladder contraction, release of pancreatic exocrine (or digestive) enzymes, and affects other gastrointestinal functions. Cholecystokinin may be the mediator of satiety. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle. [NIH] Clinical Medicine: The study and practice of medicine by direct examination of the patient. [NIH]
Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Cluster Analysis: A set of statistical methods used to group variables or observations into strongly inter-related subgroups. In epidemiology, it may be used to analyze a closely
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grouped series of events or cases of disease or other health-related phenomenon with welldefined distribution patterns in relation to time or place or both. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Cognitive restructuring: A method of identifying and replacing fear-promoting, irrational beliefs with more realistic and functional ones. [NIH] Cognitive Therapy: A direct form of psychotherapy based on the interpretation of situations (cognitive structure of experiences) that determine how an individual feels and behaves. It is based on the premise that cognition, the process of acquiring knowledge and forming beliefs, is a primary determinant of mood and behavior. The therapy uses behavioral and verbal techniques to identify and correct negative thinking that is at the root of the aberrant behavior. [NIH] Cohort Effect: Variation in health status arising from different causal factors to which each birth cohort in a population is exposed as environment and society change. [NIH] Colon: The long, coiled, tubelike organ that removes water from digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU]
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Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Compliance: Distensibility measure of a chamber such as the lungs (lung compliance) or bladder. Compliance is expressed as a change in volume per unit change in pressure. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Consolidation: The healing process of a bone fracture. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]
Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Corpus: The body of the uterus. [NIH] Corpus Luteum: The yellow glandular mass formed in the ovary by an ovarian follicle that has ruptured and discharged its ovum. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cortisol: A steroid hormone secreted by the adrenal cortex as part of the body's response to stress. [NIH] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH]
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Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cytotoxic: Cell-killing. [NIH] Cytotoxic chemotherapy: Anticancer drugs that kill cells, especially cancer cells. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Dietitian: An expert in nutrition who helps people plan what and how much food to eat. [NIH]
Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Discrimination: The act of qualitative and/or quantitative differentiation between two or more stimuli. [NIH] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drinking Behavior: Behaviors associated with the ingesting of water and other liquids; includes rhythmic patterns of drinking (time intervals - onset and duration), frequency and satiety. [NIH] Drive: A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH]
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Duodenum: The first part of the small intestine. [NIH] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalomyelitis: A general term indicating inflammation of the brain and spinal cord, often used to indicate an infectious process, but also applicable to a variety of autoimmune and toxic-metabolic conditions. There is significant overlap regarding the usage of this term and encephalitis in the literature. [NIH] Endocrine System: The system of glands that release their secretions (hormones) directly into the circulatory system. In addition to the endocrine glands, included are the chromaffin system and the neurosecretory systems. [NIH] Endogenous: Produced inside an organism or cell. The opposite is external (exogenous) production. [NIH] Endometrium: The layer of tissue that lines the uterus. [NIH] Energy balance: Energy is the capacity of a body or a physical system for doing work. Energy balance is the state in which the total energy intake equals total energy needs. [NIH] Energy Intake: Total number of calories taken in daily whether ingested or by parenteral routes. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]
Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epidemic: Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other healthrelated event occurring in such outbreaks. [EU] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH]
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Erythromycin: A bacteriostatic antibiotic substance produced by Streptomyces erythreus. Erythromycin A is considered its major active component. In sensitive organisms, it inhibits protein synthesis by binding to 50S ribosomal subunits. This binding process inhibits peptidyl transferase activity and interferes with translocation of amino acids during translation and assembly of proteins. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]
Estradiol: The most potent mammalian estrogenic hormone. It is produced in the ovary, placenta, testis, and possibly the adrenal cortex. [NIH] Estrogen: One of the two female sex hormones. [NIH] Estrogen Replacement Therapy: The use of hormonal agents with estrogen-like activity in postmenopausal or other estrogen-deficient women to alleviate effects of hormone deficiency, such as vasomotor symptoms, dyspareunia, and progressive development of osteoporosis. This may also include the use of progestational agents in combination therapy. [NIH]
Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excitatory: When cortical neurons are excited, their output increases and each new input they receive while they are still excited raises their output markedly. [NIH] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Space: Interstitial space between cells, occupied by fluid as well as amorphous and fibrous substances. [NIH] Extrapyramidal: Outside of the pyramidal tracts. [EU] Extreme obesity: A body mass index [NIH] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]
Feeding Behavior: Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. [NIH] Fenfluramine: A centrally active drug that apparently both blocks serotonin uptake and provokes transport-mediated serotonin release. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a
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fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Fluvoxamine: A selective serotonin reuptake inhibitor. It is effective in the treatment of depression, obsessive-compulsive disorders, anxiety, panic disorders, and alcohol amnestic disorders. [NIH] Follicular Phase: The period of the menstrual cycle that begins with menstruation and ends with ovulation. [NIH] Forearm: The part between the elbow and the wrist. [NIH] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Balloon: An inflatable device implanted in the stomach as an adjunct to therapy of morbid obesity. Specific types include the silicone Garren-Edwards Gastric Bubble (GEGB), approved by the FDA in 1985, and the Ballobes Balloon. [NIH] Gastric Bypass: Surgical procedure in which the stomach is transected high on the body. The resulting proximal remnant is joined to a loop of the jejunum in an end-to-side anastomosis. This procedure is used frequently in the treatment of morbid obesity. [NIH] Gastric Emptying: The evacuation of food from the stomach into the duodenum. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]
Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]
Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of
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habit, customary. [EU] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Health Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural. [NIH] Health Services: Services for the diagnosis and treatment of disease and the maintenance of health. [NIH] Health Status: The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures. [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]
Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Holidays: Days commemorating events. Holidays also include vacation periods. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Humoral: Of, relating to, proceeding from, or involving a bodily humour - now often used of endocrine factors as opposed to neural or somatic. [EU] Humour: 1. A normal functioning fluid or semifluid of the body (as the blood, lymph or bile) especially of vertebrates. 2. A secretion that is itself an excitant of activity (as certain hormones). [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hyperphagia: Ingestion of a greater than optimal quantity of food. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH]
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Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypothalamic: Of or involving the hypothalamus. [EU] Hypothalamus: Ventral part of the diencephalon extending from the region of the optic chiasm to the caudal border of the mammillary bodies and forming the inferior and lateral walls of the third ventricle. [NIH] Imipramine: The prototypical tricyclic antidepressant. It has been used in major depression, dysthymia, bipolar depression, attention-deficit disorders, agoraphobia, and panic disorders. It has less sedative effect than some other members of this therapeutic group. [NIH]
Immune response: The activity of the immune system against foreign substances (antigens). [NIH]
Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunogenic: Producing immunity; evoking an immune response. [EU] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]
Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inositol: An isomer of glucose that has traditionally been considered to be a B vitamin although it has an uncertain status as a vitamin and a deficiency syndrome has not been identified in man. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1379) Inositol phospholipids are important in signal transduction. [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insight: The capacity to understand one's own motives, to be aware of one's own psychodynamics, to appreciate the meaning of symbolic behavior. [NIH]
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Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intestinal Mucosa: The surface lining of the intestines where the cells absorb nutrients. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Jejunoileal Bypass: A surgical procedure consisting of the anastomosis of the proximal part of the jejunum to the distal portion of the ileum, so as to bypass the nutrient-absorptive segment of the small intestine, to treat morbid obesity. [NIH] Jejunum: That portion of the small intestine which extends from the duodenum to the ileum; called also intestinum jejunum. [EU] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Latent: Phoria which occurs at one distance or another and which usually has no troublesome effect. [NIH] Leptin: A 16-kD peptide hormone secreted from white adipocytes and implicated in the regulation of food intake and energy balance. Leptin provides the key afferent signal from fat cells in the feedback system that controls body fat stores. [NIH] Lesion: An area of abnormal tissue change. [NIH] Ligands: A RNA simulation method developed by the MIT. [NIH] Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Loneliness: The state of feeling sad or dejected as a result of lack of companionship or being separated from others. [NIH] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large
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numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Manic: Affected with mania. [EU] Meatus: A canal running from the internal auditory foramen through the petrous portion of the temporal bone. It gives passage to the facial and auditory nerves together with the auditory branch of the basilar artery and the internal auditory veins. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Menstrual Cycle: The period of the regularly recurring physiologic changes in the endometrium occurring during the reproductive period in human females and some primates and culminating in partial sloughing of the endometrium (menstruation). [NIH] Menstruation: The normal physiologic discharge through the vagina of blood and mucosal tissues from the nonpregnant uterus. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Processes: Conceptual functions or thinking in all its forms. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Microdialysis: A technique for measuring extracellular concentrations of substances in tissues, usually in vivo, by means of a small probe equipped with a semipermeable membrane. Substances may also be introduced into the extracellular space through the membrane. [NIH] Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group. [NIH] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the
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same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monogenic: A human disease caused by a mutation in a single gene. [NIH] Mood Disorders: Those disorders that have a disturbance in mood as their predominant feature. [NIH] Motility: The ability to move spontaneously. [EU] Motor Neurons: Neurons which activate muscle cells. [NIH] Multicenter study: A clinical trial that is carried out at more than one medical institution. [NIH]
Myopia: That error of refraction in which rays of light entering the eye parallel to the optic axis are brought to a focus in front of the retina, as a result of the eyeball being too long from front to back (axial m.) or of an increased strength in refractive power of the media of the eye (index m.). Called also nearsightedness, because the near point is less distant than it is in emmetropia with an equal amplitude of accommodation. [EU] Nadir: The lowest point; point of greatest adversity or despair. [EU] Naloxone: A specific opiate antagonist that has no agonist activity. It is a competitive antagonist at mu, delta, and kappa opioid receptors. [NIH] Naltrexone: Derivative of noroxymorphone that is the N-cyclopropylmethyl congener of naloxone. It is a narcotic antagonist that is effective orally, longer lasting and more potent than naloxone, and has been proposed for the treatment of heroin addiction. The FDA has approved naltrexone for the treatment of alcohol dependence. [NIH] Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Nearsightedness: The common term for myopia. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroendocrine: Having to do with the interactions between the nervous system and the endocrine system. Describes certain cells that release hormones into the blood in response to stimulation of the nervous system. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotransmitter: Any of a group of substances that are released on excitation from the axon terminal of a presynaptic neuron of the central or peripheral nervous system and travel
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across the synaptic cleft to either excite or inhibit the target cell. Among the many substances that have the properties of a neurotransmitter are acetylcholine, norepinephrine, epinephrine, dopamine, glycine, y-aminobutyrate, glutamic acid, substance P, enkephalins, endorphins, and serotonin. [EU] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Obsessive-Compulsive Disorder: An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension. [NIH] Ondansetron: A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and it has reported anxiolytic and neuroleptic properties. [NIH] Optic Chiasm: The X-shaped structure formed by the meeting of the two optic nerves. At the optic chiasm the fibers from the medial part of each retina cross to project to the other side of the brain while the lateral retinal fibers continue on the same side. As a result each half of the brain receives information about the contralateral visual field from both eyes. [NIH]
Osteoporosis: Reduction of bone mass without alteration in the composition of bone, leading to fractures. Primary osteoporosis can be of two major types: postmenopausal osteoporosis and age-related (or senile) osteoporosis. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Ovary: Either of the paired glands in the female that produce the female germ cells and secrete some of the female sex hormones. [NIH] Overweight: An excess of body weight but not necessarily body fat; a body mass index of 25 to 29.9 kg/m2. [NIH] Ovulation: The discharge of a secondary oocyte from a ruptured graafian follicle. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH]
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Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Panic Disorder: A type of anxiety disorder characterized by unexpected panic attacks that last minutes or, rarely, hours. Panic attacks begin with intense apprehension, fear or terror and, often, a feeling of impending doom. Symptoms experienced during a panic attack include dyspnea or sensations of being smothered; dizziness, loss of balance or faintness; choking sensations; palpitations or accelerated heart rate; shakiness; sweating; nausea or other form of abdominal distress; depersonalization or derealization; paresthesias; hot flashes or chills; chest discomfort or pain; fear of dying and fear of not being in control of oneself or going crazy. Agoraphobia may also develop. Similar to other anxiety disorders, it may be inherited as an autosomal dominant trait. [NIH] Parasite: An animal or a plant that lives on or in an organism of another species and gets at least some of its nutrition from that other organism. [NIH] Parasitic: Having to do with or being a parasite. A parasite is an animal or a plant that lives on or in an organism of another species and gets at least some of its nutrients from it. [NIH] Parenteral: Not through the alimentary canal but rather by injection through some other route, as subcutaneous, intramuscular, intraorbital, intracapsular, intraspinal, intrasternal, intravenous, etc. [EU] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]
Peer Group: Group composed of associates of same species, approximately the same age, and usually of similar rank or social status. [NIH] Peer Review: An organized procedure carried out by a select committee of professionals in evaluating the performance of other professionals in meeting the standards of their specialty. Review by peers is used by editors in the evaluation of articles and other papers submitted for publication. Peer review is used also in the evaluation of grant applications. It is applied also in evaluating the quality of health care provided to patients. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Personality Disorders: A major deviation from normal patterns of behavior. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phospholipids: Lipids containing one or more phosphate groups, particularly those derived from either glycerol (phosphoglycerides; glycerophospholipids) or sphingosine (sphingolipids). They are polar lipids that are of great importance for the structure and function of cell membranes and are the most abundant of membrane lipids, although not stored in large amounts in the system. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age.
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[NIH]
Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pilot study: The initial study examining a new method or treatment. [NIH] Placenta: A highly vascular fetal organ through which the fetus absorbs oxygen and other nutrients and excretes carbon dioxide and other wastes. It begins to form about the eighth day of gestation when the blastocyst adheres to the decidua. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postmenopausal: Refers to the time after menopause. Menopause is the time in a woman's life when menstrual periods stop permanently; also called "change of life." [NIH] Postoperative: After surgery. [NIH] Postprandial: Occurring after dinner, or after a meal; postcibal. [EU] Potentiates: A degree of synergism which causes the exposure of the organism to a harmful substance to worsen a disease already contracted. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Preoperative: Preceding an operation. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Presynaptic Terminals: The distal terminations of axons which are specialized for the release of neurotransmitters. Also included are varicosities along the course of axons which have similar specializations and also release transmitters. Presynaptic terminals in both the central and peripheral nervous systems are included. [NIH] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Probe: An instrument used in exploring cavities, or in the detection and dilatation of strictures, or in demonstrating the potency of channels; an elongated instrument for
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exploring or sounding body cavities. [NIH] Progesterone: Pregn-4-ene-3,20-dione. The principal progestational hormone of the body, secreted by the corpus luteum, adrenal cortex, and placenta. Its chief function is to prepare the uterus for the reception and development of the fertilized ovum. It acts as an antiovulatory agent when administered on days 5-25 of the menstrual cycle. [NIH] Prognostic factor: A situation or condition, or a characteristic of a patient, that can be used to estimate the chance of recovery from a disease, or the chance of the disease recurring (coming back). [NIH] Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Promoter: A chemical substance that increases the activity of a carcinogenic process. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Proximal: Nearest; closer to any point of reference; opposed to distal. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychoactive: Those drugs which alter sensation, mood, consciousness or other psychological or behavioral functions. [NIH] Psychodrama: Primarily a technique of group psychotherapy which involves a structure, directed, and dramatized acting out of the patient's personal and emotional problems. [NIH] Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH]
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Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radioimmunoassay: Classic quantitative assay for detection of antigen-antibody reactions using a radioactively labeled substance (radioligand) either directly or indirectly to measure the binding of the unlabeled substance to a specific antibody or other receptor system. Nonimmunogenic substances (e.g., haptens) can be measured if coupled to larger carrier proteins (e.g., bovine gamma-globulin or human serum albumin) capable of inducing antibody formation. [NIH] Random Allocation: A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. [NIH] Randomization: Also called random allocation. Is allocation of individuals to groups, e.g., for experimental and control regimens, by chance. Within the limits of chance variation, random allocation should make the control and experimental groups similar at the start of an investigation and ensure that personal judgment and prejudices of the investigator do not influence allocation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Refractive Power: The ability of an object, such as the eye, to bend light as light passes through it. [NIH]
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Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Relapse: The return of signs and symptoms of cancer after a period of improvement. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]
Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Research Design: A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Satiation: Full gratification of a need or desire followed by a state of relative insensitivity to that particular need or desire. [NIH] Satiety Response: Behavioral response associated with the achieving of gratification. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sedative: 1. Allaying activity and excitement. 2. An agent that allays excitement. [EU] Self Care: Performance of activities or tasks traditionally performed by professional health care providers. The concept includes care of oneself or one's family and friends. [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Sensory Deprivation: The absence or restriction of the usual external sensory stimuli to which the individual responds. [NIH] Sequential treatment: One treatment after the other. [NIH] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]
Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Serum Albumin: A major plasma protein that serves in maintaining the plasma colloidal
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osmotic pressure and transporting large organic anions. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Shame: An emotional attitude excited by realization of a shortcoming or impropriety. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]
Sibutramine: A drug used for the management of obesity that helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet. It works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. Side effects include dry mouth, headache, constipation, insomnia, and a slight increase in average blood pressure. In some patients it causes a higher blood pressure increase. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signal Transduction: The intercellular or intracellular transfer of information (biological activation/inhibition) through a signal pathway. In each signal transduction system, an activation/inhibition signal from a biologically active molecule (hormone, neurotransmitter) is mediated via the coupling of a receptor/enzyme to a second messenger system or to an ion channel. Signal transduction plays an important role in activating cellular functions, cell differentiation, and cell proliferation. Examples of signal transduction systems are the GABA-postsynaptic receptor-calcium ion channel system, the receptor-mediated T-cell activation pathway, and the receptor-mediated activation of phospholipases. Those coupled to membrane depolarization or intracellular release of calcium include the receptormediated activation of cytotoxic functions in granulocytes and the synaptic potentiation of protein kinase activation. Some signal transduction pathways may be part of larger signal transduction pathways; for example, protein kinase activation is part of the platelet activation signal pathway. [NIH] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH] Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Support: Support systems that provide assistance and encouragement to individuals with physical or emotional disabilities in order that they may better cope. Informal social support is usually provided by friends, relatives, or peers, while formal assistance is provided by churches, groups, etc. [NIH] Soma: The body as distinct from the mind; all the body tissue except the germ cells; all the axial body. [NIH]
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Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Steroid: A group name for lipids that contain a hydrogenated cyclopentanoperhydrophenanthrene ring system. Some of the substances included in this group are progesterone, adrenocortical hormones, the gonadal hormones, cardiac aglycones, bile acids, sterols (such as cholesterol), toad poisons, saponins, and some of the carcinogenic hydrocarbons. [EU] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stress management: A set of techniques used to help an individual cope more effectively with difficult situations in order to feel better emotionally, improve behavioral skills, and often to enhance feelings of control. Stress management may include relaxation exercises, assertiveness training, cognitive restructuring, time management, and social support. It can be delivered either on a one-to-one basis or in a group format. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subliminal: Below the threshold of sensation, as a subliminal stimulus. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]
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Support group: A group of people with similar disease who meet to discuss how better to cope with their cancer and treatment. [NIH] Supraspinal: Above the spinal column or any spine. [NIH] Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synapse: The region where the processes of two neurons come into close contiguity, and the nervous impulse passes from one to the other; the fibers of the two are intermeshed, but, according to the general view, there is no direct contiguity. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Systemic: Affecting the entire body. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Testis: Either of the paired male reproductive glands that produce the male germ cells and the male hormones. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thinness: A state of insufficient flesh on the body usually defined as having a body weight less than skeletal and physical standards. [NIH] Third Ventricle: A narrow cleft inferior to the corpus callosum, within the diencephalon, between the paired thalami. Its floor is formed by the hypothalamus, its anterior wall by the lamina terminalis, and its roof by ependyma. It communicates with the fourth ventricle by the cerebral aqueduct, and with the lateral ventricles by the interventricular foramina. [NIH] Threshold: For a specified sensory modality (e. g. light, sound, vibration), the lowest level (absolute threshold) or smallest difference (difference threshold, difference limen) or intensity of the stimulus discernible in prescribed conditions of stimulation. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make
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permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Tractus: A part of some structure, usually that part along which something passes. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Translation: The process whereby the genetic information present in the linear sequence of ribonucleotides in mRNA is converted into a corresponding sequence of amino acids in a protein. It occurs on the ribosome and is unidirectional. [NIH] Translocation: The movement of material in solution inside the body of the plant. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Treatment Failure: A measure of the quality of health care by assessment of unsuccessful results of management and procedures used in combating disease, in individual cases or series. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]
Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vagal: Pertaining to the vagus nerve. [EU] Vagus Nerve: The 10th cranial nerve. The vagus is a mixed nerve which contains somatic
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afferents (from skin in back of the ear and the external auditory meatus), visceral afferents (from the pharynx, larynx, thorax, and abdomen), parasympathetic efferents (to the thorax and abdomen), and efferents to striated muscle (of the larynx and pharynx). [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vasomotor: 1. Affecting the calibre of a vessel, especially of a blood vessel. 2. Any element or agent that effects the calibre of a blood vessel. [EU] VE: The total volume of gas either inspired or expired in one minute. [NIH] Vegetarianism: Dietary practice of consuming only vegetables, grains, and nuts. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Viscera: Any of the large interior organs in any one of the three great cavities of the body, especially in the abdomen. [NIH] Visceral: , from viscus a viscus) pertaining to a viscus. [EU] Visceral Afferents: The sensory fibers innervating the viscera. [NIH] Vitamin A: A substance used in cancer prevention; it belongs to the family of drugs called retinoids. [NIH] War: Hostile conflict between organized groups of people. [NIH] Xenograft: The cells of one species transplanted to another species. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH]
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INDEX A Abdominal, 20, 117, 134, 135 Aberrant, 117, 123 Accommodation, 117, 133 Acting Out, 117, 137 Adipocytes, 117, 131 Adjustment, 19, 117 Adolescence, 30, 31, 79, 117 Adrenal Cortex, 117, 124, 127, 137 Adrenergic, 117, 119, 125, 126, 142 Adverse Effect, 117, 122, 140 Aerobic, 86, 117 Aerobic Exercise, 86, 117 Afferent, 18, 20, 117, 131 Affinity, 117, 118, 122 Age Groups, 21, 117 Age of Onset, 78, 118, 143 Aged, 80 and Over, 118 Agonist, 16, 22, 118, 120, 125, 133 Agoraphobia, 118, 130, 135 A-HA, 14, 118 Algorithms, 118, 120 Allergen, 118, 139 Alternative medicine, 90, 118 Amenorrhea, 118, 119 Amino Acids, 118, 127, 135, 137, 143 Amnestic, 118, 128 Amygdala, 118, 142 Anaesthesia, 118, 130 Anal, 76, 118, 127, 131 Analysis of Variance, 20, 21, 118 Anastomosis, 118, 128, 131 Anatomical, 118, 122, 130 Animal model, 29, 67, 118 Anorexia, 4, 11, 13, 19, 23, 24, 49, 62, 76, 77, 78, 87, 103, 104, 105, 118, 119 Anorexia Nervosa, 4, 13, 19, 23, 49, 62, 76, 77, 78, 87, 103, 104, 119 Antagonism, 119, 122 Anthropology, 43, 119 Antibacterial, 119, 141 Antibiotic, 119, 127, 141 Antibody, 117, 119, 123, 129, 130, 132, 138, 139, 141 Antidepressant, 21, 26, 119, 128, 130 Antigen, 117, 119, 123, 129, 130, 132, 138, 139 Antipsychotic, 119, 122, 133
Antrectomy, 119, 120 Anus, 118, 119, 123, 131 Anxiety, 4, 5, 7, 15, 86, 87, 119, 128, 134, 135 Anxiolytic, 119, 134 Approximate, 15, 119 Arterial, 120, 130, 137 Arteries, 120, 121, 124 Aspiration, 116, 120 Assay, 120, 138 Atypical, 120, 122 Auditory, 120, 132, 144 Autoreceptors, 23, 120 B Baclofen, 16, 120 Bacteria, 119, 120, 141, 143 Bacteriostatic, 120, 127 Basal Ganglia, 119, 120, 134 Base, 120, 131, 142 Behavior Therapy, 8, 29, 39, 43, 52, 57, 79, 84, 120 Behavioral Symptoms, 22, 23, 120 Biliopancreatic Diversion, 37, 38, 120 Biochemical, 120, 139 Biological Factors, 4, 120 Biotechnology, 28, 90, 97, 120 Bipolar Disorder, 41, 102, 120 Bladder, 121, 124 Blood Glucose, 15, 121, 131 Blood Platelets, 121, 139 Blood pressure, 15, 121, 130, 140 Blood vessel, 121, 122, 141, 142, 144 Body Image, 5, 13, 14, 44, 48, 66, 68, 103, 104, 121 Body Mass Index, 11, 13, 54, 86, 121, 127, 134 Bowel, 118, 121 C Caloric intake, 22, 121 Carbohydrate, 38, 121 Carcinogenic, 121, 130, 137, 141 Cardiorespiratory, 117, 121 Cardiovascular, 15, 121, 139 Cardiovascular disease, 15, 121 Carrier Proteins, 121, 138 Case report, 39, 40, 62, 121 Case series, 75, 121 Catecholamine, 121, 125
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Caudal, 19, 121, 130, 134, 136 Caudate Nucleus, 122, 134 Causal, 122, 123 Cell, 118, 120, 121, 122, 123, 125, 126, 127, 130, 132, 134, 135, 137, 138, 140, 142, 143 Central Nervous System, 22, 122, 126, 129, 139 Cerebral, 60, 120, 122, 126, 142 Cerebrovascular, 121, 122 Cerebrum, 122 Character, 64, 122 Chin, 122, 132 Cholecystokinin, 22, 24, 122 Chronic, 11, 13, 15, 18, 23, 24, 122, 130 Chronic Disease, 24, 122 Cisplatin, 122, 134 Clinical Medicine, 122, 136 Clinical trial, 6, 7, 8, 24, 97, 122, 124, 125, 133, 137, 138 Cloning, 120, 122 Clozapine, 63, 122 Cluster Analysis, 21, 122 Cofactor, 123, 137 Cognition, 123, 133 Cognitive restructuring, 123, 141 Cognitive Therapy, 63, 123 Cohort Effect, 21, 123 Colon, 120, 123 Combination Therapy, 123, 127 Comorbidity, 9, 10, 31, 41, 58, 123 Complement, 123, 124, 139 Complementary and alternative medicine, 75, 81, 124 Complementary medicine, 75, 124 Compliance, 19, 124 Computational Biology, 97, 124 Consciousness, 124, 137 Consolidation, 19, 124 Constipation, 115, 119, 124, 140 Contraindications, ii, 124 Controlled study, 68, 124 Coordination, 9, 10, 124 Coronary, 121, 124 Coronary heart disease, 121, 124 Corpus, 124, 137, 142 Corpus Luteum, 124, 137 Cortex, 124 Cortical, 124, 127 Cortisol, 11, 42, 124 Cranial, 124, 129, 143 Cues, 25, 124 Curative, 125, 142
Cyclic, 17, 18, 125 Cytotoxic, 125, 134, 140 Cytotoxic chemotherapy, 125, 134 D Dendrites, 125, 133 Diabetes Mellitus, 59, 125, 128 Diagnostic procedure, 90, 125 Diarrhea, 120, 125 Dietitian, 34, 125 Digestion, 121, 125, 131, 141 Direct, iii, 11, 23, 47, 122, 123, 125, 138, 142 Discrete, 17, 26, 125 Discrimination, 29, 125 Distal, 25, 27, 125, 131, 136, 137 Dopamine, 13, 17, 119, 122, 125, 134 Dorsal, 16, 125, 136 Dorsum, 125 Double-blind, 18, 24, 29, 125 Drinking Behavior, 21, 68, 125 Drive, ii, vi, 6, 13, 18, 20, 71, 86, 125 Drug Interactions, 125 Duct, 125, 127, 139 Duodenum, 120, 126, 128, 131, 141 Dysphoric, 23, 126 E Effector, 16, 123, 126 Efferent, 16, 126 Efficacy, 7, 9, 10, 15, 26, 35, 62, 126, 137, 143 Embryo, 126, 130 Empirical, 60, 126 Encephalitis, 126 Encephalomyelitis, 64, 126 Endocrine System, 126, 133 Endogenous, 12, 125, 126 Endometrium, 126, 132 Energy balance, 126, 131 Energy Intake, 11, 16, 48, 126 Environmental Health, 96, 98, 126 Enzyme, 118, 126, 140 Epidemic, 34, 126 Epinephrine, 117, 125, 126, 134, 143 Erythrocytes, 126, 139 Erythromycin, 22, 127 Esophagus, 127, 135, 141 Estradiol, 12, 19, 127 Estrogen, 11, 21, 127 Estrogen Replacement Therapy, 21, 127 Ethnic Groups, 76, 127 Evacuation, 124, 127, 128 Excitatory, 22, 120, 127, 128 Exocrine, 122, 127, 134
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Exogenous, 126, 127, 143 Extracellular, 17, 23, 127, 132 Extracellular Space, 127, 132 Extrapyramidal, 119, 125, 127 Extreme obesity, 34, 127 F Family Planning, 97, 127 Fat, 16, 66, 83, 86, 117, 124, 127, 131, 134 Fatigue, 25, 127 Feeding Behavior, 16, 127 Fenfluramine, 42, 127 Fixation, 127, 139 Fluoxetine, 26, 29, 48, 128 Fluvoxamine, 29, 48, 128 Follicular Phase, 12, 23, 128 Forearm, 121, 128 G Gallbladder, 117, 122, 128 Gas, 128, 129, 144 Gastric, 16, 19, 22, 24, 32, 38, 115, 128 Gastric Balloon, 24, 128 Gastric Bypass, 32, 38, 128 Gastric Emptying, 16, 22, 24, 128 Gastrin, 128, 129 Gastrointestinal, 22, 122, 126, 128, 139, 141 Gastrointestinal tract, 128, 139 Gene, 17, 23, 33, 120, 128, 133 Genotype, 128, 135 Glucose, 121, 125, 128, 130, 131 Glucose Intolerance, 125, 128 Glutamate, 20, 128 Governing Board, 128, 136 H Habitual, 122, 128 Haptens, 117, 129, 138 Headache, 129, 140 Health Behavior, 31, 47, 79, 129 Health Services, 12, 102, 129 Health Status, 123, 129 Heart attack, 121, 129 Hemostasis, 129, 139 Heredity, 128, 129 Holidays, 86, 129 Homeostasis, 15, 129 Homologous, 129, 139, 142 Hormonal, 127, 129 Hormone, 11, 19, 120, 124, 126, 127, 128, 129, 131, 137, 140 Humoral, 16, 129 Humour, 129 Hydrogen, 120, 121, 129, 133 Hyperphagia, 16, 17, 24, 129
Hypersensitivity, 50, 118, 129, 139 Hypertension, 121, 129, 130 Hypothalamic, 17, 130 Hypothalamus, 17, 91, 130, 142 I Imipramine, 53, 130 Immune response, 119, 129, 130, 139, 141 Immunization, 130, 139 Immunogenic, 130, 138 Impairment, 6, 9, 10, 13, 50, 130 In vivo, 130, 132 Induction, 18, 119, 130 Infant, Newborn, 117, 130 Infection, 126, 130, 141 Inflammation, 126, 130, 136 Ingestion, 13, 24, 129, 130 Initiation, 19, 130 Inositol, 46, 130 Inotropic, 125, 130 Insight, 11, 17, 18, 130 Insomnia, 131, 140 Insulin, 4, 15, 41, 131, 143 Insulin-dependent diabetes mellitus, 131 Intermittent, 16, 131 Intestinal, 19, 35, 122, 131 Intestinal Mucosa, 122, 131 Intestines, 117, 128, 131 J Jejunoileal Bypass, 120, 131 Jejunum, 120, 128, 131 K Kb, 96, 131 L Larynx, 131, 144 Latent, 21, 131 Leptin, 15, 50, 61, 62, 131 Lesion, 131 Ligands, 16, 131 Limbic, 17, 118, 131 Lipid, 15, 131 Liver, 117, 128, 131 Localization, 20, 131 Loneliness, 86, 131 Longitudinal study, 38, 131 Loop, 128, 132 M Manic, 119, 120, 132 Meatus, 132, 144 Mediate, 17, 125, 132 Mediator, 25, 122, 132, 139 MEDLINE, 97, 132 Meiosis, 132, 142
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Membrane, 123, 131, 132, 135, 139, 140 Memory, 75, 118, 132 Meninges, 122, 132 Menstrual Cycle, 23, 128, 132, 137 Menstruation, 118, 128, 132 Mental Health, iv, 6, 7, 12, 25, 29, 60, 96, 98, 102, 104, 105, 132, 137 Mental Processes, 25, 132 Mesolimbic, 13, 119, 132 Microdialysis, 13, 132 Minority Groups, 37, 132 Modeling, 20, 21, 132 Modification, 24, 31, 49, 52, 91, 132, 138 Molecular, 19, 97, 99, 120, 124, 132, 138, 143 Molecule, 119, 120, 123, 126, 132, 138, 140 Monogenic, 15, 133 Mood Disorders, 55, 133 Motility, 133, 139 Motor Neurons, 16, 133 Multicenter study, 49, 133 Myopia, 25, 133, 138 N Nadir, 18, 133 Naloxone, 133 Naltrexone, 29, 36, 133 Narcotic, 133 Nausea, 119, 133, 134, 135 Nearsightedness, 133 Nervous System, 117, 122, 132, 133, 136, 141, 142 Neural, 13, 17, 63, 117, 129, 133 Neuroendocrine, 22, 133 Neuroleptic, 119, 122, 133, 134 Neuronal, 19, 23, 133 Neurons, 13, 15, 125, 127, 133, 142 Neurotransmitter, 125, 128, 133, 134, 140, 141 Nonverbal Communication, 134, 137 Norepinephrine, 117, 125, 134, 140 Nucleus, 13, 16, 17, 19, 125, 132, 134, 137, 142 Nucleus Accumbens, 13, 17, 134 O Obsessive-Compulsive Disorder, 128, 134 Ondansetron, 18, 134 Optic Chiasm, 130, 134 Osteoporosis, 103, 127, 134 Outpatient, 5, 48, 134 Ovary, 124, 127, 134 Overweight, 5, 9, 10, 20, 25, 32, 35, 55, 60, 62, 72, 91, 134
Ovulation, 128, 134 Ovum, 124, 134, 137 P Palliative, 134, 142 Pancreas, 117, 131, 134 Pancreatic, 122, 134 Panic, 128, 130, 135 Panic Disorder, 128, 130, 135 Parasite, 135 Parasitic, 35, 135 Parenteral, 126, 135 Pathophysiology, 11, 18, 21, 24, 135 Patient Education, 106, 110, 112, 116, 135 Peer Group, 20, 135 Peer Review, 7, 71, 135 Peptide, 17, 24, 122, 131, 135, 137 Perception, 56, 84, 135 Personality Disorders, 39, 135 Pharmacologic, 26, 56, 135, 143 Pharynx, 135, 144 Phenotype, 33, 135 Phospholipids, 127, 130, 135 Physiologic, 118, 132, 135, 138 Physiology, 13, 17, 41, 51, 80, 136 Pilot study, 7, 15, 20, 23, 42, 136 Placenta, 127, 136, 137 Plasma, 24, 46, 128, 129, 136, 139 Pleomorphic, 134, 136 Pneumonia, 124, 136 Polymorphism, 23, 136 Posterior, 118, 125, 134, 136 Postmenopausal, 127, 134, 136 Postoperative, 19, 136 Postprandial, 22, 136 Potentiates, 17, 136 Practicability, 136, 143 Practice Guidelines, 98, 136 Precursor, 75, 125, 126, 134, 136, 143 Preoperative, 19, 136 Presynaptic, 120, 133, 136 Presynaptic Terminals, 120, 136 Prevalence, 5, 20, 24, 57, 58, 66, 77, 84, 106, 136 Probe, 132, 136 Progesterone, 11, 137, 141 Prognostic factor, 137, 142 Program Evaluation, 55, 137 Progression, 118, 137 Progressive, 127, 137 Promoter, 23, 137 Prophase, 137, 142 Prospective study, 131, 137
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Protein S, 79, 120, 127, 137 Proteins, 20, 118, 119, 121, 123, 127, 133, 135, 136, 137, 138, 139 Protocol, 16, 26, 137 Proximal, 125, 128, 131, 136, 137 Psychiatric, 3, 4, 9, 10, 11, 14, 22, 27, 30, 31, 45, 52, 58, 76, 105, 137 Psychic, 132, 137 Psychoactive, 21, 137 Psychodrama, 77, 137 Psychopathology, 5, 9, 10, 13, 26, 31, 33, 36, 39, 40, 45, 46, 54, 59, 64, 68, 137 Psychotherapy, 8, 9, 10, 26, 40, 48, 78, 91, 102, 123, 137 Public Health, 6, 14, 98, 137 Public Policy, 97, 138 Pulmonary, 116, 121, 138, 144 Pulmonary Artery, 121, 138, 144 Q Quality of Health Care, 135, 138, 143 Quality of Life, 19, 38, 46, 138 R Race, 25, 78, 138 Radioimmunoassay, 17, 138 Random Allocation, 138 Randomization, 20, 138 Randomized, 8, 9, 10, 13, 14, 18, 19, 20, 23, 24, 50, 67, 76, 126, 138 Randomized clinical trial, 8, 13, 19, 138 Receptor, 15, 16, 20, 23, 30, 33, 91, 119, 122, 125, 134, 138, 139, 140 Receptors, Serotonin, 138, 139 Recurrence, 120, 138 Refer, 1, 123, 127, 131, 133, 138 Refraction, 133, 138, 141 Refractive Power, 133, 138 Regimen, 126, 139 Relapse, 57, 84, 139 Reliability, 36, 61, 139 Remission, 120, 138, 139 Research Design, 8, 139 Retina, 133, 134, 139 Risk factor, 12, 14, 15, 27, 29, 61, 66, 78, 137, 139 S Saliva, 139 Salivary, 12, 139 Satiation, 19, 139 Satiety Response, 22, 139 Screening, 6, 12, 25, 61, 105, 122, 139 Sedative, 130, 139 Self Care, 4, 139
Sensitization, 13, 139 Sensory Deprivation, 80, 139 Sequential treatment, 27, 139 Serotonin, 17, 22, 23, 60, 68, 75, 119, 122, 127, 128, 134, 138, 139, 140, 143 Sertraline, 56, 62, 139 Serum, 62, 123, 138, 139 Serum Albumin, 138, 139 Sex Characteristics, 117, 140 Shame, 5, 62, 140 Shock, 17, 140 Sibutramine, 46, 140 Side effect, 117, 119, 140, 143 Signal Transduction, 130, 140 Signs and Symptoms, 139, 140 Skeletal, 140, 142 Skull, 140, 142 Small intestine, 120, 126, 129, 131, 140 Social Environment, 138, 140 Social Support, 84, 85, 140, 141 Soma, 140, 141 Somatic, 18, 117, 129, 132, 141, 143 Spasticity, 120, 141 Specialist, 107, 141 Species, 126, 132, 135, 138, 141, 144 Specificity, 65, 117, 141 Spectrum, 12, 63, 141 Spinal cord, 120, 122, 126, 132, 133, 141 Steroid, 124, 141 Stimulus, 125, 141, 142 Stomach, 24, 117, 119, 120, 127, 128, 129, 131, 133, 135, 140, 141 Stress, 11, 17, 44, 67, 76, 86, 87, 116, 121, 124, 133, 141 Stress management, 76, 141 Striatum, 17, 134, 141 Stroke, 96, 121, 141 Subclinical, 14, 130, 141 Subliminal, 48, 141 Substance P, 127, 141 Support group, 4, 142 Supraspinal, 120, 142 Survival Analysis, 21, 30, 142 Sympathomimetic, 125, 126, 134, 142 Symptomatology, 63, 142 Synapse, 117, 136, 142, 143 Synapsis, 142 Synaptic, 20, 23, 134, 140, 142 Systemic, 13, 121, 126, 130, 142 T Temporal, 18, 118, 132, 142 Testis, 127, 142
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Thalamic, 22, 142 Therapeutics, 142 Thinness, 85, 142 Third Ventricle, 130, 142 Threshold, 59, 130, 141, 142 Thrombosis, 137, 141, 142 Tissue, 117, 119, 126, 130, 131, 132, 133, 139, 140, 142, 143 Tone, 141, 142, 143 Tonic, 19, 143 Toxic, iv, 126, 143 Toxicity, 125, 143 Toxicology, 98, 143 Tractus, 19, 143 Transfection, 120, 143 Translation, 127, 143 Translocation, 127, 143 Transmitter, 120, 125, 132, 134, 143 Treatment Failure, 11, 143 Treatment Outcome, 8, 20, 37, 57, 66, 143 Tricyclic, 130, 143 Tryptophan, 139, 143 Tubercle, 134, 143 Type 2 diabetes, 50, 86, 143 Tyrosine, 125, 143
U Urban Population, 76, 143 Uterus, 124, 126, 132, 137, 143 V Vaccine, 137, 143 Vagal, 16, 18, 20, 143 Vagus Nerve, 18, 143 Vasodilator, 125, 144 Vasomotor, 127, 144 VE, 86, 144 Vegetarianism, 85, 144 Venous, 137, 144 Ventral, 130, 134, 144 Ventricle, 118, 122, 134, 138, 142, 144 Veterinary Medicine, 97, 144 Viscera, 141, 144 Visceral, 144 Visceral Afferents, 144 Vitamin A, 130, 144 W War, 48, 144 X Xenograft, 118, 144 Y Yeasts, 135, 144
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