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The endocrine system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
Appetite An increase in appetite is a frequent association with hyperthyroidism and, less commonly, with Cushing’s syndrome. In hyperthyroidism, the increased appetite is frequently associated with weight loss. By contrast, hypoadrenalism frequently presents with anorexia and malaise.
Pregnancy
Published in Kate B. Daigle, The Clinical Guide to Fertility, Motherhood, and Eating Disorders, 2019
However, even for women who desire to have a family so badly, the changes that occur emotionally and physically during pregnancy may take them off-guard. Your body changes more rapidly when you are pregnant than at any other time of your life. In the first trimester, your body may once again feel as if it’s against you, or you against it. Symptoms of early pregnancy include nausea, constipation, weight gain/bloat, dizziness, lack of appetite or increased appetite, and sleep disturbances, among other things. All of these are messages from your body to you, saying that it’s working extra hard and trying to grow another human inside of it.
Magnitude of the problem
Published in Kathleen M Berg, Dermot J Hurley, James A McSherry, Nancy E Strange, ‘Rose’, Eating Disorders, 2018
DSM-IV-TR includes a condition called ‘binge eating disorder’ within the category EDNOS, but does not classify it as a separate discreet entity. Strongly associated with mood disturbances, particularly depression, binge eating is thought to be a major factor in about 5% to 8% of persons affected by obesity, especially in its more severe forms (Marcus, 1995). Affected individuals have recurrent episodes of uncontrollable consumption of excessive quantities of food over a short period of time. Eating past satiety to the point of physical discomfort, they dissociate eating from hunger, eat rapidly and alone, and feel guilt and disgust at their own behaviors. They do not purge, fast or undertake excessive exercise. Increased appetite may be a feature of psychiatric conditions such as depression, dementia and mania, or a consequence of systemic corticosteroid therapy and use of psychotropic drugs.
Adding liraglutide to diet and exercise to maintain weight loss – is it worth it?
Published in Expert Opinion on Pharmacotherapy, 2022
As increased appetite is probably associated with weight regain, medications that reduce appetite like GLP-1 receptor agonists are a rational treatment for this condition. S-LITE showed that liraglutide, with or without exercise, was effective in reducing weight regain in a group of subjects with obesity. However, this group of the obese was limited by the enrollment criteria, and the findings of S-LITE cannot be generalized to all subjects with obesity. The increased heart rate with liraglutide did not occur when liraglutide was combined with exercise, and this suggests that liraglutide should probably not be used alone, but only with exercise to maintain weight loss. As the only presently available medicine to have been shown to be effective against weight regain, liraglutide should probably be preferred to other weight-loss medicines in this circumstance. However, without clear-cut direct evidence from clinical trials, that liraglutide treatment reduces diabetes or further cardiovascular risk in subjects with obesity, it is difficult to justify using it for the prevention of diabetes and/or cardiovascular risk in this group.
Vitamin B-6 and depressive symptomatology, over time, in older Latino adults
Published in Nutritional Neuroscience, 2019
Sandra P. Arévalo, Tammy M. Scott, Luis M. Falcón, Katherine L. Tucker
In addition to the longitudinal design, this study adds to the current literature by examining the association between plasma vitamin B-6 and depression after adjusting for a number of important confounders that have been overlooked in previous research, such as objective and subjective stress, and the physiological response to environmental challenges, i.e. allostatic load. A link between stress and nutrition has been established.87 Under conditions of persistent stress or conditions perceived as such, the adrenal glands increase the release of cortisol. Elevated stress-induced cortisol may disrupt the antagonistic effects of insulin and glucocorticoids creating an unbalance that may lead to desensitization of satiety signals and increased appetite.88 Research shows that stress may affect food preferences toward non-nutritious foods high in fats or sugars or both.87 Previous work with this Puerto Rican cohort found that greater perceived stress was associated with lower fruit, vegetable, and protein intake, and greater consumption of salty snacks.38 The authors found a positive and significant association between cortisol and stress in those without diabetes, and with higher insulin and BMI, independent of diabetes; providing support for a link between stress, cortisol, and dietary patterns.38 In turn, stress itself may contribute to depressive symptomatology.32,89,90
A comprehensive review of the clinical utility of and a combined analysis of the clozapine/norclozapine ratio in therapeutic drug monitoring for adult patients
Published in Expert Review of Clinical Pharmacology, 2019
Georgios Schoretsanitis, John M. Kane, Can-Jun Ruan, Edoardo Spina, Christoph Hiemke, Jose de Leon
It is believed that antipsychotic-induced and CLO-induced weight gain is mainly mediated by appetite increase. As a matter of fact, an RCT in patients has verified that CLO is associated with increased appetite [56]. It is usually hypothesized that increased appetite is mediated by H1 antagonism [42]. CLO affinity for H1 is three times larger than NCLO affinity (Box 1) and CLO serum concentrations are also higher, but in a study of Chinese CLO patients randomized to fluvoxamine versus placebo, Lu et al. [57] found that plasma NCLO concentrations, but not CLO, were associated with increases in weight and serum glucose and triglyceride levels. In summary, this study suggested that NCLO may be important in weight gain and secondary metabolic disturbances. Some animal studies indicated that blockade of others, particularly serotonin 2C receptors (5-HT2C) and muscarinic receptors beyond H1, may be needed to produce hyperphagia [58].