Framing physical activity as a distinct and uniquely valuable behavior independent of weight management: a pilot randomized controlled trial for overweight and obese sedentary persons.

PURPOSE: Promoting benefits of physical activity independent of weight management may help overweight/obese persons. DESIGN: Pilot randomized-controlled-trial. SUBJECTS: Twenty-six sedentary, overweight/obese persons receiving health-care at Stanford Medical Center, no contraindications for exercise. CONTROL/INTERVENTION GROUPS: Usual medical care and community weight-management/fitness resources versus same plus a brief intervention derived from behavioral-economic and evolutionary psychological theory highlighting benefits of activity independent of weight-management. ANALYSIS: Intent-to-treat. Cohen's d effect-sizes and 95% confidence intervals (95%CI) for changes in moderate-intensity-equivalent physical activity/week, cardiorespiratory fitness, and depression at 3 months relative to baseline. RESULTS: Intervention group participants demonstrated 3.76 hour/week of increased physical activity at study endpoint, controls only 0.7 hours/week (Cohen's d=0.74, 95% CI -0.06 to +1.5). They also improved cardiorespiratory fitness (Cohen's d=0.51, 95% CI -0.3 to +1.3) and reduced depression relative to controls (Cohen's d=0.66, 95% CI -0.1 to +1.4). CONCLUSION: Promoting activity independent of weight-management appears promising for further study.

Establishing guidelines for pharmacotherapy trials in bulimia nervosa and anorexia nervosa.

OBJECTIVE: This paper addresses the lack of a standard protocol for pharmacotherapy trials for patients with bulimia nervosa (BN) and anorexia nervosa (AN). METHOD: Twenty-two surveys were sent to established researchers in the field of eating disorders to elicit their opinions regarding medication trials, including baseline laboratory tests, the optimal length/frequency of medication management sessions, and the information that should or should not be included in these sessions. RESULTS: Sixteen of 22 researchers completed and returned the survey. Their answers are the basis of the data presented. DISCUSSION: We propose a battery of screening laboratory tests for both conditions. We suggest 30-45-min initial medication management sessions in both AN and BN trials with 15-min follow-ups to be held weekly for AN subjects, and weekly for 2 weeks, then biweekly for 2 weeks, then monthly, for BN subjects. We also recommend that published trials should include explicit details of medication management.

A prospective study of the influence of eating-disordered mothers on their children.

OBJECTIVE: This study examined the effects of eating disordered mothers on their children. METHOD: Women with a past or present eating disorder (ED; N = 41) and non-eating disordered women (NED); N = 153) and their offspring were followed prospectively. RESULTS: Female infants of ED mothers sucked significantly faster and were weaned 9 months later than offspring of NED mothers. ED mothers fed their children on a less regular schedule, used food for nonnutritive purposes, and demonstrated significantly higher concern about their daughters' weight than NED mothers from 2 years of age onward. At 5 years, the offspring of ED mothers were reported to demonstrate greater negative affect than the offspring of NED mothers. DISCUSSION: The female offspring of ED mothers demonstrate a high avidity for feeding early in life which, combined with increased maternal concern over their daughters weight and the use of food for nonnutritive purposes, may pose a serious risk for the later development of an eating disorder.

Caloric intake and activity levels are related in young children.

In this study the relationship between caloric intake and activity levels was examined in forty-three 18-month-old children. Caloric consumption was measured during a laboratory meal, and activity levels were assessed using an ambulatory monitor over a 24-hour period. Caloric intake was found to be significantly correlated with activity levels, such that children with a high caloric intake tended to have lower activity levels. This finding suggests that two risk factors influencing the development of obesity, caloric intake and physical activity levels, are likely to occur together in a subset of young children. A possible mechanism underlying this association is discussed.

Treadmill exercise test and ambulatory measures in panic attacks.

Treadmill exercise test performance and ambulatory heart rate and activity patterns of 40 patients with panic attacks were compared with 20 age-matched controls (control group 1) and 20 nonexercising controls (control group 2). All patients underwent a symptom-limited exercise stress test. Panic attack patients and control group 1 wore an ambulatory heart rate/activity monitor for up to 3 days. Panic patients had a significantly higher heart rate at 4 and 6 METS than either control group. The max METS were 11.2 +/- 2.3, 13.5 +/- 2.3 and 11.2 +/- 1.8 for the panic attack patients and control groups 1 and 2, respectively. One panic patient had ischemia on the treadmill at 12 METS. Panic patients had a significantly higher standing heart rate than controls. Furthermore, 11 of 39 panic patients had tachycardia on standing compared with 3 of 40 controls. Panic attack patients had higher wake and sleep heart rates than control group 1, but the differences were not significant. These results are consistent with autonomic dysfunction in panic patients but may also be due to differences in physical conditioning. The treadmill can be useful for reassuring patients and for identifying the rare patient with ischemia on exercise.

Relaxation therapy and high blood pressure.

Thirty-one patients receiving medical treatment for essential hypertension were randomly distributed into three groups: (1) relaxation therapy, (2) nonspecific therapy, and (3) medical treatment only. The nonspecific therapy group spent the same amount of time with the therapists as the relaxation group but was not given a specific therapy. Blood pressures were measured at a different time and in a different place from the behavioral treatments. The relaxation therapy group showed a significant reduction in blood pressure postreatment compared with the nonspecific therapy and medical treatment only groups, even when those patients whose medication was increased were excluded from the data analysis. At follow-up six months post-treatment, the relaxation group showed a slight decrement in treatment effects, while both the nonspecific therapy and medical treatment only groups showed continued improvement; thus, there was not a significant difference between groups.

A comparison of two methods of diagnosing hysteria.

The authors compare the syndrome of hysteria, defined as or indicated by a specified response to a 55-item symptom checklist previously used by Guze and other researchers, with the definition of hysterical personality in the second edition of APA's Diagnostic and statistical Manual of Mental Disorders (DSM-II). When 20 control subjects and 10 hysterical personalities (DSM-II) were given the Perley-Guze test, the results showed a close correlation between positive scores on the symptom checklist and the DMS-II diagnosis. The authors comment briefly on the theoretical usefulness and practicality of the test and note some difficulties in administration.

Lemon-juice therapy: the control of life-threatening rumination in a six-month-old infant.

Chronic, life-threatening rumination was eliminated in a six-month-old infant by squirting a small amount of lemon juice into her mouth whenever rumination or its precursors were detected. A brief suspension of this therapy demonstrated its crucial role. Lemon-juice therapy offers a practical and acceptable alternative to other therapies for rumination, namely electric shock and massive noncontingent attention. However, since this study is limited to a single case, claims as to the effectiveness of this therapy across children are premature.