A psychoeducational program for weight loss in patients who have experienced weight gain during antipsychotic treatment with olanzapine.

INTRODUCTION: The aim of this study was to evaluate the efficacy of a psychoeducational program (PEP) for weight control in patients who had experienced an increase of body weight during treatment with olanzapine. METHODS: Eligible patients were randomised to the PEP (Group 1) or to no intervention (Group 2) and continued on olanzapine. After 12 weeks, the PEP was also started in Group 2 and continued in Group 1, up to week 24. Body weight was measured every month. Other measures included quality of life, and change in plasma glucose and lipids levels. RESULTS: Patients in Group 1 (n=15) had a mean weight loss of 3.6 kg at week 12 and 4.5 kg at week 24 (p<0.01 at both times, p<0.01 between groups at week 12), while those in Group 2 (n=18) had no changes at week 12 and a significant weight loss at week 24 (-3.6 kg from week 12, p<0.01). Changes of BMI paralleled those of body weight. Quality of life (Q-LES-Q-SF categorisation) and functioning (GAF) significantly improved in the total population at endpoint (p<0.01). No significant changes were observed in fasting glucose and lipid profile, while insulin levels significantly decreased from baseline to endpoint in both groups (p<0.05). HOMA index and hepatic insulin sensitivity improved, too. DISCUSSION: Patients with increased BMI during treatment with olanzapine experienced significant weight and BMI loss following a structured psychoeducational program.

The relationship between binge eating disorder and non-purging bulimia nervosa.

AIMS: To further investigate the differentiation between non-purging bulimia nervosa (BN-NP) and binge eating disorder (BED), particularly as concerns weight-shape overconcern affecting self-esteem, a core belief to both anorexia and bulimia nervosa. METHODS: Twenty-five female subjects with BN-NP and 25 female subjects with BED, consecutively referred to the Eating Disorder Unit of the DPPhNB, were administered the BEDCI, the EDI-2 and the BUT. RESULTS: BED patients had a higher BMI (35.5 vs. 23.8 kg/m2, p<0.0001) and were slightly older than BN-NP ones. Weight-shape concerns as one of the main/the most important things influencing self-esteem were reported by 68% of BN-NP patients and 62.5% of BED ones. Age at onset of binge-eating, weight-cycling, overall impairment due to the eating behavior, sexual harassment, depressive and substance abuse comorbidity were equally represented in the two groups of patients. BN-NP patients scored higher than BED ones as regards EDI drive for thinness (p<0.05) and BUT weight phobia (p<0.05), with these scores significantly related to differences in BMI (p<0.0005 and p=0.012). Weight-shape overconcern influencing self-esteem was predictive of an earlier onset of binge-eating (p<0.05) and higher scores at the BUT weight phobia, and body image concerns (p<0.05). CONCLUSIONS: Differences between BED and BN-NP seem to be more of degree than type and there seems little value in the separation between BED and BN-NP based on weight-shape concerns that substantially impair self-esteem. This construct seems core to both disorders and plays a substantial role in triggering and maintaining the binge-eating cycle.

Nutrition survey in elite rhythmic gymnasts.

BACKGROUND: Young female rhythmic gymnasts have been identified as a potential risk group for malnutrition because of their attitude of weight reduction and leanness. METHODS: This study aimed to assess the dietary practices of 20 rhythmic gymnasts of the Italian national team, on the basis of a three-day food records collected by clinical interview. Twenty-four age-matched non-athletic females served as controls. RESULTS: The reported energy intake was similar in gymnasts and controls (28.5+/-5.6 vs 28.2+/-7.8 kcal/kg b.w., per day), but less than the recommended and the estimated requirements. Energy intake from carbohydrates was higher (53+/-6 vs 49+/-6%, p<0.05) and that from lipids lower (31+/-6 vs 34+/-4%, p<0.05) in gymnasts than in controls. In the former the energy supply from breakfast was higher (24+/-2 vs 16+/-4%, p<0.001) and from snacks was lower (8+/-9 vs 17+/-10%, p<0.01). Gymnasts also distinguished from controls for lower cholesterol and saturated fatty acid intake, and for higher fibre (14+/-5 vs 9+/-2 g/1,000 kcal, p<0.001) and Vitamin A dietary content. Calcium, iron and zinc intake were less than 100% RDA in both groups. CONCLUSIONS: In some ways, dietary practices of rhythmic gymnasts meet nutritional recommendations more than those of non athletic controls, though discrepancy between reported energy intake and estimated energy requirement exists. Suboptimal calcium, iron and zinc intake were observed both in gymnasts and in controls, hence minerals supplementation could be required. The dietary attitude could be regarded as a positive aspect of rhythmic gymnastics, provided athletes, physicians and coaches correct dietary errors and avoid excessive food restrictions.