The relationship between non-purging compensatory behaviors, clinical severity, and treatment outcomes in adults with binge-spectrum eating disorders.

Non-purging compensatory behaviors (NPCB; e.g. driven exercise, fasting, other extreme behaviors) are a subcategory of compensatory behaviors typically characterized as infrequent and less severe. Limited prior research has studied NPCB despite their increasing prevalence among adults with binge-spectrum eating disorders (B-ED). More research is needed to understand the types of NPCB present among B-ED and the association between NPCB, clinical severity, and treatment outcomes. Secondary analyses were conducted among 155 adults with B-ED in cognitive-behavioral (CBT)-based clinical trials. At baseline and post-treatment, clinical interviews of eating pathology assessed binge eating frequency, purging compensatory behavior frequency, and global eating pathology. The following NPCB were also assessed: driven exercise, 24-h fasting, 8+ waking hours of compensatory fasting, chewing and spitting, and other extreme weight control behaviors. Participants engaging in NPCB reported higher global eating pathology than those not engaging in NPCB. Frequency of chewing and spitting and 24-h fasting significantly decreased over treatment. Engagement in NPCB at baseline did not predict CBT outcomes. The current study highlights the prevalence and clinical severity of NPCB in B-ED but offers promising results regarding the potential for CBT to improve these behaviors. More research is needed on other extreme weight control behaviors reported qualitatively in our sample and on the maintenance of improvements in non-purging behaviors after CBT.

Autotransplantation of porcine islets of Langerhans.

Autotransplantation of the islets of Langerhans in pancreatic tissue fragments, prepared with no attempt to separate exocrine tissue, produced viable, well vascularized implants in the peritoneal cavity of pigs. We autografted 31 pancreatectomized pigs with pancreatic preparations in which exocrine tissue either was separated completely, partially, or not at all. Nine pancreatectomixed pigs were used as control animals. On the basis of the results of the standard serum glucose and insulin level tests and the mean survival results, the various methods of tissue preparation had no discernible effect. One month after grafting, the implants from the unseparated pancreatic preparations contained significant amounts of insulin and cells identical to normal beta cells. One pig with a free-fragment autograft is alive and well, with an increase in the size of its implants, 6 months later. Separation of pancreatic endocrine and exocrine tissue is not essential for autografting the islets of Langerhans in the pig. The exocrine tissue apparently can be removed by in vivo mechanisms, and the endocrine tissue is preserved in free-fragment pancreatic grafts.

Comparative evaluation of pancreas transplantation techniques.

Three operative techniques for pancreatic transplantation have been compared: pancreaticoduodenal, pancreatic duct-jejunostomy and pancreatic duct-ureterostomy. There were no significant differences in results among these techniques when the autotransplant model was used. The pancreatic duct anastomosis without duodenum probably offers more advantages in the allograft recipient.