Effect of a satiating meal on the concentrations of procolipase propeptide in the serum and urine of normal and morbidly obese subjects.

The effect of a satiating meal on the serum and urinary concentrations of procolipase propeptide (Ala-Pro-Gly-Pro-Arg, APGPR) immunoreactivity, as measured by enzyme linked immunosorbent assay (ELISA) specific for free APGPR, has been studied in normal and morbidly obese human subjects. The normal subjects displayed a biphasic response with coordinate increases in both serum and urine APGPR immunoreactivity both occurring within the first two hours after the meal. In two of three of the morbidly obese subjects, this early rise in APGPR concentration in urine was not seen but was followed by a slow rise in urinary APGPR immunoreactivity at four to six hours. In both the normal and obese groups, the urinary immunoreactive signal was found to coelute with synthetic APGPR on gel chromatography. In rats, procolipase propeptide (Val-Pro-Asp-Pro-Arg, VPDPR) specifically inhibits fat intake early in the postprandial period when given peripherally or centrally. This study suggests that in humans APGPR reaches the circulation shortly after feeding and is excreted in the urine. These findings are consistent with the hypothesis that human procolipase propeptide may also act as a satiety signal. In addition the late appearance of the peptide in some of the morbidly obese patients could be associated with perturbation of appetite control in these subjects.

Eating Behavior, Physical Symptoms and Psychological Factors Associated with Weight Reduction Following the Scopinaro Operation as Modified by Gazet.

Sixteen morbidly obese patients (12 females, four males) underwent the Scopinaro operation according to Gazet. Profound weight loss occurred, along with marked improvements in eating patterns, mood and psychosocial functioning which were reported retrospectively 1 year and repeated 2 years after surgery. Continued binge eating, comfort eating and 'eating sensibly/making up in private' were associated with reduced weight loss, suggesting that a therapeutic cognitive behavioral program to correct eating problems in association with the Scopinaro operation may increase weight loss. Some physical symptoms were related to increased (burping) or decreased (hunger, thirst) intake of food, but the patterns of preoperative symptoms did not predict postoperative physical symptoms or weight loss. Subjects were divided into two subgroups with (n = 8) or without (n = 8) a history of self-damaging and addictive behaviors. The aberrant behavior subgroup had more disturbed eating patterns preoperatively (higher BITE severity scores) but similar BITE scores postoperatively. Mean BMIs were similar before and after surgery. This suggested that patients with these aberrant behaviors should not be denied surgery. Half of the female patients reported early sexual abuse, and were lighter than the non-abused group. This merits further investigation.

Stealing in bulimia nervosa.

This clinical study examines the prevalence of stealing and the personal and behavioural factors which distinguish stealing and non-stealing behaviour in a population of 312 female normal-weight bulimics. Bulimic patients who stole had poorer early interpersonal relationships, earlier onset of sexual feelings with greater subsequent sexual activity and increased illicit drug use. The suggestion is made that stealing is a marker of severity. In addition, bulimics who stole appeared to exhibit more obsessional qualities with increased ritualisation.