Obesity and the hedonic response 2

Published on January 31, 2016   35 min

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Other Talks in the Series: Obesity: Science, Medicine and Society

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So welcome back. This is part 2 of our talk around the hedonic aspects of eating.
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Now there may be particular types of people for whom the addictive behaviors and eating behaviors may be particularly more homogeneous and may be some of the reasons why our differences in obesity are so marked between the different studies is because we're with a very heterogeneous cause. So binge eating disorder may be regarded as perhaps a more homogeneous cause of obesity and a more homogenous eating behavior. In bariatric clinics it accounts for about a quarter to maybe a third of patients, and it's characterized by situations in which people will eat a large amount of food, maybe the amount they would normally eat in a whole day in a relatively short period of time with the subjective feeling of loss of control with no associated purging such as vomiting as is seen in bulimia nervosa or use of laxatives or excessive exercise. There are some certain frequencies which needs to be done in order to meet the diagnoses. And the episodes are associated with eating very rapidly and people feeling quite uncomfortable, even eating when they are not hungry, often eating alone or in secret, and feelings of disgust or guilt afterwards. It's exacerbated by emotional stress and also by skipping meals, suggesting that the homeostatic changes may also impact on that. There have been some brain imaging studies comparing people with binge eating and non-binge eating. Binge eating may be associated with normal weight, but in these studies they compare people who are overweight with and without binge eating. And as you can see in the picture, people who had binge eating had greater activation within the brain including within the orbitofrontal cortex. Binge eating is associated with worse outcomes in lifestyle interventions such as the Look Ahead study recently from the States, and bariatric surgery is not a cure for these behaviors, and psychological support is needed. And if people do persist to having some of these abnormal eating behaviors, after surgery, they necessarily don't do as well in terms of losing weight.