1/5. Peripheral neuropathy and starvation after gastric partitioning for morbid obesity.Three months after gastric partitioning for morbid obesity, two patients developed an unusual and severe form of polyneuropathy that affected their sense of position maximally. This disorder produced severe ataxia of the upper extremities and trunk, and pseudochorea. One patient died and the autopsy showed an extensive demyelinating polyneuropathy. Neuronal cell bodies in the anterior horns and dorsal root ganglia showed extensive accumulations of lipofuscin and schwann cells showed extensive accumulations of lipid. This neuronal and Schwann cell lipidosis appears to result from starvation of the obese and has never been reported in other forms of human starvation or nutritional deficiency.- - - - - - - - - - ranking = 1keywords = obesity (Clic here for more details about this article) |
2/5. serum lipids during starvation in obesity.The HDL-cholesterol level was found to decrease during the first week of therapeutic starvation in hyperlipoproteinaemic (hypertriglyceridaemic), diabetic (non-insulin dependent) patients. The possible causes of the finding are discussed, and the view is expressed that the fall in HDL given no cause for discontinuing the caloric restriction or starvation as the therapeutic measures in obesity.- - - - - - - - - - ranking = 1keywords = obesity (Clic here for more details about this article) |
3/5. Recent developments in the treatment of obesity with particular reference to semistarvation ketogenic regimens.Three new techniques have been developed for the treatment of obesity--behavior modification, semistarvation ketogenic regimens, and surgical therapy. behavior modification appears to be effective for weight maintenance after weight loss through balanced deficit dieting for patients at less than 130 per cent of desirable body weight and semistarvation ketogenic regimens for patients from 130 to 200 per cent of desirable body weight. When indicated, surgical therapy is more efficacious for patients who are in excess of 200 per cent desirable body weight. All three approaches should be considered experimental until a larger experience is acquired and preliminary results are confirmed.- - - - - - - - - - ranking = 1keywords = obesity (Clic here for more details about this article) |
4/5. starvation diet and very-low-calorie diets may induce insulin resistance and overt diabetes mellitus.We have observed seven initially obese individuals who, during the course of a strenuous weight-reduction program, developed diabetes mellitus: non-insulin-dependent diabetes mellitus in five cases and insulin-dependent diabetes mellitus in two cases. None had any sign of prior diabetic symptoms. Although weight reduction is encouraged in obesity, crash diets without proper medical surveillance may have deleterious effects. This sequence of induction of diabetes has not previously been reported in the medical literature. The metabolic situation in extremely low-calorie diets may be comparable to that in starvation. An attempt is made to explain our observation concerning the induction of a diabetic state during such diets, on the basis of increased insulin resistance in states of starvation and anorexia nervosa, with a concomitant role in stress hormones.- - - - - - - - - - ranking = 0.2keywords = obesity (Clic here for more details about this article) |
5/5. starvation injury after gastric reduction for obesity.Gastric reduction operations are designed to control body weight by establishing a small, meal-size juxtaesophageal, gastric pouch that empties into the jejunum (gastric bypass) or the larger portion of the stomach (gastroplasty). If the outlet of the pouch is too small, a patient may be limited to ingesting clear liquids. vomiting then occurs if heavier liquids or normal foods are taken. An occasional patient has difficulty eating properly and vomits even though the pouch volume and outlet are of optimum size. For a patient who reports vomiting, a distinction must be made between episodic improper eating and uncontrolled starvation. Three types of starvation injury are described: (1) sudden death from protein malnutrition; (2) refeeding syndrome; and (3) Wernicke-korsakoff syndrome. The mechanisms of the development, manifestations, prevention, and treatment of these complications are explained. Surgeons who treat severe obesity should be aware of these complications and be prepared to manage patients who have uncontrolled vomiting so that such complications either do not develop or are recognized and treated as early as possible before serious and irreversible injury occurs.- - - - - - - - - - ranking = 1keywords = obesity (Clic here for more details about this article) |