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Gastric function in the control of food intake

Robinson, Paul Hyman; (1993) Gastric function in the control of food intake. Doctoral thesis (M.D), UCL (University College London). Green open access

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Abstract

In this thesis the relationships between gastric function, satiety and eating disorders are investigated by means of studies in animals and in patients with eating disorders. Previous work is reviewed and hypotheses presented. The effects of oral dl-fenfluramine on eating behaviour during a laboratory meal in 15 patients with bulimia nervosa are described. Eating and bulimic symptoms were significantly reduced by the drug. dl-Fenfluramine also significantly reduced glucose consumption and gastric emptying in Rhesus Monkeys and the two effects were interrelated. The putative satiety peptide cholecystokinin (CCK) was then studied in immature rats, believed to lack brain CCK receptors. Extensive receptors were found using autoradiography in the rat stomach, present before birth. CCK also inhibited independent milk ingestion and gastric emptying in neonatal rats. The ingestive and gastric inhibitory effects of CCK may be functionally related. Patients with eating disorders were studied using gamma-camera imaging of radio-labelled meals. Acutely starving (but not low weight refed) patients with anorexia nervosa had delayed gastric emptying suggesting that starvation produces delayed emptying. Patients of normal weight with anorexia nervosa or bulimia nervosa had normal gastric emptying. Rats were fed on a restricted time schedule, and developed profoundly delayed gastric emptying which improved with refeeding. Lastly, in a study of hunger and satiety, patients with anorexia nervosa had elevated satiety levels, reported hunger abnormally, and frequently showed correlations between gastric contents (measured on the gamma scan) and affective state and symptoms of eating disorder. This phenomenon, not observed in controls, was termed paraceptivity. Patients with bulimia nervosa reported hunger and satiety normally, but demonstrated paraceptivity. It is postulated that delayed gastric emptying mediates the reduced feeding observed after dl-fenfluramine and CCK administration and contributes to the maintenance of anorexia nervosa by enhancing satiety and provoking interoceptive distortion.

Type: Thesis (Doctoral)
Qualification: M.D
Title: Gastric function in the control of food intake
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Thesis digitised by ProQuest.
Keywords: Psychology; Eating disorders
URI: https://discovery.ucl.ac.uk/id/eprint/10105762
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