PubMed Health⌕ Search

Biomedical subjects

H R Kissileff

Publications and source records attributed to H R Kissileff.

At least 19 recordsLinked to original sources
PubMed2000

Microstructural analyses of human ingestive patterns: from description to mechanistic hypotheses.

Continuous automated weighing of food while subjects ate was used to test the hypothesis that failure to slow eating rate during a meal indicated a deficient response to satiety signals in obese patients. Cumulative intake curves were fitted to a quadratic equation. The physical form of the food and its palatability were a greater influence on the equation's parameters than the subjects' body weights, and the hypothesis was abandoned for several years (1984-1993). The hypothesis was revived with modifications when we discovered disturbances in eating behavior in patients with bulimia nervosa. The new hypothesis was that overeating was attributable to subjects' inability to detect or respond to satiety-related signals after eating large amounts of food. Patients with eating disorders showed lower ratings of satiety after eating the same amounts of food as controls, but only after eating more than normal. In conclusion, microstructural examination of eating behavior may be more useful for tests of specific hypotheses about the control of eating than as a description of clinical disturbance.

Eating↗
PubMed1997

Patterns of food selection during binges in women with binge eating disorder.

OBJECTIVE: The aim of this study was to determine whether temporal patterns of food selection during binges in obese subjects with binge eating disorder (BED) differ from those of patients with bulimia nervosa (BN). METHOD: Ten obese women with BED and 10 weight-matched women without BED each consumed a multiple-item meal identical to that used in previous studies with bulimics, and all subjects were instructed to binge. An experimenter recorded the subjects' food choices every 10 s throughout the meal via a closed-circuit TV camera. RESULTS: Subjects with BED consumed significantly more meat than subjects without BED (397.78 vs. 270.64 kcal), but the food choices and percentages of time spent eating each of the foods were similar among BED, non-BED, and normal weight controls. While bulimics ate dessert foods earlier in the meals, all other groups ate meat towards the beginning of their meal and ate more dessert foods towards the end of the meal. DISCUSSION: Food selection patterns during binges in subjects with BED are more similar to eating patterns of noneating disordered subjects, than to patterns seen in patients with BN. These data suggest that binge episodes between different groups of eating-disordered populations are qualitatively different.

Adult↗
PubMed1997

Postprandial cholecystokinin release and gastric emptying in patients with bulimia nervosa.

This study was designed to investigate the biological underpinnings of the observed deficit in satiety in patients with bulimia nervosa. Eight women with bulimia nervosa and 10 age- and weight-matched control subjects consumed three laboratory meals consisting of 200, 400, and 600 g of a radiolabeled liquid meal. For 1 h after each meal, blood samples were obtained at 10-min intervals for measurement of cholecystokinin concentration and gastric emptying was measured. Subjects also completed perceptual rating scales at 10-min intervals. Compared with control subjects, patients with bulimia nervosa showed a blunting of postprandial cholecystokinin release, particularly with larger meal sizes, as well as delayed gastric emptying. Increasing meal size was associated with increased desire to binge eat in patients but not in control subjects. These data lend support to a model in which increased gastric capacity, perhaps resulting from repeated binge eating, gives rise to delayed gastric emptying and blunted postprandial cholecystokinin release, leading to an impaired satiety response, which tends to perpetuate the illness.

Adolescent↗
PubMed1996

The effect of social setting on response to a preloading manipulation in non-obese women and men.

To determine the effect of a social setting on the physiological controls of eating, four pairs of subjects consumed a 15% and a 1% glucose (sweetened with aspartame to match the 15%) preload drink, preceding a test lunch meal, individually in a laboratory, and as a pair in a cafeteria. Compared with the 1% glucose preload, the 15% glucose preload significantly reduced food intake by the same amount in both settings (mean meal intakes: 467.4 g vs. 610.2 g, respectively). Intakes were 141.3 g +/- 41.8 SED less after the 15% than the 1% preload in the laboratory setting (t28df = 3.38, p = 0.0022), and 144.2 g +/- 41.8 SED in the cafeteria setting (t28df = 3.45, p = 0.0018). This result suggests that different social settings do not significantly alter physiological satiety cues and demonstrates that at least one of the physiological controls of eating, that has been tested in a laboratory setting, is reproducible in a cafeteria setting.

Adult↗
PubMed1996

A direct measure of satiety disturbance in patients with bulimia nervosa.

To determine whether patients with bulimia nervosa (BN) experience the development of satiety during a meal differently than control subjects, a novel laboratory meal procedure was employed. Eleven women with BN and 11 women without eating disorders consumed a yogurt shake meal after being instructed to binge. After each 75-g increment consumed, the subjects were signaled by a tone to fill out a questionnaire on which they were asked to rate various sensations on visual analog scales. The sensations included "Fullness", "Hunger", "Desire" for a favorite food, "Pleasantness" of consuming the shake, "Sickness", and having "Enough" to consume. Although patients, before purging, consumed significantly more food than the controls, who did not purge (1597 +/- 626.5 g vs. 1004 +/- 362.5 g, mean +/- SD), their final questionnaire ratings were not significantly different from the controls' ratings. Patients ate significantly more than the controls before reaching 50% of their range of "Hunger" rating and 75% of their "Full", "Desire", "Sick", and "Enough" rating ranges. The patients also ate significantly more than the controls between 75% and 100% of their "Hunger" rating range. These data suggest that one possible mechanism for overeating in patients with BN may be their failure to perceive or respond as normal subjects do to the range of sensations associated with satiety. Collecting ratings as a function of intake may provide a method for assessing and studying eating disturbances in clinical populations.

Adult↗
PubMed1995

Subjective ratings as a function of amount consumed: a preliminary report.

A new technique has been developed to study the changes in feelings of satiety during food consumption. Five non obese women were interrupted after eating 75 g increments of a tomato soup test meal served on an eating monitor to complete rating scales of hunger, satiety, fullness, sickness, and pleasantness of the meal. They were instructed to eat as much as they could, and their intakes ranged from 590 to 1288 g. The measured responses to each question were then plotted against the corresponding intakes. The slopes of the linear portions (in mm/g on 150 mm scales) were -.22 for hunger, -.21 for pleasantness of the food, and .27 for both fullness and satiety. The slope of the relationship between satiety and intake or the difference in intake between 25% and 75% of the maximum satiety response range could be useful measures for assessing either disturbances in satiety in clinical populations, or assessing relative satiating potencies of foods or beverages.

Adolescent↗
PubMed1994

Effects of glucose and fructose solutions on food intake and gastric emptying in nonobese women.

The differential effects of fructose and glucose on food intake were studied by giving two concentrations (1 and 10%) of glucose and fructose solutions (500 ml) to one group of women 30 min, and to another 135 min, before a meal of macaroni and beef. The 1% solutions of each sugar were sweetened to match 10% fructose by selective additions of aspartame. Gastric emptying of the 10% solutions and water was measured for 90 min. Under the 30-min delay, subjects ate a mean of 75.8 g more (P < 0.05) after the 1% solutions than after water, and 52.2 g (P > 0.05) less after the 10% solutions than after water, but there were no differences in intake between types of sugar under either delay nor between concentrations at the 135-min delay. However, 10% fructose and 1% glucose sweetened to match it reduced intake significantly compared with water. Glucose (10%) emptied significantly slower (t1/2 = 93.61 min) than water (t1/2 = 29.77 min), while fructose (10%) was intermediate (t1/2 = 65.45 min). Therefore, gastric emptying differences did not account for these results. We conclude that sweetener-enhanced dilute sugar solutions may increase subsequent intake at 30 min, but dilute glucose solutions may have potential for substantial energy savings if consumed 135 min before a meal.

Adult↗
PubMed1993

Eating behavior in binge eating disorder.

In order to examine the eating behavior of individuals with the newly proposed diagnosis, binge eating disorder (BED), standardized meals were served to 20 obese women, 10 with BED and 10 without BED. When asked to binge eat from a multiple-item array of foods, obese subjects with BED consumed significantly more calories than did obese subjects without BED. Significant differences between the two groups were also found on several of the self-report measures.

Adult↗
PubMed1993

Intravenous infusion of bombesin reduces food intake in humans.

Infusion of bombesin into healthy young men at two dosages (1.33 and 4.0 ng.kg-1.min-1) resulted in a significant 135-g reduction in intake of a yogurt and fruit blend, compared with saline infusions, at the higher dose, but only a 20-g (nonsignificant) reduction at the lower dose. There were no overt side effects, although half of the subjects reported a slightly elevated (mean elevation = 0.5 on a 1-5 category scale) sick sensation when receiving bombesin at the higher dose, but not when receiving saline. At the higher dose, the mean palatability of the test meal was reduced by 0.5 units on a nine-point scale of liking. This study demonstrates for the first time in humans that a slow intravenous infusion of bombesin can decrease spontaneous food intake when infused at the rate of 4 ng.kg-1.min-1 beginning at the onset of a meal. These results confirm that the short-term satiety effect of peripherally administered bombesin previously reported in animals can be obtained in humans.

Bombesin↗
PubMed1992

The single-item meal as a measure of binge-eating behavior in patients with bulimia nervosa.

To determine whether the characteristics of binge eating could be observed in a single-item meal, in a laboratory, patients with bulimia nervosa and controls ate two single-item meals and two multiple-item meals. When they were instructed to binge eat, the patients ate significantly more and for a longer time on both single- and multiple-item meals than did controls. When they were instructed not to binge, intakes of the two groups did not differ. Controls, but not most of the patients, showed deceleration in their eating rate when they were asked to binge. Intakes of the single- and multiple-item meals were significantly correlated for the patients under both sets of instructions. These results are consistent with previous reports in indicating that patients with bulimia nervosa eat differently from controls and suggest that a single-item meal can be used to examine the characteristics of binge eating in patients with bulimia nervosa.

Adult↗
PubMed1992

The threshold for satiating effectiveness of psyllium in a nutrient base.

A combination of psyllium fiber with nutrients in a commercially available wafer (Fiberall-Ciba Consumer Pharmaceutical) was evaluated for its effectiveness in reducing food intake and appetite. Each of 15 nonobese healthy women received no wafers and four different amounts (39, 104, 169, and 234 kcal) of the fiber wafer with water, in a ratio of 13 kcal (and 0.565 g psyllium) wafer per 41.67 g water, 30 minutes prior to a test meal of macaroni and beef, on nonconsecutive days. Intake of the test meal and hunger ratings were both significantly reduced after intake of the two largest wafer amounts (169 and 234 kcal, respectively), in comparison with the two smaller amounts and none at all. The reduction produced by the largest amount compared to none at all was 122 kcal (about half the energy of the amount given). There were no significant differences in intake and hunger ratings among the two smaller amounts and none at all. Thus the threshold for intake reduction by this product with water lies between 104 and 169 kcal. Methodologically, this work underscores the importance of testing the satiating effects of foods at multiple levels before conclusions are drawn about their satiating effectiveness, and suggests that the threshold for significant reduction should be considered as a measure of the product's satiating effectiveness. The relative contributions of the nutrients, the fiber, and the water to the satiating effect still need to be determined.

Adolescent↗
PubMed1992

Behavioral assessment of satiety in bulimia nervosa.

The abnormalities in eating behavior associated with bulimia nervosa suggest that patients with this illness may have a disturbance in satiety. The present study employed a six-meal protocol to assess satiety in both binge and non-binge eating episodes in women with bulimia nervosa and normal controls by examining whether an increase in the size of a soup preload led to a decrease in the amount of food consumed in a subsequent test meal. In control subjects, the increase in preload size was associated with an increase in fullness and a reduction in consumption of the non-binge test meal. Patients did not report consistent changes in ratings of hunger and fullness in response to the change in preload size, and few patients were able to complete the non-binge meals and refrain from vomiting afterwards. When instructed to binge eat, patients ate considerably more than control subjects, but patients did significantly reduce their intake of the test meal after the large compared to the small preload. These findings demonstrate that, although patients with bulimia nervosa exhibit abnormalities in the development of satiety, some mechanisms responsible for the control of food intake are functional during binge eating episodes.

Adolescent↗
PubMed1992

Where should human eating be studied and what should be measured?

Meiselman's (1992) proposal for redirection of research on human eating behavior towards eating in real settings is misdirected, because it does not take into consideration the questions being addressed by laboratory studies. In fact many of the studies for which he has called have in fact been done and will be cited. There is no compelling scientific or strategic reason that investigators who are making good progress on the problem of what controls the amount eaten should be exhorted to examine what controls the place or time of eating or what is selected for eating. They are different problems which require different methodology. The field is large enough for both kinds of studies and there is no reason to berate investigators as Meiselman does for not investigating the problem he happens to be studying.

Eating↗
PubMed1992

Food selection and intake of obese women with binge-eating disorder.

We studied food selection and intake of 19 women [body mass index (in kg/m2) > 30] [corrected], 10 of whom met proposed DSM-IV criteria for binge-eating disorder (BED). All subjects ate two multicourse meals in the laboratory, and were given tape-recorded instructions at each meal either to binge or eat in a normal fashion. Subjects with BED consumed significantly more energy than did subjects without BED at both the binge [12,400 vs 8440 kJ (2963 vs 2017 kcal), P < 0.005] and normal [9810 vs 6870 kJ (2343 vs 1640 kcal), P < 0.02] meals. During the binge meal subjects with BED consumed a greater percentage of energy as fat (38.9% vs 33.5%, P < 0.002) and a lesser percentage as protein (11.4% vs 15.4%, P < 0.01) than did subjects without BED. There were no differences in macronutrient composition of food choices between groups in the normal meal. Obese women who meet criteria for BED show differences in both intake and macronutrient composition of food choices from obese women who do not meet these criteria when asked to eat in a laboratory setting, supporting the validity of this new diagnosis.

Adult↗