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Appetite Disturbance and the Problems of Overweight

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Summary

During the past 50 years, obesity has increasingly become a problem in Western societies. If low energy output by these individuals (i.e. lack of exercise) cannot be held totally accountable for this problem, then their energy input (i.e. appetite) must play a significant role. There are many elements that give rise to appetite disturbances and their effects on weight gain, weight loss or its maintenance.

Previously, it was thought that emotional disturbances led to overeating and overweight; a theory that was supplanted later by the theory that physiological rather than psychological causes were to blame. Today, it is generally believed that appetite is controlled by the interaction of internal (genetic, physiological and chemical) and external (environmental and psychosocial) processes. The role of nutritional and dietary factors in controlling the expression of appetite are particularly important.

Thus, appetite (hyperphagia or increased hunger) can be induced by changes in brain neurotransmitters and neuromodulators, altered liver metabolism, adjustments of the nutrient/sensory components of the diet, environmentally applied Stressors, the mental and behavioural imposition of dieting and the administration of various psychotropic medications. This review focuses on the role each of these mechanisms plays in the genesis and maintenance of appetite disturbances; the conclusion of each of these contributions is the same — control of appetite must be achieved in order to treat obesity, and to do this, control must be exerted via regulation of the food supply, cognitive methods, environmental adjustment or by pharmacological tools.

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References

  • Abrahamson EC, Wunderlich RA. Anxiety, fear and eating: a test of the psychosomatic concept of obesity. Journal of Abnormal Psychology 79: 317–321, 1972

    Google Scholar 

  • Amdisen A. Drug-produced obesity. Experience with chlorpromazine, perphenazine and clopenthixol. Danish Medical Bulletin 11: 182–189, 1964

    PubMed  CAS  Google Scholar 

  • Antelman SM, Szechtman H. Tail pinch induces eating in sated rats which appears to depend on nigrostriatal dopamine. Science 189: 731–733, 1975

    PubMed  CAS  Google Scholar 

  • Antelman SM, Black GA, Rowland NE. Clozapine induces hyperphagia in undeprived rats. Life Sciences 21: 1747–1750, 1977

    PubMed  CAS  Google Scholar 

  • Blundell JE. Hunger and satiety in the control of food intake: implications for the treatment of obesity. Clinica Dietologia 23: 257–272, 1977

    Google Scholar 

  • Blundell JE. Hunger, appetite and satiety — constructs in search of identities. In Turner M (Ed.) Nutrition and lifestyle, pp. 21–42, Applied Science Publications, London, 1979

    Google Scholar 

  • Blundell JE. Pharmacological adjustment of the mechanisms underlying feeding and obesity. In Stunkard AJ (Ed.) Obesity, pp. 470, Saunders, Philadelphia, 1980

    Google Scholar 

  • Blundell JE. Neuroregulators and feeding: implications for the pharmacological manipulation of hunger and appetite. Reviews in Pure and Applied Pharmacological Sciences 3(4): 381–462, 1982

    CAS  Google Scholar 

  • Blundell JE, Burley VJ. Satiation, satiety and the action of fibre on food intake. International Journal of Obesity 11(Suppl. 1): 9–25, 1987

    PubMed  Google Scholar 

  • Blundell JE, Hill AJ. Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet 1: 1092–1093, 1986a

    PubMed  CAS  Google Scholar 

  • Blundell JE, Hill AJ. Biopsychological interactions underlying the study and treatment of obesity. In Christie M, Mellett PG (Eds) The psychosomatic approach: contemporary practice, pp. 115–138, Libbey, Chichester, 1986b

    Google Scholar 

  • Blundell JE, Tombros E, Rogers PJ, Latham CJ. Ecological analysis of feeding: implications for the pharmacological manipulation of food intake in animals and man. Progress in Neuro-Psychopharmacology and Biological Psychiatry 4: 319–326, 1980

    CAS  Google Scholar 

  • Blundell JE, Hill AJ, Rogers PJ. Artificial sweeteners and appetite. In Birch GG, Lindley MG (Eds) Low calorie products, pp. 147–170, Elsevier, Elsevier Applied Science, England, 1988a

    Google Scholar 

  • Blundell JE, Rogers PJ, Hill AJ. Uncoupling sweetness and calories, methodological aspects of laboratory studies on appetite control. Appetite 11: 54–61, 1988b

    PubMed  Google Scholar 

  • Booth DA. Satiety and appetite are conditioned reactions. Psychosomatic Medicine 39: 76–81, 1977

    PubMed  CAS  Google Scholar 

  • Bouchard C. Inheritance of fat distribution and adipose tissue metabolism. In Vague J, et al. (Eds) Metabolic complications of human obesities, pp. 87–96, Excerpta Medica, Amsterdam, 1985

    Google Scholar 

  • Brobeck JR. Food and temperature. Recent Progress in Hormone Research 16: 439–459, 1960

    PubMed  CAS  Google Scholar 

  • Brown RF, Houpt KA, Schryver HF. Stimulation of food intake in Laresby diazepam and promazine. Pharmacology, Biochemistry and Behavior 5: 495–497, 1976

    CAS  Google Scholar 

  • Bray GA, Gallagher TF. Manifestations of hypothalamic obesity in man; a comprehensive investigation of eight patients and a review of the literature. Medicine 54: 301–330, 1975

    PubMed  CAS  Google Scholar 

  • Bruch H. The importance of overweight. Norton & Co, New York, 1957

    Google Scholar 

  • Bruch H, Touraine R. Obesity in childhood v. the family frame of obese children. Psychosomatic Medicine 2: 141–206, 1940

    Google Scholar 

  • Cappell H, Leblanc AE, Endrenyl L. Effects of chlordiazepoxide and ethanol on the extinction of a conditioned taste aversion. Physiology and Behavior 9: 167–169, 1972

    PubMed  CAS  Google Scholar 

  • Caspar RC. Psychological aspects of obesity: searching for the evidence. In Billows G, et al. (Eds) Handbook of eating disorders. Part II. Elsevier, Amsterdam, 1987

    Google Scholar 

  • Cooper SJ. Benzodiazepines as appetite-enhancing compounds. Appetite 1: 7–19, 1980

    CAS  Google Scholar 

  • Cooper SJ. Benzodiazepines and appetite: recent pre-clinical advances and their clinical implications. Human Psychopharmacology 4: 81–89, 1989

    CAS  Google Scholar 

  • Critchley M, Hoffman HL. The syndrome of periodic somnolence and morbid hunger. British Medical Journal 1: 137–139, 1942

    PubMed  CAS  Google Scholar 

  • Drewnowski A, Greenwood MRC. Cream and sugar: human preferences for high-fat foods. Physiology and Behavior 30: 639–643, 1983

    Google Scholar 

  • Duncan KH, Bacon JA, Weinsier RL. The effect of high and low energy density diets on satiety, energy intake, and eating time of obese and non-obese subjects. American Journal of Clinical Nutrition 37: 763–767, 1983

    PubMed  CAS  Google Scholar 

  • Edwards JG. Unwanted effects of psychotropic drugs. IV. Drugs for anxiety. Practitioner 219: 117–121, 1977

    PubMed  CAS  Google Scholar 

  • Faust IM. Nutrition and the fat cell. International Journal of Obesity 4: 314–321, 1980

    PubMed  CAS  Google Scholar 

  • Faust IM, Johnson PR, Stern JS, Hirsch J. Diet-induced adipocyte number increase in adult rats — a new model of obesity. American Journal of Physiology 235: E279–E286, 1978

    PubMed  CAS  Google Scholar 

  • Faust IM, Triscari J, Sclatani A, Miller WH, Sullivan AC. Moderate adipocyte hyperplasia in the chow-fed VMH rat. Federation Proceedings 39: 887, 1980

    Google Scholar 

  • Friedman MI, Sawchenko PE. Evidence of hepatic involvement in control of ad libitum food intake in rats. American Journal of Physiology 247: R106–R113, 1984

    PubMed  CAS  Google Scholar 

  • Friedman MI, Lamirez I, Edens NK, Granneman J. Food intake in diabetic rats: isolation of primary metabolic effects of fat feeding. American Journal of Physiology 249: R44–R51, 1985

    PubMed  CAS  Google Scholar 

  • Fuller JL. Genetics of eating behaviour in animals. In Gioffi LA et al. (Eds) The body weight regulatory system: normal and distributed mechanisms, pp. 197–204, Raven Press, New York, 1981

    Google Scholar 

  • Garrow J. Does plumpness matter? Nutrition Bulletin 7: 49–53, 1982

    Google Scholar 

  • Goodman LS, Gilman A. The pharmacological basis of therapeutics, 4th ed., Macmillan, New York, 1970

    Google Scholar 

  • Hendley BG, Seymour V. Markets for low-calorie foods. In Birch GG, Lindley MG (Eds) Low calorie products, pp. 1–9, Elsevier Applied Science, 1988

    Google Scholar 

  • Herman CP, Mack D. Restrained and unrestrained eating. Journal of Personality 43: 647–660, 1975

    PubMed  CAS  Google Scholar 

  • Herman CP, Polivy J. A boundary model for the regulation of eating. Stunkard AJ, Stellar E. (Eds) Eating and its disorders, pp. 141–156, Raven Press, New York, 1984

    Google Scholar 

  • Hetherington AW, Ranson SW. Hypothalamic lesions and adiposity in the rat. Anatomical Record 78: 149–172, 1940

    Google Scholar 

  • Hill AJ, Blundell JE. Model system for investigating the actions of anorectic drugs: effect of dexfenfluramine on food intake, nutrient retention, food preferences and patterns, hunger and satiety in healthy human subjects. Advances in the biosciences, pp. 377–389, Pergamon Press, Oxford, 1986

    Google Scholar 

  • Hill W, Castonguay TW, Collier GH. Taste or diet balancing. Physiology and Behavior 24: 765–767, 1980

    PubMed  CAS  Google Scholar 

  • Hoebel RG. Neurotransmitters in the control of feeding and its rewards: monoamines, opiates and brain-gut peptides. In Stunkard AJ, Stellar E (Eds) Eating and its disorders, pp. 15–38, Raven Press, New York, 1984

    Google Scholar 

  • Hoebel BG, Lebowicz SP. Brain monoamines in the modulation of self-stimulation, feeding and body weight. In Weiner HA et al. (Eds) Brain, behaviour and bodily disease, pp. 103–142, Raven Press, New York, 1981

    Google Scholar 

  • Jeanrenaud B, Assimacopoulos-Jeannet P, Cretta M, Berthoud HR, Bereiter DA, et al. Experimental obesities: a progressive pathology with reference to the potential importance of the CNS in hyperischaemia. In Bjorntorp P et al. (Eds) Recent advances in obesity research pp. 159–171, Libby, London, 1981

    Google Scholar 

  • Jeffery RW, Bjornson-Benson WM, Rosenthal BS, Lindquist RA, Kurth CL, et al. Correlates of weight loss and its maintenance over two years of follow-up among middle-aged men. Preventive Medicine 13: 155–168, 1984

    PubMed  CAS  Google Scholar 

  • Jen KLC. The effect of high fat diet on the behavioural patterns of male rats. Physiology and Behaviour 25: 373–381, 1980

    CAS  Google Scholar 

  • Kanarek RB, Marks-Kaufmann R. Developmental aspects of sucrose-induced obesity in rats. Physiology and Behavior 23: 881–885, 1979

    PubMed  CAS  Google Scholar 

  • Kaplan HI, Kaplan HS. The psychosomatic concept of obesity. Journal of Nervous and Mental Disease 125: 181–201, 1957

    PubMed  CAS  Google Scholar 

  • Le Magnen J. Effets D’une pluralité de stimuli alimentaires sur le determinime quantitif de l’ingestion chez le rat blanc. Archives des Sciences Physiologiques 14: 411–419, 1960

    Google Scholar 

  • Le Magnen J. Hunger. Cambridge University Press, Cambridge, 1985

  • Leon G, Chamberlain K. Comparison of daily eating habits and emotional states of overweight persons successful or unsuccessful in maintaining a weight loss. Journal of Consulting and Clinical Psychology 41: 108–115, 1973

    PubMed  CAS  Google Scholar 

  • Lissner L, Levitsky DA, Strupp BV, Kackwarf H, Roe DA. Dietary fat and the regulation of energy intake in human subjects. American Journal of Clinical Nutrition 46: 856–892, 1987

    Google Scholar 

  • Macqorquodale K, Meehl PE. On the distrinction between hypothetical constructs and intervening variables. Psychological Review 55: 95–101, 1948

    Google Scholar 

  • Margules DL, Stein L. Neuroleptics v. tranquillisers — evidence from animals of mode and site of action. In Bril H, et al. (Eds) Neuropsychopharmacology, pp. 108–120, Excerpta Medica, Amsterdam, 1967

    Google Scholar 

  • Mei N. Intestinal chemosensitivity. Physiological Reviews 65: 211–237, 1985

    PubMed  CAS  Google Scholar 

  • Mereu GP, Fratta W, Gessa P, Gessa GL. Voraciousness induced in rats by benzodiazepines. Psychopharmacology 47: 101–103, 1976

    PubMed  CAS  Google Scholar 

  • Morgan R. Three weeks in isolation with two schizophrenic patients. British Journal of Psychiatry 131: 504–513, 1977

    PubMed  CAS  Google Scholar 

  • Morley JE, Blundell JE. The neurobiological basis of eating disorders: some formulations. Biological Psychiatry 23: 53–78, 1988

    PubMed  CAS  Google Scholar 

  • Morley JE, Levine AS. The pharmacology of eating behavior. American Review of Pharmacology and Toxicology 25: 127–146, 1985

    CAS  Google Scholar 

  • Morley JE, Levine AS, Willenbring MC. Stress-induced feeding disorders. In Carruba MO, Blundell JE (Eds) Pharmacology of eating disorders, pp. 71–99, Raven Press, New York, 1986

    Google Scholar 

  • Paykel ES, Mueller PS, De La Vergne PM. Amitriptyline, weight gains and carbohydrate craving; a side effect. British Journal of Psychiatry 123: 501–507, 1973

    PubMed  CAS  Google Scholar 

  • Persson T, Olssen L, Ortman E. The Kleine-Levin syndrome. Acta Psychiatrica Scandinavica 46: 106–110, 1970

    PubMed  CAS  Google Scholar 

  • Perusse L, Tremblay A, Lebranc C, Cloninger CI, Reich J, et al. Familial resemblance in energy intake: contribution of genetic and environmental factors. American Journal of Clinical Nutrition 47: 629–635, 1988

    PubMed  CAS  Google Scholar 

  • Polivy J, Herman CP. Dieting and bingeing: a causal analysis. American Psychologist 40: 193–201, 1985

    PubMed  CAS  Google Scholar 

  • Polivy J, Herman CP, Warsh S. Internal and external components of emotionality in restrained and unrestrained eaters. Journal of Abnormal Psychology 87: 497–504, 1978

    PubMed  CAS  Google Scholar 

  • Poschel BP. A simple and specific screen for benzodiazepine-like drugs. Psychopharmacologia 19: 193–198, 1971

    PubMed  CAS  Google Scholar 

  • Powley TL, Berthoud H-R. Diet and cephalic phase insulin responses. American Journal of Clinical Nutrition 42: 991–1002, 1985

    PubMed  CAS  Google Scholar 

  • Prentice AM, Black AE, Murgatroyd PR, Goldberg GR, Coward WA. Metabolism or appetite: questions of energy balance with particular reference to obesity. Journal of Human Nutrition and Diatetics 2: 95–104, 1989

    Google Scholar 

  • Quaade F, Vaernet K, Larsson S. Stereotaxic stimulation and electrocoagulation of the lateral hypothalamus in obese humans. Acta Neurochirurgica 30: 111–117, 1974

    PubMed  CAS  Google Scholar 

  • Reeves MG, Plum T. Hyperplagia, rage and dementia accompanying a ventromedial hypothalamic neoplasm. Archives of Neurology 20: 616–624, 1969

    PubMed  CAS  Google Scholar 

  • Robinson RG, McHugh PR, Folstein MF. Measurement of appetite disturbances in psychiatric disorders. Journal of Psychiatric Research 12: 59–68, 1975

    PubMed  CAS  Google Scholar 

  • Rogers PJ. Returning ‘cafeteria-fed’ rats to a chow diet: negative contrast and effects of obesity in feeding behaviour. Physiology and Behavior 35: 443–499, 1985

    Google Scholar 

  • Rogers PJ, Blundell JE. Investigation of food selection and meal parameters during the development of dietary induced obesity. Appetite 1: 85, 1980

    Google Scholar 

  • Rogers PJ, Blundell JE. Meal patterns and food selection during the development of obesity in rats fed a cafeteria diet. Neuroscience and Biobehavioural Reviews 8: 441–453, 1984

    CAS  Google Scholar 

  • Rogers PJ, Blundell VE. Evaluation of the influence of intense sweeteners on the short term control of appetite and caloric intake: a psychobiological approach. In Grenby TH (Ed.) Progress in sweeteners, Elsevier Applied Science, New York, in press

  • Rolls BJ. Sweeteners and satiety. In Dobbing J (Ed.) Sweeteners, pp. 161–173, Springer-Verlag, Berlin, Heidelberg, 1987

    Google Scholar 

  • Rothwell NJ, Stock MJ. A role for brown adipose tissue in diet-induced thermogenesis. Nature 281: 31–35, 1979

    PubMed  CAS  Google Scholar 

  • Rowland NE, Antelman SM. Stress-induced hyperplagia and obesity in rats — possible model for understanding human obesity. Science 191: 310–312, 1976

    PubMed  CAS  Google Scholar 

  • Royce JF. Factors as theoretical constructs. American Psychologist 18: 522–528, 1963

    Google Scholar 

  • Sclafani A, Springer D. Dietary obesity in adult rats: similarities to hypothalamic and human obesity syndromes. Physiology and Behavior 17: 461–471, 1976

    PubMed  CAS  Google Scholar 

  • Sclafani A, Xenakis S. Sucrose and polysaccharide induced obesity in the rat. Physiology and Behavior 32: 169–174, 1984

    PubMed  CAS  Google Scholar 

  • Sjostrom L, Garellick G, Krotkiewski M, Luyckx A. Peripheral insulin in response to the sight and smell of food. Metabolism 29: 901–909, 1980

    PubMed  CAS  Google Scholar 

  • Soper WY, Wise RA. Hypothalamically induced eating: eating from non-eaters with diazepam. TIT Journal of Life Sciences 1: 79–84, 1971

    CAS  Google Scholar 

  • Soubrie P, Kulkarni S, Simon P, Boissier JR. Effets des anxiolytiques sur la prise de nourriture de rats et de souris places en situation nouvelle ou familière. Psychopharmacologia 45: 203–210, 1975

    PubMed  CAS  Google Scholar 

  • Stein EM, Stein S, Linn MW. Geriatric sweet tooth — a problem with tricyclics. Journal of the American Geriatrics Society 33: 687–692, 1985

    PubMed  CAS  Google Scholar 

  • Stellar E. The physiology of motivation. Psychological Review 61: 5–22, 1954

    PubMed  CAS  Google Scholar 

  • Stunkard AJ, Sorensen TIA, Hanis C, Teasdale TW, Chakraborty R, et al. An adoption study of human obesity. New England Journal of Medicine 314: 193–198, 1986

    PubMed  CAS  Google Scholar 

  • Sullivan AC, Hogan S, Triscari J. New developments in pharmacological treatments for obesity. In Wirtman RJ, Wirtman JJ (Eds) Human obesity, Association of New York Academy of Sciences 499: 269–276, 1987

    Google Scholar 

  • Teskey GC, Kavaliers M, Hirst M. Social conflict activates opioid analgesic and ingestive behaviors in male mice. Life Sciences 35: 303–315, 1984

    PubMed  CAS  Google Scholar 

  • Tordoff MG, Friedman MI. Drinking saccharine increases food intake and preference. I. Comparison with other drinks. Appetite 12: 11–21, 1989

    PubMed  CAS  Google Scholar 

  • Tremblay A, Plourde G, Despres J-P, Bouchard C. Impact of dietary fat content and fat oxidation on energy intake in humans. American Journal of Clinical Nutrition 49: 799–805, 1989

    PubMed  CAS  Google Scholar 

  • Van Amelsvoort JMM, Van Stratum P, Kraal JH, Lussenburg RN, Houtsmulle VMT. Effects of varying the carbohydrate: fat ratio in a hot lunch on postprandial variables in male volunteers. British Journal of Nutrition 61: 267–283, 1989

    PubMed  Google Scholar 

  • Van Itallie TB, Abraham S. Some hazards of obesity and its treatment. In Hirsch J, Van Stallie TB (Eds) Recent advances in obesity research IV, pp. 1–19, Libbey, London 1985

    Google Scholar 

  • Van Itallie TB, Vanderweele DA. The phenomena of satiety. In Bjorntorp P, et al. (Eds) Recent advances in obesity research III, pp. 278–289, Libbey, London 1981

    Google Scholar 

  • Vendsborg PB, Bech P, Rafaelson OJ. Lithium treatment and weight gain. Acta Pscyhiatrica Scandinavica 53: 139–147, 1976

    CAS  Google Scholar 

  • Watson PJ, Cox VS. An analysis of barbiturate-induced eating and drinking in the rat. Physiological Psychology 4: 325–332, 1976

    Google Scholar 

  • Weinsier RL, Johnston MH, Doleys DM, Bacon JA. Dietary management of obesity: evaluation of the time-energy displacement diet in terms of its efficacy and nutritional adequacy for long-term weight control. British Journal of Nutrition 47: 367–379, 1982

    PubMed  CAS  Google Scholar 

  • Wise RA, Dawson V. Diazepam-induced eating and lever pressing for food in sated rats. Journal of Comparative Physiology and Psychology 86: 930–941, 1974

    CAS  Google Scholar 

  • Wise RA, Berger BD, Stein L. Benzodiazepines: anxiety reducing activity by reduction of serotonergic turnover in the brain. Science 177: 180–183, 1972

    PubMed  CAS  Google Scholar 

  • Wood JD, Reid JT, Wise RA, et al. The influence of dietary fat on fat metabolism and body fat deposition in meal-feeding and nibbling rats. British Journal of Nutrition 34: 15–24, 1975

    PubMed  CAS  Google Scholar 

  • Wooley SC. Physiological v. cognitive factors in short term food regulation in the obese and non-obese. Psychoanalytical Medicine 34: 622–68, 1972

    Google Scholar 

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  1. Department of Psychology, University of Leeds, Leeds, LS2 9JT, UK

    John E. Blundell

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Blundell, J.E. Appetite Disturbance and the Problems of Overweight. Drugs 39 (Suppl 3), 1–19 (1990). https://doi.org/10.2165/00003495-199000393-00003

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