pica and Obesity

Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes. Food-related deaths are important in terms of global mortality, and thus autopsies need to be comprehensive with full ancillary testing. Medicolegal matters may involve issues concerning likely exposure to infectious agents, possible foods ingested, the declared content and possible components of food, the significance of toxicological analyses, and aspects of duty of care in cases of café coronary syndrome and gastroenteritis while in care.

Topics: Airway Obstruction; Anaphylaxis; Esophageal Perforation; Food; Food Hypersensitivity; Food Microbiology; Foodborne Diseases; Forensic Medicine; Humans; Mediastinal Diseases; Obesity; Pica; Prader-Willi Syndrome

Topics: Body Weight; Deficiency Diseases; Diet, Diabetic; Diet, Reducing; Edema; Female; Fetus; Folic Acid Deficiency; Humans; Infant Mortality; Infant, Newborn; Nutritional Physiological Phenomena; Obesity; Physician-Patient Relations; Pica; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics

Pica and rumination disorder (RD)-formerly classified within DSM-IV Feeding and Eating Disorders of Infancy or Early Childhood-are now classified within DSM-5 Feeding and Eating Disorders. Though pica and RD have been studied in select populations (e.g., pregnant women, intellectually disabled persons), their typical features and overall prevalence remain unknown. This study examined the clinical characteristics and frequency of DSM-5 pica and RD among individuals seeking treatment for eating disorders and obesity.. We conducted structured interviews with adolescent and young adult females from a residential eating disorder center (N = 149), and adult males and females with overweight or obesity from an outpatient weight-loss clinic (N = 100).. Several participants reported ingesting non-nutritive substances (e.g., ice) for weight-control purposes. However, only 1.3% (n = 2; 95% CI: .06% to 5.1%) at the residential eating disorder center and 0% at the weight-loss clinic met DSM-5 criteria for pica, consuming gum and plastic. Although no eating disorder participants were eligible for an RD diagnosis due to DSM-5 trumping rules, 7.4% (n = 11; 95% CI: 4.0% to 12.9%) endorsed rumination behavior under varying degrees of volitional control. At the weight-loss clinic, 2.0% (n = 2; 95% CI: 0.1% to 7.4%) had RD.. DSM-5 pica and RD were rare in our sample of individuals seeking treatment for eating disorders and obesity, but related behaviors were more common. The wide range of pica and rumination presentations highlights the challenges of differential diagnosis with other forms of disordered eating.

Topics: Adolescent; Ambulatory Care; Case-Control Studies; Diagnosis, Differential; Feeding and Eating Disorders of Childhood; Feeding Behavior; Female; Humans; Male; Obesity; Pica; Weight Loss; Young Adult

Children with neuromuscular disorders have special health needs that place them at risk of nutritional problems. These needs may have detrimental effects on their development, immune and respiratory system. Identified nutrition-related problems are malnutrition, obesity, food intolerance, food allergies, drug-nutrient interactions, constipation and reflux. In order to improve the nutritional status of these patients, a nutritional assessment is recommended which should include anthropometric measurements and laboratory tests.

Topics: Cerebral Palsy; Child; Child Nutrition Disorders; Gastroesophageal Reflux; Humans; Neuromuscular Diseases; Nutritional Status; Obesity; Pica; Pseudobulbar Palsy; Starvation

In a prospective study, pica behavior was investigated during baseline interviews with a cohort of incident patients (n = 226) who began chronic dialysis therapy in metropolitan Atlanta, GA, during 1996 to 1997. Pica, defined as current pica behavior and/or reported history of pica behavior, was reported by 16% of the sample. Patients reporting pica were significantly more likely to be African American women and were significantly younger than the remainder of the sample. Approximately two thirds of patients who reported pica behaviors craved and excessively consumed ice; the remainder craved and consumed starch, dirt, flour, or aspirin. Among patients reporting pica, average serum albumin values were low and average phosphorus was increased. The average hematocrit of patients reporting ice pica was low. Over half of the hemodialysis patients reporting pica behavior had excessive usual interdialytic weight gain. Potential symptoms/problems affecting quality of life among patients practicing pica, eg, cramps, are shown in a case report. The data indicate the need for targeted education and support for dietitians' increased interaction with dialysis patients involved in pica behaviors.

Topics: Adult; Aged; Black People; Body Mass Index; Female; Hematocrit; Humans; Kidney Diseases; Male; Middle Aged; Nutritional Status; Obesity; Peritoneal Dialysis; Phosphorus; Pica; Prospective Studies; Renal Dialysis; Serum Albumin; Sex Characteristics; Soil

Topics: Animals; Animals, Domestic; Anorexia; Cat Diseases; Cats; Coprophagia; Dog Diseases; Dogs; Drinking; Feeding and Eating Disorders; Feeding Behavior; Garbage; Humans; Obesity; Pica; Plants; Predatory Behavior; Sucking Behavior; Wool