Ukutywala amaRats: Umzekelo Wokuziphatha Okugqithiseleyo? (2006)

IINKCUKACHA: Ngokweli phepha, ukutya iigundane kuyimodeli elungileyo yokulutha komntu- kukuziphatha kunye neekhemikhali. Ukondla iigundane ngokwenyani ukutya okuneeshedyuli kukhuthaza isimilo sokutya kakhulu. Isifundo kwiibongo zezi gundane zizinkcinkca ziveza i-neurobiology yeziyobisi ebantwini.

Isifundo esigqibeleleyo: Iigundane zokuBinisa: Ngaba uMzekelo wokuPhakathi oPhakathi?

Umdla. I-2006 Jan; I-46 (1): 11-15.

Ipapashwe kwi-intanethi ye-2005 Sep 26. doi: I-10.1016 / j.appet.2004.09.002

PMCID: PMC1769467

I-NIHMSID: I-NIHMS15066

URebecca L. Corwin

Abstract

Iindlela zokuziphatha ezigwenxa kakhulu (IEB) zibonisa ukuphazamiseka okungafaniyo noluntu kubandakanya ukutya kakhulu, ukusebenzisa iziyobisi, ubunxila, ukuziphatha okubi ngokwesini kunye nokungcakaza okunganyanzelekanga. Ukubakho koxinizelelo lwekliniki kukho phakathi kwe-IEB, kwaye iindlela zonyango ezinomda ziyafumaneka. Ukusetyenziswa kweendlela zokuziphatha zokutya ngokungxama kunye nezinye iiprotheyini zokondla kuqala ukucacisa ukufana okungafaniyo kunye nolwahluko okhoyo phakathi kwe-IEB eyalelwa ekufumaneni nasekutyeni ukutya kunye ne-IEB ejolise ekufumaneni nasekusebenziseni iziyobisi zokuxhatshazwa. Uphando olusuka kule elebhu usebenzisa iprotocol yokutya engalunganga yokufumana uhlobo kunokubonelela ngengqondo entsha kwi-IEB.

Internet: Ukutya kakhulu, ukuxhaphaza iziyobisi, Iindlela zokuziphatha

Zintoni iindlela zokuziphatha ngokuthe kratya?

Ukuziphatha okungagungqiyo okungapheliyo (i-IEB) kubonakalisa ukungahambi kakuhle kwabantu kubandakanya ukutya utywala, ukusebenzisa iziyobisi, ukunxila, ukuziphatha gwenxa ngokwesondo, kunye nokungcakaza okunyanzelekileyo. Ezi ndlela zokuziphatha zinxulunyaniswa nokwanda kokugula kunye nokufa, kodwa zigcinwa ngaphandle kweziphumo ezibi ezinxulumene nazo. Kule minyaka imbalwa idlulileyo, ukonyuka kwengqwalaselo kuye kwanikezelwa ekuqondeni isiseko se-neurobiological yeziqendu zokuziphatha okugqithileyo, ngokukodwa kwimizamo egxile ekunciphiseni ukusetyenziswa gwenxa kweziyobisi kunye nokusetyenziswa kakhulu kokutya. Ithemba kukuba ukucaciswa kwesiseko se-neurobiological yohlobo olunye lokuziphatha (umz. Ukondla) kuya kukhulisa ukuqonda kwethu kolunye uhlobo lokuziphatha (umz. Ukusebenzisa iziyobisi). Oku kuya kubonelela ngesiseko sokuphuhliswa kongenelelo ngoncedo olutsha olunokuthi lusebenze kwiziphazamiso ezahlukeneyo. Nangona, iingxelo zamva nje zibonisa inkqubela phambili kunyango lwe-pharmacological yokuphazamiseka okubandakanya ukuzinkcinkca ngotywala kunye neziyobisi ezithile, ukhetho kunyango luhlala lilinganiselwe kwaye amaqondo okubuyela umva aphezulu (de Lima, Soares, Reisser, & Farrellde, 2002; UHalmi, uAgras, uMitchell, uWilson, uCraw kunye noBryson, 2002; IKreek, iLaForge, kunye neButelman, 2002; Ngokukhuselekileyo, ngokuDlamkileyo, eTelch, nakwiAgras, ngo-2002; UZhu kunye noWalsh, 2002).

Ebantwini, i-IEB ejolise ekutyeni ukutya yeyona nto iboniswayo xa kutyiwa kakhulu kukuzitya. Ukutya ngokuzinkozo kubandakanya ukugqithiswa kakhulu kokutya ngexesha elincinci ngesixa esingaphezulu kwesinokutyiwa ngabantu abaninzi phantsi kweemeko ezifanayo. Ukuluma kunokuthi okanye kungalandelwa ziindlela zokuziphatha ezinje ngokuhlanza ('ukucoca'), ukuzila ukutya, okanye ukuzilolonga kakhulu. Kwiingxaki zokutya ezinento yokwenza nokutya, ukuntywila kuyenzeka rhoqo ixesha elide kwaye kunxulunyaniswa nemeko yokulahleka kolawulo kunye noxinzelelo lweemvakalelo (I-DSM-IV, 1994).

Ukutya kakhulu ukutya kuyabelana nge-comorbidity kunye nezinye i-IEB. Umzekelo, izigulana ezifuna unyango lotywala kunye nokusetyenziswa gwenxa kwecocaine zinamaqondo aphezulu okutya okuzinkcinkca (UJohnson, Spitzer, Williams, Kroenke, Linzer kunye noBrody, 1997; I-Wilson, i-1993), kunye nabantu abafuna unyango malunga nokutya okuneengxaki zokutya abanamava okuphathwa gadalala kweziyobisi, ngakumbi isiselo esinxilisayo kunye necocaine (UBrewerton, uLyddiard, uHerzog, uBrotman, u-O'Neill kunye noBallenger, 1995; Bulik, Sullivan, kunye noKendler, 2002; UBushnell et al., 1994; UHerzog et al., 1992; ILaessle, iWittchen, iFichter, kunye nePirke, ngo-1989; IWiederman kunye nePryor, ngo-1996). Ubudlelwane phakathi kokutya ngokutya ngokungcakaza kunye nokungcakaza kuye kwaxelwa (Engwall, Hunter, & Steinberg, 2004).

Ukunyaniseka phakathi kwe-IEB kucebisa ukuba iindlela ezinxibelelanisa ezi ndlela zinokugqitha. Iimodeli zezilwanyana ziyafuneka ukuvavanya utshintsho olwenzeka ngexesha lokuphuhliswa kwe-IEB, ukugcinwa, kunye nokubuyela umva, kunye nokuthelekisa ukufana kunye nokungafani phakathi kweeklasi ezahlukeneyo ze-IEB. Iiprotokholi zisebenzisa imbuyekezo yendalo ezinje ngokutya zinomdla okhethekileyo ngenxa yesakhono sazo sokuveza utshintsho olwenzeka xa kuxhaphaziseka imeko yokuziphatha eqhelekileyo (umzekelo, ukunxunguphala) ukuguqulwa ukuphindaphinda, ukunqena, ukuziphatha okungalunganga ngokugqithileyo (umz. Iindidi zokuziphatha ezahlukeneyo zokutya zohlobo oluthile lokutya olucetywayo ziphakanyisiwe, eziye zaqwalaselwa kutsha nje (ICorwin kunye neBuda-Levin, 2004). Ukusetyenziswa kwezi kunye nezinye iiprotokholi ziqala ukucacisa ukufana okungafaniyo numahluko okhoyo phakathi kwe-IEB eyalelwa kukutya kunye ne-IEB ejolise kumachiza okuphatha gadalala (umzekelo, IBello, iSweigart, iLakoski, iNorgren, kunye neHajnal, 2003; UDeSousa, uBush, kunye neVaccarino, 2000; Di Chiara, 2002; IGosnell, 2000; I-Grigson, 2002; UHagan & Moss, ngo-1991; IKelley kunye neBerridge, 2002; ISchroeder, iBinzak, kunye neKelley, 2001; I-Spangler, iWittkowski, i-Goddard, i-Avena, i-Hoebel kunye neLeibowitz, i-2004).

Ukutya kweempuku kunye ne-IEB

Inkqubo yokufikelela encinci

Uphando oluvela kule elebhu lujolise ngqo ekuqulunqweni kwendlela yokuziphatha yokutya okungafuneki kuthintelo lwamandla, ukuze kuncitshiswe ukungqubana okunokubakho okunxibelelene nokutya. Ke ngoko, ilabhoratri egqibeleleyo yesondo yokutya kunye namanzi inikezelwa ngamaxesha onke kwiprothokholi yethu. Ukuphembelela ukutya uhlobo oluthile lokutya okunguniki, kunikwa umda kumthombo onganyanzelekileyo wokutya okunamafutha (ukutshitshiswa kwemifuno hydrogenated). Uphando lwethu lubonakalisile ukuba, njengokufikelela kokuncipha kuyancipha, ukusetyenziswa koshicilelo kunyusa ixesha le-2-h limited ukufikelela (I-Corwin, i-2004; UCorwin, uWojnicki, uFisher, uDimitriou, uRice kunye noMncinci, 1998; UDimitriou, Rice, kunye noCorwin, 2000; UThomas, Ilayisi, Weinstock, kunye noCorwin, 2002). Xa iigundane zifumana kuphela ukunqunyanyiswa kwe-2 h kathathu ngeveki, ukuthatha ixesha le-2-h ixesha lokufikelela liphezulu kakhulu, oko kukuthi, kulingana naleyo yamagundwane ngokufikelela okuthe kratya kokuncitshiswa kokusetyenziswa kwi-24 h. Ukuseka la manzi anyukayo kuthatha malunga neeveki ze-4. Nangona kunjalo, yakuba iqinisekisiwe, indlela yokuziphatha igcinwa ngokulula. Le protocol ibonelela ngeendlela ezilula nezingabizi zokumisela i-IEB ezinokuthi zigcinwe ixesha elide. Le nto yinto eyomeleleyo kwaye ithembekile, njengoko siyibonisile kwiintlobo ezahlukeneyo kunye nobudala bamagundane (Thomas et al., 2002), njengamadoda nabasetyhini (UCorwin et al., 1998; UDimitriou et al., 2000).

Iigundane ngokufikelela ekunciphiseni kwe-2 h kwi-Mon, Weds, Fri (MWF) veki nganye ayikhuphi mxhesho wamandla amaninzi athe kratya asetyenzisiweyo ngexesha lokuxinana kwi-22 h kulandela isiqephu sokuxhuzula. Oko kukuthi, ukunxila okugqithisileyo ngexesha le-2-h bingeyona nto ibalulekileyo kwi-24-h overconspt ngomhla we-binge. Kwiintsuku ezizayo ezingalunganga, nangona kunjalo, i-24-h ye-ethake energy iyancitshiswa. Ke ngoko, indlela ebambekayo / yokuphelisa imilo yokuziphatha iphuhla kwiigundane ze-MWF, nangona zingaze zithintelwe ekutyeni; kuphela ukufikelela kwabo kunqumamo kunqunyelwe. Ipatheni yokutya kokutya kwiigundane ze-MWF zahlukile kuleyo iigundane zigcinwa kwishedyuli yemihla ngemihla ye-2-h yokufinyeza. Ukutya kwemihla ngemihla kwe-24-h yokutya kuloo magundane akufani nolawulo lwe-chow-kuphela kwiintsuku ezininzi.

Inyaniso yokuba ukubambisa kakhulu kwimigaqo yokufikelela encinci kuthintelwe kukunciphisa ukufikelela kukutya okukhethwayo okunamafutha aphezulu kufanelekile, kuba ukutya okutya okutyiwa ngabantu kuqhelekileyo kubandakanya izinto ezithintelwe ngamanqatha aphezulu 'anqatshelwe' njengama-snacks kunye nama dessert (DSM-IV ; UGuertin, 1999; UHadigan, uKissileff, kunye noWalsh, ngo-1989; Kales, 1990; IRosen, Leitenberg, Gross, kunye neWillmuth, ngo-1986). Ukongeza, ukukhawulela ukufikelela kokutya okune-snack kukonyusa ukusetyenziswa kwabo kwimo elungiselelwe ilungiselelo elebhu (IFisher kunye neBirch, ngo-1999). Into yokuba amagundane kwiprotokholi yokufikelela ayikuphelelwa kukutya ikwabalulekile, njengoko ukutya ukungabikho kwendlala kunxulunyaniswa nokuzithoba ebantwini (UMarcus noKalarchian, 2003). Ukuziphatha kwezilwanyana kwiprotocol yokufikelela encinci, ke, kuyahambelana nokutya kwabantu, kwaye kuyafana kwezinye iindlela zabantu abanengxaki yokutya okuhambelana nokutya.

Iipeptides ezilawula ukuthathwa kwamafutha azinantsingiselo phantsi kwemeko zokufikelela limited

Kwiiprotokholi ezingezizo izilwanyana, i-galanin ivuselela ukutyeba okunamafutha xa ilawulwa ngqo kwi-penventricular nucleus ye-hypothalamus (UCorwin, uRobinson, kunye noCrawley, ngo-1993; UKyrkouli, uStanley, uSeirafi, kunye noLeibowitz, ngo-1990), kunye ne-galanin ye-antagonist M40 inciphisa ukungena kwamafutha (I-Leibowitz kunye neKim, ngo-1992). Nangona kunjalo, xa kuvavanywa phantsi kweemeko zokufikelela ezinqamlekileyo akukho galamin okanye i-M40 echaphazelekayo yokutya kwamafutha (UCorwin, uRowe, kunye noCrawley, ngo-1995). Iziphumo ezifanayo zafunyanwa nge-enterostatin, i-neuropeptide ecinga ukuba negalelo kwisibindi esine-mediated (U-Erlanson-Albertsson kunye neYork, ngo-1997). Oko kukuthi, phantsi kweemeko ezinqamlekileyo zokufikelela, i-enterostatin ayinasiphumo sokondla ukutya kwamafutha (ICorwin kunye nelayisi, ngo-1998; Ilayisi kunye neCorwin, ngo-1996, 1998). Ezi ziphumo zibonisa ukuba i-neurobiology yokutya kwamafutha phantsi kweemeko zokufikelela ezinqamlekileyo kwahlukile kwi-neurobiology yokutya kwamafutha phantsi kwezinye iimeko.

Ukutya kakhulu okwenziwa kukufikelela ngokulingeneyo kunokufana nokusetyenziswa gwenxa kweziyobisi

Izifundo zamva nje ziqalisiwe ukuphanda ukufana okunokwenzeka phakathi kokutya kwamafutha okubangelwa kukufikelela ngokulingeneyo kunye nenye i-IEB, ukusetyenziswa gwenxa kweziyobisi. Iingxelo ezivela kwamanye amaqela zibonise ukuba i-GABA-B agonist baclofen inciphisa ukuzilawula kweziyobisi ezilwanyaneni (UFattore, Cossu, Martellotta, kunye noFratta, 2002; UJanak kunye noGill, 2003; IRanaldi kunye nePoeggel, 2002; bona kwakho uBrebner, uPhelan, noRoberts, 2002; Abazala, uRoberts, kunye noWit, 2002, uphononongo), kwaye ubonise isithembiso kwiklinikhi kunyango lokusetyenziswa gwenxa kweziyobisi kunye nokuxhomekeka (IAddororato, iCaputo, iCapristo, iDenenicali, iBernard neJaniri, 2002; UAsadi, uRadgoodarzi, kunye no-Ahmadi-Abhari, 2003; I-Shoptaw, iYang, iRotheram-Fuller, iHsieh, iKintaudi neCharuvastra, i-2003; bona kwakho UBrebner et al., 2002; Cousins et al., 2002, yoqwalaselo). Idatha yamva nje yale labhoratri ibonisa ukuba i-baclofen inciphisa ukusetyenziswa kwe-binge-uhlobo lwamafutha aqhutywa kukufikelela ngokulinganiselweyo ngaphandle kokunciphisa ukusetyenziswa kokutya okunamafutha aphezulu okanye i-chow (UBuda-Levin, uWojnicki, kunye noCorwin, 2005). Oku kubangela umdla kuba ukubhexesha kunye nokusetyenziswa gwenxa kweziyobisi kwabelana ngeklinikhi yekliniki (UBrewerton et al., 1995; Bulik et al., 2002; UBushnell et al., 1994; UHerzog et al., 1992; UJohnson et al., 1997; I-Laessle et al., 1989; IWiederman kunye nePryor, ngo-1996; I-Wilson, i-1993) kunye ne-baclofen ngokubanzi ayinasiphumo okanye yonyusa ukutya ukutya kwiiprotokholi zezilwanyana ezingalungelanga (UBrebner et al., 2000; I-Ebenezer, 1995; I-Echo, iLamonte, iAckerman, kunye neBodnar, 2002; IiHiggs kunye neBarber, ngo-2004; IMinano, iMeneres Sancho, iSancibrian, iSalinas, kunye neMyers, ngo-1992; IStratford kunye neKelley, 1997; Iwadi, Somerville, kunye neClifton, 2000; IWirtshafter, iStratford, kunye nePitzer, ngo-1993; UZnamensky, uEcho, uLamonte, uMkristu, uRagnauth noBodnar, 2001). Xa zidibene kunye, ezi ziphumo zibonisa ukuba ukubekwa kwe-neural ekubandakanyekeni kokutya kohlobo oluthile lokutya, njengoko kudweliswe kumgaqo wokungena okulingeneyo, kwahlukile kokungazityi. Endaweni yoko, imiqondiso ye-neural ehambelana ne-IEB yokuloba inokunamathela ngokusondeleyo kwabo babandakanyeka kwi-IEB yokusetyenziswa gwenxa kweziyobisi.

izigqibo

I-neurobiology yokuphindaphindiweyo, okwethutyana, iziqendu zokuziphatha okugqithisileyo akuqondwa kakuhle. Nangona kunjalo, ubungqina obuguqulwayo bacebisa ukuba iindlela eziqhelekileyo zinokuba negalelo kwiziphazamiso ezibandakanya olu hlobo lokuziphatha. Uphando oluvela kule elebhu lubonise ukuba ukufikelela okungapheliyo kunqamla kunokubangela ukuphindaphindiweyo, ukunqamleza, ukusetyenziswa okuthe gabalala kokunciphisela iigundane ezingakunyanzelwanga ukutya. Iprothokholi ilula kwaye ayibizi, kwaye indlela yokuziphatha iyafana kwezinye iindlela zokuzonwabisa kwabantu. Idatha yakutshanje iphakamisa ukuba ukubekwa kwe-neural phantsi kwemeko yohlobo olunqabileyo lokungena kuhlukile kwiimeko ezingalunganga, kwaye kunokuba nokuhambelana kakhulu nokusetyenziswa gwenxa kweziyobisi. Okwangoku kukho iindlela ezahlukeneyo zokomelela zokutya ezinokusetyenziselwa ukuqhubela phambili ukuqonda kwethu malunga nokutshintsha komzimba kunye ne-neurological eyenzeka ngenxa yokuzibandakanya kwi-IEB. Olu phando lubaluleke kakhulu ukuba siza kucacisa iindlela ezifaka isandla kuphuhliso, kulondolozo, nasekubuyeleni kwakhona kwezi ndlela zitshabalalisayo zokuziphatha.

Imibulelo

Yenziwe kuMbutho woFundo lweNdlela yokuziPhatha (SSIB) yeNtlanganiso yeSatellite, iHueston Woods Resort, eOhio, ngoJulayi 18-20, 2004. Usihlalo ka-Allan Geliebter noHarry R. Kissileff. Isathelayithi yaxhaswa ngenxalenye yeZiko loPhando lokuTyeba kweNew York, i-SSIB, iGeneral Mills Foods, iMcNeil Nutritionals, iOrtho-McNeil Pharmaceuticals, iProcter kunye neGamble.

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