Doug Brunk

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN FRANCISCO – The best way to prepare for optimal delivery of care to anaphylaxis patients is to make sure you have the proper equipment on hand.

Suggested universal equipment includes a stethoscope and sphygmomanometer, epinephrine, oxygen, IV fluid, tourniquets, syringes, hypodermic needles, and large-bore needles, according to a 2010 practice parameter update developed by the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Joint Council of Allergy, Asthma, and Immunology.

"These should be available in all medical facilities and ready to use at the drop of a hat," Dr. Phillip Lieberman, a chief editor of the practice parameter, said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Depending on the availability of emergency support services, the parameter advises having on hand a one-way valve face mask, oxygen inlet port, diphenhydramine, corticosteroids for IV use, vasopressors, and atropine (J. Allergy Clin. Immunol. 2010;126:477-80). In addition, some clinicians may strongly consider having glucagon available, as well as a defibrillator and oral airway devices.

Prompt recognition of anaphylaxis signs and symptoms is crucial, said Dr. Lieberman of the departments of medicine and pediatrics at the University of Tennessee, Memphis.

"If there is any doubt, it is generally better to administer epinephrine, because a sin of omission in this case exceeds a sin of commission," he said. "The drug in general is safe to use and it very rarely causes any significant side effects."

The parameter also noted that "the more rapid the treatment, the better the outcome. Therefore, personnel in a medical office dealing directly with the patient’s medical care should be familiar with the manifestations of anaphylaxis and be able to recognize an event quickly."

Dr. Lieberman said this means that "you need to charge your medical personnel with the task of being able to recognize symptoms that are early suggestions of an anaphylactic event."

The parameter lists epinephrine and oxygen as the most important therapeutic agents to administer in anaphylaxis. It calls epinephrine "the drug of choice, and the appropriate dose should be administered promptly at the onset of apparent anaphylaxis. In general, treatment in order of importance is: epinephrine, patient position, oxygen, intravenous fluids, nebulized therapy, vasopressors, antihistamines, corticosteroids, and other agents."

Dr. Lieberman disclosed that he is a consultant or paid speaker for Dey, Sanofi-Aventis, Genentech, Ista, Merck-Schering, Teva, Novartis, Meda, and Alcon.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – Great saphenous vein diameter is a poor surrogate marker for assessing the impact of superficial venous incompetence on a patient's quality of life, results from a study of 91 patients showed.

The finding runs counter to the current practice of some health insurance carriers that use great saphenous vein (GSV) diameter to determine coverage for treatment of axial venous insufficiency.

"It is inappropriate to use GSV diameter as a sole criterion for determining medical necessity for the treatment of GSV reflux," Dr. Kathleen Gibson said at the annual meeting of the American Venous Forum. "Further investigation should be undertaken to look for more appropriate surrogate markers to guide treatment decisions."

Dr. Gibson and her associates collected data from the charts of 91 patients who were prospectively enrolled in two varicose vein trials that examined changes in quality-of-life measures with different varicose vein treatments. It was the first study of its kind, said Dr. Gibson, a vascular surgeon at Lake Washington Vascular in Bellevue, Wash.

The current analysis looked for correlations between GSV diameter and quality-of-life measures prior to any vein treatment.

GSV diameter was measured on duplex ultrasound within 5 cm of the saphenofemoral junction, while the patient was standing. Clinicians also determined Venous Clinical Severity Score (VCSS), and patients completed the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ-2), the Venous Insufficiency Epidemiological and Economic Study-Quality of Life (VEINES-QOL) questionnaire, and the VEINES Symptoms (VEINES-SYM) questionnaire prior to treatment.

Values for VCSS range from 0 to 30, with 30 being the most severe. Scores on the CIVIQ-2 range from 0 to 100, with 100 being the most severe. Higher scores on both the 25-item VEINES-QOL and the 10-item VEINES-SYM indicate better outcomes.

The mean age of patients was 45 years, 72 were women, and the mean GSV diameter was 6.77 mm.

Dr. Gibson reported that the mean VCSS value was 6.4 (range 2-12). The mean CIVIQ-2 score was 42.5 (range 20-85), the mean VEINES-QOL score was 82.7 (range 35-188), and the VEINES-SYM scores had a mean value of 40.5 (range 12-60).

Before vein treatment, there was a moderate correlation between VCSS and QOL measures, she said, and a strong correlation between VCSS and patient-derived quality-of-life measures, which were both significant (P less than .01).

Scatter plot analysis and Pearson correlation coefficients revealed a poor correlation between GSV diameter and VCSS, and no correlation between GSV diameter and any of the following: CIVIQ-2, VEINES-SYM, or VEINES-QOL.

"The only statistically significant findings we had for correlation were a weak correlation between height and body mass index and GSV diameter," Dr. Gibson said. "There was no statistical significance with the weak correlation we saw with VCSS and GSV diameter, and no correlation with any of the quality-of-life surveys. For reflux time, there was a trend toward a weak correlation inversely with height and BMI."

Dr. Gibson said that she had no relevant financial disclosures.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN DIEGO – The manifestations of chronic venous insufficiency generally increase with higher body mass index, results from a national screening program demonstrated.

However, venous abnormalities on screening duplex ultrasound were not correlated with increasing BMI.

"We did not find an increase in obstruction or venous reflux in higher-BMI individuals, which leads us to believe that obesity in and of itself is a contributor to chronic venous disease in the absence of valvular insufficiency," Dr. Colleen Moore said at the annual meeting of the American Venous Forum.

To determine differences in venous disease across a spectrum of BMI, Dr. Moore and her associates analyzed results from the National Venous Screening program. The program, launched by the American Venous Forum in 2005, was designed to educate participants about venous thromboembolism (VTE) risk, varicose veins, and chronic venous insufficiency through screening, literature, promotional materials, and an interview with a venous expert.

"The program strives to identify those at risk for VTE, the presence of venous obstruction or reflux on a modified duplex ultrasound, and the presence of chronic venous insufficiency based on a quick leg inspection," said Dr. Moore, of the vascular surgery department at Southern Illinois University, Springfield. "It then empowers individuals to go forth and inform their primary care providers and family of their risk of venous disease and the presence of venous disease."

Dr. Moore and her colleagues divided participants into six BMI categories: underweight (less than 18.5 kg/m²), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9), morbidly obese (35-39.9), and supermorbidly obese (greater than 40).

The researchers collected several data points for comparison, including demographic and health information, a VTE risk assessment, venous quality of life with the Chronic Venous Insufficiency Questionnaire 2 (CIVIQ2), and an abbreviated duplex ultrasound. Participants in the screening program also underwent a lower-extremity inspection and were assigned a CEAP classification (based on clinical severity, etiology or cause, anatomy, and pathophysiology).

Dr. Moore presented findings from 7,227 people who have been screened since 2005. Of these, 1.3% were underweight, 34.9% were normal weight, 34.8% were overweight, 16.6% were obese, 7.7% were morbidly obese, and 4.7% were supermorbidly obese.

The prevalence of diabetes significantly increased incrementally with BMI (from 4.9% in the normal-weight group to 25.2% in the supermorbidly obese group), as did the prevalence of hypertension (from 22.9% in the normal-weight group to 54.3% in the supermorbidly obese group).

Mean VTE risk-assessment scores significantly increased incrementally with BMI (from 3.3 in the normal-weight group to 4.1 in the supermorbidly obese group), as did mean quality-of-life scores (from 20.3 in the normal-weight group to 29.0 in the supermorbidly obese group). "We looked at social activities such as the ability to play sports or do housework," Dr. Moore said. "As you become heavier those scores increase, indicating a worse quality of life, and are statistically significant, compared with the normal-weight individuals."

Quality-of-life assessments regarding physical function such as the ability to walk briskly or climb stairs yielded similar results.

Mean CEAP scores significantly increased incrementally with BMI (from 1.4 in the normal-weight group to 1.9 in the supermorbidly obese group), as did mean venous clinical severity scores (from 2.6 in the normal-weight group to 4.3 in the supermorbidly obese group).

Dr. Moore also reported that evidence of venous obstruction on duplex examination appeared to increase across the BMI spectrum, but this did not reach statistical significance. The same association was seen for venous reflux as assessed by duplex examination.

Dr. Moore said that she had no relevant financial conflicts to disclose.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

SAN FRANCISCO – Parents of urban children with asthma tend to overestimate their child’s asthma control, but the factors predicting this association remain unclear, a study has shown.

"There’s a disconnect," lead investigator Joy N. Saams, R.N., said in an interview during a poster session at the annual meeting of the American Academy of Allergy, Asthma, and Immunology. "We tried to look for what made overestimating parents different from other parents. We had a hard time setting them apart."

In an effort to determine if parents’ perception of their child’s asthma was consistent with their child’s asthma control, Ms. Saams and her associates evaluated data from a 1-year observational study of 150 children aged 5-17 years with persistent asthma who lived in Baltimore. All children underwent spirometry. Days of symptoms and rescue medication use as well as parent/guardian perception of the child’s asthma were determined by questionnaire, said Ms. Saams of the division of pediatric allergy and immunology at Johns Hopkins University, Baltimore.

She and her associates defined misperception of asthma control as parent report of well-controlled asthma when the child’s asthma met National Asthma Education and Prevention Program criteria for disease that is not well controlled or is poorly controlled. They administered a questionnaire to determine family income, education level of the parents, and risk of depression, which was defined as scoring higher than 8 on the 10-item Center for Epidemiologic Studies Depression Scale.

The mean age of the children was 12 years, 57% were male, 91% were African American, and 53% were from households with an income of less than $25,000 per year. Nearly half of the children (43%) had asthma that was not well controlled, 32% had asthma that was poorly controlled, and 25% had asthma that was well controlled. Boys were significantly more likely than girls to have uncontrolled asthma (81% vs. 67%), Ms. Saams reported.

Parents of children with well-controlled asthma were significantly more likely to believe that their child’s asthma was well controlled, compared with parents of children with uncontrolled asthma (90% vs. 67%). "The good news may be that 90% of parents correctly identified well-controlled asthma, but 67% did not recognize uncontrolled asthma," Ms. Saams commented. "The story isn’t about who got it right, but who got it wrong."

When only reported symptoms and use of short-acting beta-agonists determined control, 62% of parents still believed that their child’s asthma was well controlled when it was not.

Although there were no statistically significant predictors of parent overestimation of asthma control, parents with less education and those with older children were more likely to overestimate their child’s asthma control, compared with parents who had higher levels of education and younger children.

There was no significant association between overestimating asthma control and increasing use of health services, but a larger percentage of children whose parents overestimated disease control had acute health care visits (56% vs. 45% among parents who did not overestimate asthma control).

The researchers concluded that parents of urban children with persistent asthma may benefit from explicit education regarding assessment of asthma control. "When you’re working with a parent and imparting education regarding asthma, pay attention to their background," Ms. Saams advised. "Are you reaching them at their level of understanding? Help them realize not only when their child’s having symptoms, but [also] that when they do have symptoms, that indicates a problem."

The study was funded by grants from the National Institute of Environmental Health Sciences and the National Institute of Allergy and Infectious Diseases.

Ms. Saams said that she had no relevant financial disclosures.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.

Food addiction appears to be associated with the same type of reward-related neural activation that is often implicated in substance dependence, results from a small imaging study demonstrated.

"If certain foods are addictive, this may partially explain the difficulty people experience in achieving sustainable weight loss," researchers led by Ashley N. Gearhardt, of Yale University, New Haven, Conn., reported online April 4 in the Archives of General Psychiatry. "If food cues take on enhanced motivational properties in a manner analogous to drug cues, efforts to change the current food environment may be critical to successful weight loss and prevention efforts."

In what they said is the first study of its kind, Ms. Gearhardt, a clinical psychology doctoral student at Yale, and her associates examined the role of food addiction symptoms as assessed by the 25-item Yale Food Addiction Scale (YFAS) with neural activation in response to cues signaling impending delivery of a highly palatable food (chocolate milkshake) vs. a tasteless control solution, as well as intake of a chocolate milkshake vs. a tasteless solution among 48 healthy young women who ranged from lean to obese.

Study participants were enrolled in a program developed to help people achieve and maintain a healthy weight. Women who reported DSM-IV binge eating were excluded from analysis, as were smokers, women who reported using psychotropic medications or illicit drugs in the past 3 months, those who sustained a head injury with loss of consciousness within the past 3 months, and those with Axis I disorders. The mean age of the participants was 21 years, and their mean body mass index (BMI) was 28 kg/m² (Arch. Gen. Psychiatry 2011 April 4 [doi:10.1001/archgenpsychiatry.2011.32]).

For the functional magnetic resonance imaging (fMRI) portion of the trial, stimuli consisted of two images – a glass of chocolate milkshake and a glass of water – that signaled the delivery of either 0.5 mL of milkshake or a calorie-free tasteless solution designed to mimic the taste of natural saliva. The images were presented for 2 seconds. Delivery of either substance occurred 5 seconds after the onset of cue and lasted 5 seconds.

The researchers reported results from a final sample of 39 study participants. Food addiction scores on the YFAS correlated positively with activation of the left anterior cingulate cortex (ACC), left medial orbitofrontal cortex (OFC), and left amygdala in response to anticipated intake of palatable food. All peaks remained statistically significant after adjustment for BMI.

"The ACC and medial OFC have both been implicated in motivation to feed and to consume drugs among individuals with substance dependence," the researchers noted. "Elevated ACC activation in response to alcohol-related cues is also associated with reduced D2 receptor availability and increased risk for relapse. Similarly, increased activation in the amygdala is associated with increased appetite motivation and exposure to foods with greater motivational and incentive value."

Compared with their counterparts who had low food addiction scores, those with high food addiction scores showed greater activation in the dorsolateral prefrontal cortex (DLPFC) in response to anticipated intake of palatable food, as well as less activation in the left lateral OFC. At least one previously published study, the researchers noted, "found that participants who attempted to resist pleasurable foods also exhibited elevated DLPFC activation, which was linked to reduced activity in areas implicated in coding food reward, such as the ventromedial prefrontal cortex. Thus, participants with higher food addiction scores may respond to increased appetitive motivation for food by attempting to implement self-control strategies."

Dr. Mark S. Gold said in an interview that the findings confirm observations that he and his group at the University of Florida, Gainesville, have made about hedonic or addictive eating.

"We have observed patients who quit smoking only to overeat and gain weight," said Dr. Gold, Distinguished Professor of Psychiatry & Neuroscience and chairman of the psychiatry department at the university. "We have also observed morbidly obese patients who have had successful bariatric surgery with large weight loss become alcoholics. Drugs and food compete in the brain for the same reinforcement sites," he noted.

"For food addicts, addiction treatment is more logical than current treatments that they have to choose from," he said.

Ms. Gearhardt and her associates acknowledged certain limitations of the study, including its small sample size, cross-sectional design, and the fact that only women were assessed. They recommended that future research assess the impact of neural activation in response to food advertisements as well as measure feelings of loss of control and ad libitum food consumption. "Further, the use of functional MRI technology does not allow for the direct measurement of dopamine release or dopamine receptors," they wrote. "It will be important to examine induced dopamine release and D2 receptor availability in participants who report indicators of food addiction."

The research was funded by a grant from the National Institutes of Health Roadmap for Medical Research. Ms. Gearhardt said she had no relevant financial conflicts to disclose.