Albert Stunkard, M.D.
Photo provided by New Harbinger
A 16-year-old woman, more than 100 pounds overweight, told the physician
treating her for depression that she had no appetite in the morning. She ate
voraciously in the evening, however, and even rose from sleep to snack.
This unusual pattern of food consumption intrigued her therapist, Albert
Stunkard, M.D., then a resident in psychiatry at the Johns Hopkins Hospital.
Although the woman dropped out of treatment, Stunkard never forgot her.
After completing his residency in 1953, Stunkard started a fellowship in
psychosomatic medicine at the New York Hospital-Cornell Medical Center.
Assigned to the obesity clinic, he asked patients both what and when they
Stunkard and his mentor at Cornell, neurologist Harold Wolff, M.D.,
published the first report on what they called the night eating syndrome (NES)
in the July 1955 American Journal of Medicine. They described 20
obese patients with morning anorexia who commonly consumed at least a quarter
of their total daily calories after their evening meal. None of their 38
healthy non-obese control subjects displayed this pattern.
Fifty-two years and 447 papers later, Stunkard, at age 85, continues to
investigate NES and other eating disorders. In 2006 alone, he and colleagues
published nine papers on NES and other eating disorders. He also has
co-authored a book for patients and their families, published in 2004,
Overcoming Night Eating Syndrome: A Step-by-Step Guide to Breaking the
Cycle (New Harbinger Publications).
"At meetings, he's usually in the front row listening attentively or
presenting his latest research findings," said James Mitchell, M.D.,
professor and chair of clinical neuroscience at the University of North Dakota
School of Medicine and a specialist in eating disorders.
Stunkard, a professor of psychiatry at the University of Pennsylvania,
chaired its Department of Psychiatry from 1962 to 1973 and later founded its
Center for Weight and Eating Disorders. The National Institute of Mental
Health has supported his research for more than four decades.
Stunkard's many honors include APA's Award for Research in both 1960 and
1980 and Distinguished Service Award in 1994. He received the Rhoda G. and
Bernard G. Sarnat International Prize in Mental Health from the Institute of
Medicine in 2004.
And no, Stunkard has never had a weight problem himself, nor have any of
his close relatives, he reports. Once 6 feet tall, now slightly stooped,
Stunkard weighs 163 pounds.
Stunkard's career path, like that of many of his contemporaries, included
time in the military. After graduating from the Columbia University College of
Physicians and Surgeons in 1945, he completed a one-year internship in
medicine at Massachusetts General Hospital. He then spent two years in the
Army taking care of Japanese prisoners charged with war crimes at Sugamo
Prison in Tokyo. His recently completed memoir of his experiences in Japan,
After the War: Remembrances of an American in Japan, will be
published this spring by EastBridge Books.
Stunkard started his psychiatric residency at Hopkins in 1948, planning to
become a psychoanalyst. Psychosomatic medicine, however, proved more
appealing. While still a resident, Stunkard conducted a placebo-controlled
trial of a psychotropic agent. The American Journal of Psychiatry
published his report on this study, his first paper, in December 1950.
He arrived at Cornell with no thought of exploring obesity, he told
Psychiatric News. "But the glamorous diseases—migraine,
ulcers, and hypertension—already had been claimed by other research
fellows," he recalls. Wolff, a pioneer investigator in psychosomatic
medicine, proposed that Stunkard study Buerger's disease. The young
psychiatrist could not muster zeal for that disorder.
Then Stunkard's friend and former classmate at Columbia, Theodore
VanItallie, M.D., piqued his interest with details of his own fledgling
research on brain centers controlling hunger and satiety in rats. With Wolff's
encouragement, Stunkard began to explore these issues in humans. He and
VanItallie, a professor emeritus of medicine at Columbia, collaborated on
studies of gastric hunger contractions, coming to view not only hunger but
also satiety as an active process.
"Stunkard had the imagination to see that adoption studies and twin
studies could clarify the role of genetics in the development of
obesity," VanItallie asserts.
Using data from the Danish Adoption Registry, Stunkard and colleagues found
that adopted children developed a body mass index (BMI) similar to that of
their biological parents. "Genetic influences have an important role in
determining human fatness in adults, whereas the family environment alone has
no apparent effect," his group wrote in the January 23, 1986, New
England Journal of Medicine.
Data from the large Swedish twin registry affirmed and extended the
importance of genetics by showing that identical twins reared apart have a BMI
as adults that is the same as that of twins raised together. Stunkard and
colleagues reported these findings in the May 24, 1990, New England
Journal of Medicine. In a study now in progress, his group is using the
Swedish twin registry to explore genetic influences on NES.
He and colleagues also are conducting genetic studies of obesity among the
Old Order Amish. Using linkage and association studies, they have identified a
region on chromosome 7 that may be responsible, at least in part, for BMI and
other obesity-related traits.
For an ongoing study at Penn that started in 1993, Stunkard's group
recruited 40 obese pregnant women and 40 non-obese pregnant women and have
followed their children from birth. By age 9, half of the children of obese
mothers had become obese. "My guess is that most of the other half will
become obese, too," Stunkard says. "No children of lean mothers
have become obese."
Over the years, Stunkard has shown that the environment can lead to obesity
in genetically vulnerable people. He was the first to show the now widely
recognized inverse relationship between social class and obesity. He also
designed a widely used eating assessment inventory and has documented the
efficacy of psychological and pharmacological therapies, weight-loss regimens,
and bariatric surgery on obesity.
He often returns to NES. Stunkard's group has reported that both
normal-weight and obese individuals develop this disorder, and suggested NES
may serve as a path to obesity.
"There's hardly an aspect of obesity that Stunkard hasn't
investigated—from etiology, to treatment, to prevention of this
disorder," said Thomas Wadden, Ph.D., director of Penn's Center for
Weight and Eating Disorders.
"He has inspired many young investigators to pursue research in these
areas," Wadden added. "He's the dean of our field."▪