Post Graduate Program of Nutrition, Federal University of São Paulo - Paulista Medicine School - UNIFESP, São Paulo, Brazil.
Int J Clin Pract. 2010 May;64(6):784-90. doi: 10.1111/j.1742-1241.2009.02306.x.
The aim of this study was to evaluate the role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders.
Thirty-seven post-pubertal, obese adolescents (14 to 19 years old) with symptoms of eating disorders were submitted to long-term interdisciplinary therapy (1 year). Bulimic and binge eating symptoms were measured using the Bulimic Investigatory Test, Edinburgh, and the Binge Eating Scale respectively. Neuropeptide Y, melanin-concentrating hormone, total ghrelin, alpha-melanocyte stimulating hormone and leptin were measured using radioimmunoassay.
After long-term interdisciplinary therapy, the adolescents showed significantly improved body composition, visceral and subcutaneous fat and reduced symptoms of bulimia and binge eating. Intriguingly, orexigenic peptides were up-regulated after short-term therapy and down-regulated at the end of therapy, whereas the anorexigenic pathway was improved with therapy. Furthermore, after long-term therapy, a negative correlation was observed between leptin concentration and melanin-concentrating hormone.
We suggest that long-term therapy promotes an intrinsic association between weight loss, improvement of eating disorder symptoms and a decrease in orexigenic factors. Together, these results represent a more effective course by which patients can normalise behaviours related to eating disorders as well the actions of hormones involved in energy balance, and thus advance obesity control.
Long-term interdisciplinary therapy was effective to improve anorexigenic and orexigenic factors that influence energy balance and avoid the development of eating disorders in obese adolescents. However, the associations between eating disorders and neuroendocrine factors need to be confirmed in future studies.
本研究旨在评估摄食因子在肥胖伴进食障碍症状青少年的跨学科减肥治疗中的作用。
37 名青春期后肥胖（14 至 19 岁）伴进食障碍症状的青少年接受长期（1 年）跨学科治疗。使用暴食症调查测试、爱丁堡暴食症测试和暴食量表分别测量贪食和暴食症状。使用放射免疫法测量神经肽 Y、黑素细胞刺激素、总胃饥饿素、α-黑素细胞刺激素和瘦素。
经过长期的跨学科治疗，青少年的身体成分、内脏和皮下脂肪显著改善，贪食和暴食症状减轻。有趣的是，短时间治疗后食欲肽上调，治疗结束时下调，而厌食途径则随着治疗而改善。此外，经过长期治疗后，瘦素浓度与黑素细胞刺激素呈负相关。
我们认为，长期治疗促进了减肥、改善进食障碍症状和减少食欲肽之间的内在联系。总之，这些结果代表了一种更有效的治疗方法，使患者能够使与进食障碍相关的行为以及参与能量平衡的激素正常化，从而促进肥胖控制。
长期的跨学科治疗对改善影响能量平衡的厌食和摄食因子有效，可避免肥胖青少年进食障碍的发展。然而，进食障碍和神经内分泌因素之间的关联需要在未来的研究中得到证实。
