Post Graduate Program of Nutrition, São Paulo, Brazil.
Physiol Behav. 2012 Jan 18;105(2):175-80. doi: 10.1016/j.physbeh.2011.08.014. Epub 2011 Aug 17.
The purpose of the present investigation was to compare the effect of interdisciplinary therapy on the physical and metabolic profiles, including body composition, insulin resistance and sensitivity as well as adiponectin and leptin concentrations, of obese adolescents with and without eating disorder symptoms.
A total of 83 obese adolescents (28 with and 55 without eating disorder symptoms) were enrolled for 1 year of interdisciplinary weight-loss therapy (clinical, nutritional, exercise, physiotherapy and psychological). Bulimic and binge eating symptoms were measured by the Bulimic Investigatory Test, Edinburgh, and the Binge Eating Scale, respectively. Leptin and adiponectin concentrations were measured with enzyme-linked immunosorbent assay kits. Visceral and subcutaneous fat were assessed by ultrasonography.
Both groups demonstrated improved body mass, body mass index, body fat (%), lean mass, visceral fat, subcutaneous fat, homeostasis model assessment insulin-resistance index (HOMA-IR), quantitative insulin sensitivity check index, total cholesterol, LDL-cholesterol, VLDL, triglycerides, adiponectin and leptin concentrations after therapy. We found a positive correlation between leptin concentrations and subcutaneous fat in the control group and a negative correlation between adiponectin concentrations and HOMA-IR and fat mass (%). The prevalence of obese adolescents with eating disorders was reduced by 89% after 1 year of interdisciplinary therapy.
The eating disorder symptoms did not impair the metabolic state during weight loss therapy of obese adolescents. Additionally, long-term interdisciplinary therapy was effective in reducing the chances of developing several co-morbidities in both groups.
本研究旨在比较跨学科治疗对肥胖青少年身体和代谢特征的影响，包括身体成分、胰岛素抵抗和敏感性以及脂联素和瘦素浓度，这些青少年中有些有饮食障碍症状，有些则没有。
共有 83 名肥胖青少年（28 名有饮食障碍症状，55 名无饮食障碍症状）接受了为期 1 年的跨学科减肥治疗（临床、营养、运动、物理治疗和心理治疗）。采用暴食调查测试（Bulimic Investigatory Test, Edinburgh）和暴食量表（Binge Eating Scale）评估贪食和暴食症状。采用酶联免疫吸附试验试剂盒检测瘦素和脂联素浓度。采用超声检查评估内脏和皮下脂肪。
两组治疗后体重、体重指数、体脂肪（%）、瘦体重、内脏脂肪、皮下脂肪、稳态模型评估胰岛素抵抗指数（HOMA-IR）、定量胰岛素敏感性检查指数、总胆固醇、LDL-胆固醇、VLDL、甘油三酯、脂联素和瘦素浓度均有所改善。我们发现对照组瘦素浓度与皮下脂肪呈正相关，脂联素浓度与 HOMA-IR 和脂肪量（%）呈负相关。经过 1 年的跨学科治疗，肥胖青少年中饮食障碍的患病率降低了 89%。
在肥胖青少年的减肥治疗中，饮食障碍症状并没有损害其代谢状态。此外，长期的跨学科治疗对减少两组中多种共病的发生机会是有效的。
