Links between body mass index, total body fat, cholesterol, high-density lipoprotein, and insulin sensitivity in patients with obesity related to depression, anger, and anxiety.
OBJECTIVE
Define links between psychosocial parameters and metabolic variables in obese females before and after a low-calorie diet.


METHODS
Nine female obese patients (age 36.1 +/- 7.1 years, body mass index [BMI] > 30 kg/m2) were investigated before and after a 6-week low-calorie diet accompanied by behavior therapy. Blood lipids, insulin sensitivity (Bergman protocol), fat distribution (by dual-energy X-ray absorptiometry [DEXA]), as well as psychological parameters such as depression, anger, anxiety, symptom load, and well-being, were assessed before and after the dieting period.


RESULTS
The females lost 9.6 +/- 2.8 kg (p < .0001) of body weight, their BMI was reduced by 3.5 +/- 0.3 kg/m2 (p < .0001), and insulin sensitivity increased from 3.0 +/- 1.8 to 4.3 +/- 1.5 mg/kg (p = .05). Their abdominal fat content decreased from 22.3 +/- 5.5 to 18.9 +/- 4.5 kg (p < .0001). In parallel, psychological parameters such as irritability (p < .05) and cognitive control (p < .0001) increased, whereas feelings of hunger (p < .05), externality (p < .05), interpersonal sensitivity (p < .01), paranoid ideation (p < .05), psychoticism (p < .01), and global severity index (p < .01) decreased. Prospectively, differences in body fat (percent) were correlated to nervousness (p < .05). Waist-to-hip ratio (WHR) differences were significantly correlated to sociability (p < .05) and inversely to emotional instability (p < .05), whereas emotional instability was inversely correlated to differences in insulin sensitivity (p < .01).


CONCLUSIONS
Weight reduction may lead to better somatic risk factor control. Women with more nervousness and better sociability at the beginning of a diet period may lose more weight than others.
Psychiatric Outpatient Clinic University of Berne, Inselspital, CH-3010 Bern, Switzerland. laederach@insel.ch
Kurt
K
Laederach-Hofmann
Susanne
S
Kupferschmid
Lutz
L
Mussgay
D000273:Adipose Tissue / Q000378:metabolism*; D000328:Adult; D000786:Anger; D001008:Anxiety Disorders / Q000523:psychology*; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D002149:Energy Intake; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000453:epidemiology; D007398:Interpersonal Relations; D008075:Lipoproteins, HDL / Q000097:blood*; D009765:Obesity / Q000209:etiology* / Q000378:metabolism* / Q000628:therapy; D010551:Personality; D011446:Prospective Studies; D012919:Social Behavior; D011795:Surveys and Questionnaires
D008075:Lipoproteins, HDL; D002784:Cholesterol