The role of orexigenic and anorexigenic factors in an interdisciplinary weight loss therapy for obese adolescents with symptoms of eating disorders.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Carnier
J
J
Post Graduate Program of Nutrition, Federal University of São Paulo - Paulista Medicine School - UNIFESP, São Paulo, Brazil. junecarnier@hotmail.com
de Piano
A
A
de Lima Sanches
P
P
Tock
L
L
do Nascimento
C M O
CM
Oyama
L M
LM
Corrêa
F A
FA
Ernandes
R H
RH
Lederman
H
H
de Mello
M T
MT
Tufik
S
S
Dâmaso
A R
AR
D000293:Adolescent; D056912:Binge-Eating Disorder / Q000178:diet therapy*; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000178:diet therapy*; D002149:Energy Intake; D005260:Female; D054439:Ghrelin / Q000378:metabolism; D006801:Humans; D007028:Hypothalamic Hormones / Q000378:metabolism; D008297:Male; D008543:Melanins / Q000378:metabolism; D009478:Neuropeptide Y / Q000378:metabolism; D009765:Obesity / Q000178:diet therapy*; D010348:Patient Care Team; D026741:Physical Therapy Modalities; D010907:Pituitary Hormones / Q000378:metabolism; D015431:Weight Loss / Q000502:physiology*
D054439:Ghrelin; D007028:Hypothalamic Hormones; D008543:Melanins; D009478:Neuropeptide Y; D010907:Pituitary Hormones; C019463:melanin-concentrating hormone