Obese adolescents with eating disorders: Analysis of metabolic and inflammatory states

Objective: 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.Methods: 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.Results: 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.Conclusion: 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. (C) 2011 Elsevier Inc. All rights reserved.AFIPCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CEMSAUNIFESPFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Posgrad Program Nutr, São Paulo, BrazilDept Physiol, São Paulo, BrazilAssoc Found Incent Res, São Paulo, BrazilDept Psychobiol, São Paulo, BrazilDept Biosci, São Paulo, BrazilPosgrad Program Interdisciplinary Hlth Sci, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, São Paulo, BrazilUniversidade Federal de São Paulo, UNIFESP, São Paulo, BrazilFAPESP: 9814302-3FAPESP: 2006/00684-3FAPESP: 2008/53069-0FAPESP: 2011/50356-0Web of Scienc