Neuroendocrine Control, Inflammation, and Psychological Aspects After Interdisciplinary Therapy in Obese Women.

Obesity is a chronic and multifactorial disease promoted by positive energy balance. The objective was to evaluate the effects of interdisciplinary therapy in the neuroendocrine control of food intake, inflammatory markers, and psychological aspects in obese women. Forty-seven obese women (43.32±5.82 years, 34.86±3.08 kg/m2), aged 30-50 years, participated in an interdisciplinary lifestyle change therapy, consisting of nutritional counseling, physical exercises, and psychological therapy for 36 weeks. After the long-term therapy, there was a decrease in body weight (Δ -5.36 kg), BMI (Δ -2.01 kg/m2), abdominal (Δ -9.09 cm), hip (Δ -5.03 cm), and thigh (Δ -5.07 cm) perimeters. There was also a significant improvement in body composition, with an increase in fat-free mass (Δ 1.60%) and reduction of body fat (Δ -3.74 kg). The therapy proposed also provided an improvement in depression scores (Δ -6.63), anxiety (Δ -4.07), body image (Δ -25.25), and binge eating (Δ -5.25). There was a significant reduction in serum levels of leptin (Δ -15.62 ng/ml). The interdisciplinary therapy was able to provide both, physical and psychological benefits in energy balance, which enables the use of this model as a feasible clinical strategy for the treatment of obesity.

Long-term interdisciplinary therapy decreases symptoms of binge eating disorder and prevalence of metabolic syndrome in adults with obesity.

Obesity-associated comorbidities greatly impact the quality and expectancy of life. Binge eating disorder (BED) is the most prevalent eating disorder and it is an important risk factor for obesity and metabolic syndrome (MetS). For these reasons, we aimed to assess the effect of an interdisciplinary therapy on the symptoms of BED and the prevalence of MetS in obese adults. It was hypothesized that the interdisciplinary therapy would decrease symptoms of BED and markers of MetS. Twenty-four volunteers (BMI 34.80±3.17 kg/m2; 41.21±6.28 years old) completed a 32-week intervention. Biochemical characteristics, body composition, the degree of symptoms of binge eating, and macronutrients, and sodium consumption pre- and post-treatment were determined. The prevalence of MetS dropped from 75% to 45.8%, post-therapy. Among the markers of MetS, waist circumference and systolic blood pressure decreased significantly, whereas high-density lipoprotein levels increased. Fasting plasma glucose, diastolic blood pressure, and triglycerides did not change. Based on binge-eating scale (BES) scores, before therapy, 33.3% of volunteers were classified as moderate bingers, and after therapy all volunteers were classified as having no BED symptoms. No difference in the prevalence of MetS between individuals classified as normal or moderate bingers was observed, but we found a positive post-therapy correlation between the BES score and body fat, gynoid fat and trunk fat. Sodium, fat, and carbohydrate consumption decreased. Protein intake did not change. In conclusion, the interdisciplinary approach was efficient in reducing symptoms of BED and MetS prevalence in this population.

Composição corporal e aptidão aeróbia de mulheres obesas: efeitos benéficos da terapia interdisciplinar / Body composition and aerobic fitness in obese women: beneficial effects of interdisciplinary therapy

Introdução: A obesidade é uma doença crônica multifatorial de proporções epidêmicas. O sedentarismo e hábitos alimentares pouco saudáveis são considerados seus principais fatores etiológicos. Estudos recentes apontam que o tratamento interdisciplinar pode promover benefícios favorecendo a perda de peso e a melhora da qualidade de vida. Objetivo: Verificar o efeito de 20 semanas de um programa de terapia interdisciplinar de mudança de estilo de vida no consumo máximo de oxigênio, na composição corporal e nos parâmetros antropométricos de mulheres adultas obesas. Metodologia: vinte e nove voluntárias do gênero feminino, com idade entre 30 e 50 anos e índice de massa corporal (IMC) entre 30 e 40 Kg/m², foram submetidas a 20 semanas da terapia interdisciplinar, composta por cinco intervenções semanais, sendo três de exercícios físicos, uma de nutrição e uma de psicologia, com duração de 60 minutos cada intervenção. Foi avaliada a composição corporal e a aptidão aeróbia através de um teste ergoespirométrico máximo. Resultados: Pós-terapia foi encontrado uma redução significativa na massa corporal (- 4,71% p<0,001), IMC (- 4,72% p<0,001) e perímetros analisados, como o perímetro abdominal (- 6,03% p<0,001). Foi verificado também uma melhora significativa na composição corporal, diminuindo a gordura corporal (- 2,2% p<0,001) e no consumo máximo de oxigênio relativo ao peso (+ 15,79% p<0,001) e absoluto (+ 10,91% p<0,001). Conclusão: Após 20 semanas, a terapia interdisciplinar apresentou efeitos benéficos em mulheres obesas o que reforça este modelo como uma estratégia viável para o tratamento da obesidade clínica, melhora da composição corporal e aptidão aeróbia.

Introduction: Obesity is a chronic multifactorial disease and it?s considered a global epidemic. Sedentary lifestyle and unhealthy eating habits are considered its main etiological factors. Recent studies indicate that interdisciplinary therapy can promote benefits favoring weight loss and improve quality of life. Aims: To investigate the effect of an interdisciplinary therapy on maximal oxygen uptake, body composition and anthropometric parameters in obese adult women. Methods: twenty-nine female volunteers, aged between 30 and 50 years and body mass index (BMI) between 30 and 40 kg/m², were enrolled at 20 week interdisciplinary therapy consisting of physical exercise sessions three times a week and nutritional and psychological intervention once a week at the Federal University of São Paulo ? UNIFESP. It was evaluated body composition and aerobic fitness (VO2max) using a maximal cardiopulmonary exercise test. Results: Post-therapy was found a significant reduction on body weight (- 4.71%, p <0.001), BMI (- 4.72%, p <0.001) and perimeters, such as the abdominal circumference (- 6.03 wt% <0.001). We also noticed a significant improvement in body composition, reducing body fat (- 2.2%, p <0.001) and maximal oxygen consumption relative to weight (+ 15.79% p <0.001) and absolute (+ 10.91% p <0.001). Conclusion: In 20 weeks, interdisciplinary therapy showed beneficial effects in obese adult women which reinforces this model as a viable strategy for the treatment of clinical obesity, body composition and aerobic fitness improvement.