Effects of a Weight Loss Program on Metabolic Syndrome, Eating Disorders and Psychological Outcomes: Mediation by Endocannabinoids?

Obes Facts. 2018;11(2):144-156. doi: 10.1159/000487890. Epub 2018 Apr 10.

Abstract

Objective: To evaluate the effects of weight loss on endocannabinoids, cardiometabolic and psychological parameters, eating disorders (ED) as well as quality of life (QoL) and to elucidate the role of endocannabinoids in metabolic syndrome (MS).

Methods: In total, 114 patients with obesity were prospectively included in a 12-month weight loss program. Plasma endocannabinoids were measured by mass spectrometry; ED, psychological and QoL-related parameters were evaluated by self-reported questionnaires; physical activity was measured by accelerometer. Nutritional assessment was done by a 3-day food diary.

Results: Among completers (n = 87), body weight decreased in 35 patients (-9.1 ± 8.6 kg), remained stable in 39 patients, and increased in 13 patients (+5.8 ± 3.4 kg). 75% of patients with MS at baseline were free of MS at follow-up, and their baseline plasma N-palmitoylethanolamide (PEA) values were significantly lower when compared to patients with persisting MS. At baseline, there was a positive relationship between PEA and waist circumference (p = 0.005, R2 = 0.08), fasting glucose (p < 0.0001, R2 = 0.12), total cholesterol (p = 0.001, R2 = 0.11), triglycerides (p = 0.001, R2 = 0.11), LDL-cholesterol (p = 0.03, R2 = 0.05) as well as depression score (p = 0.002, R2 = 0.29).

Conclusion: Plasma PEA might play a role in metabolic improvement after weight loss. Even in subjects without weight loss, a multidisciplinary intervention improves psychological outcomes, ED, and QoL.

Keywords: Eating disorders; Endocannabinoids; Metabolic syndrome; Patient education; Quality of life; Weight loss.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • Body Weight / physiology
  • Endocannabinoids / blood
  • Endocannabinoids / physiology*
  • Exercise / physiology
  • Exercise / psychology
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / psychology
  • Feeding and Eating Disorders / therapy*
  • Female
  • Humans
  • Male
  • Mental Health / statistics & numerical data
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / psychology
  • Metabolic Syndrome / therapy*
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology
  • Obesity / psychology*
  • Obesity / therapy*
  • Overweight / complications
  • Overweight / epidemiology
  • Overweight / psychology
  • Overweight / therapy
  • Quality of Life
  • Surveys and Questionnaires
  • Treatment Outcome
  • Waist Circumference
  • Weight Loss / physiology
  • Weight Reduction Programs* / statistics & numerical data

Substances

  • Endocannabinoids