Is obesity a risk factor for psychopathology among adolescents?

BACKGROUND: Although several studies have documented the existence of psychopathology in obese adolescents, disagreement remains regarding the extent and nature of this psychopathology. The aim of the present study was to explore the type and frequency of psychopathology in a clinical as well as a non-clinical sample of obese adolescents, and in a normal weight control group. METHODS: The study sample consisted of a clinical study group of 30 obese adolescents, a non-clinical obese group of 30 obese adolescents, and a control group of 30 normal weight adolescents. Psychological assessment was performed using a non-structured psychiatric interview, the Child Behavior Checklist (CBCL), Children Depression Inventory (CDI), Rosenberg Self-esteem scale (SES) and the Eating Attitude Test (EAT). RESULTS: More than half of the clinical obese adolescents (16/30) had a DSM-IV diagnosis, often involving major depressive disorder (n = 10). The mean scores of anxiety-depression, social problems, social withdrawal and total problem in the CBCL scale of the clinical obese group were significantly higher than the non-clinical obese group and the normal weight control group. The mean total scores of the SES and the CDI of the clinical obese group were higher than the normal weight control group. The mean total score of EAT of the clinical obese group was significantly higher than the normal weight control group, and the mean score of EAT of the non-clinical obese group was significantly higher than the normal weight control group. CONCLUSIONS: The results support previously published reports which show a higher ratio of psychopathology (depression, behavioral problems, low-esteem) among clinical obese adolescents than among non-clinical obese adolescents. Findings provided evidence for a psychosocial at-risk population in a subgroup of obese adolescents.     

Leptin and Its Emerging Role in Children and Adolescents

Leptin is an adipocyte-secreted hormone which plays a key role in energy homeostasis. Recent “proof of concept” studies involving leptin administration to humans support its critical role in regulating energy homeostasis, neuroendocrine and immune function as well as insulin resistance in states of energy/ caloric deprivation. Moreover, interventional studies in leptin deficient children and observational studies in normal girls and boys support a role for leptin as a permissive factor for the initiation of puberty in children. The potential clinical usefulness of leptin in several disease states in children and adolescents, including hypothalamic amenorrhea, eating disorders and syndromes of insulin resistance is still under investigation.     

A Review on Rhubarb-Derived Substances as Modulators of Cardiovascular Risk Factors—A Special Emphasis on Anti-Obesity Action

The currently available anti-obesity therapies encounter many associated risks and side effects often causing the ineffectiveness of treatment. Therefore, various plant-derived substances have been extensively studied as a promising support or even an alternative for existing anti-obesity therapies. This review is dealing with the anti-obesity potential of edible and ethnomedicinal rhubarb species and emerging possible role of the rhubarb-derived extracts or individual compounds in the prevention of obesity and perspectives for their use in an anti-obesity treatment. A special emphasis is put on the most popular edible specimens, i.e., Rheum rhabarbarum L. (garden rhubarb) and Rheum rhaponticum L. (rhapontic rhubarb, Siberian rhubarb); however, the anti-obesity potential of other rhubarb species (e.g., R. officinale, R. palmatum, and R. emodi) is presented as well. The significance of rhubarb-derived extracts and low-molecular specialized rhubarb metabolites of diversified chemical background, e.g., anthraquinones and stilbenes, as potential modulators of human metabolism is highlighted, including the context of cardiovascular disease prevention. The available reports present multiple encouraging rhubarb properties starting from the anti-lipidemic action of rhubarb fibre or its use as purgative medicines, through various actions of rhubarb-derived extracts and their individual compounds: inhibition of enzymes of cholesterol and lipid metabolism, targeting of key molecular regulators of adipogenesis, regulators of cell energy metabolism, the ability to inhibit pro-inflammatory signalling pathways and to regulate glucose and lipid homeostasis contributing to overall in vivo and clinical anti-obesity effects.     

Comparing Digital Therapeutic Intervention with an Intensive Obesity Management Program: Randomized Controlled Trial

In this study, we evaluated whether the digital program Vitadio achieves comparable results to those of an intensive in-person lifestyle intervention in obesity management. This is a 12-month prospective, randomized controlled trial. Obese patients with insulin resistance, prediabetes or type 2 diabetes were included. The intervention group (IG) used Vitadio. The control group (CG) received a series of in-person consultations. Body weight and various metabolic parameters were observed and analyzed with ANOVA. The trial is ongoing and the presented findings are preliminary. Among 100 participants (29% men; mean age, 43 years; mean BMI, 40.1 kg/m²), 78 completed 3-month follow-up, and 51 have completed the 6-month follow-up so far. Participants significantly (p < 0.01) reduced body weight at 3 months (IG: −5.9 ± 5.0%; CG: −4.2 ± 5.0%) and 6 months (IG: −6.6±6.1%; CG: −7.1 ± 7.1%), and the difference between groups was not significant. The IG achieved favorable change in body composition; significant improvement in TAG (−0.6 ± 0.9 mmol/l, p < 0.01), HDL (0.1 ± 0.1%, p < 0.05), HbA1c (−0.2 ± 0.5%, p < 0.05) and FG (−0.5 ± 1.5 mmol/l, p < 0.05); and a superior (p = 0.02) HOMA-IR reduction (−2.5 ± 5.2, p < 0.01). The digital intervention achieved comparable results to those of the intensive obesity management program. The results suggest that Vitadio is an effective tool for supporting patients in obesity management and diabetes prevention.     

穴位埋线疗法治疗单纯陛肥胖症有效性的系统评价

目的：系统评价穴位埋线疗法对单纯性肥胖症的治疗效果。方法：计算机检索中国知网（CNKI）、万方数据资源系统、中国生物医学文献数据库中关于穴位埋线疗法对单纯性肥胖症效果的随机对照试验,用ladad质量计分法对纳入研究的质量进行评价,结局指标采用ReviewManage5．1软件分析。结果：最终纳入16．g随机对照试验文献。Meta分析结果显示,穴位埋线治疗单纯性肥胖症总有效率与对照组相比,差异有统计学意义[OR=2．51,95％可信区间（1．74,3．63）,Z=4．91,P〈0．000011;文献质量评价显示,仅1篇文献得3分,其余15篇文献得分≤2分,文献质量普遍较低,发表存在偏倚,且对盲法、退出失访及随访的追踪报道过少;统计治疗选穴共有27个穴位,以天枢、中脘、丰隆、水分、阿是穴、大横等穴为主。结论：穴位埋线治疗单纯性肥胖症疗效肯定,但其临床有效性尚缺乏充分证据,因此．还需进一步临床研究才能为今后临床决策提供可靠依据。