Psychosomatic aspects of obesity as a risk factor of metabolic syndrome

Aim. To investigate the role of obesity (O), as a psychopathological disorder, in metabolic syndrome (MS) development; to assess the effectiveness of psychotherapeutist’s participation in MS prevention and treatment. Material and methods. The presence and stage of O was assessed by body mass index (BMI). The study included 3 groups: Group I – patients with bulimia nervosa and O (n=64), including individuals with cardiovascular disease, CVD (n=12); Group II – patients with CVD, but without O or psychopathology (n=28); Group III – patients with CVD and with or without O, MS, and diabetes mellitus, DM (n=78). Group III was divided into 4 subgroups by symptom severity. In Groups I and II, psychological profile was assessed by clinical interview and MMPI test; in Group III, all MS components were measured, including lipid and glucose metabolism parameters. Results. In Groups I and II, CVD patients, regardless of concomitant O, had similar MMPI profiles, with maximal scores for scale 1 (hypochondria), which was different from the profile of bulimic patients in Group I. In Group II, in contrast to Group I and CVD subgroup, a tendency towards weight reduction in more advanced age was observed. The same tendency was also observed in 3 subgroups of Group III, being the strongest in the subgroup with the most severe symptoms (MS and DM). In all 4 subgroups of Group III O as a specific MS component, preceding the other MS symptoms, but independent from them in the case of developed MS. Conclusion. The only effective method for MS prevention is psychotherapeutic diagnostics and treatment of O at the stage preceding the development of metabolic disturbances. In the treatment of MS patients, the role of psychotherapeutist is complementary, being aimed at weight reduction by treating eating disorders.

1. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among U.S. adults: findings from the Third National Health and Nutrition Examination Survey. JAMA 2002; 287: 356-9.

2. Robinson TM. Save the world, prevent obesity: Piggybacking on existing social and ideological movements. Obesity 2010; 18: S17-22.

3. Park Y, Zhu S, Palaniappan L, et al. The metabolic syndrome prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2003; 163: 427-36.

4. Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: A joint interim statement of the Of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Association; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640-5.

5. Brown S, Inskip H, Barraclough B. Causes of the excess mortality of schizophrenia. Br J Psychiatry 2000; 177: 212-7.

6. Osby U, Correia N, Brandt L, et al. Mortality and causes of death in schizophrenia in Stockholm County, Sweden. Schizophr Res 2000; 45: 21-8.

7. Heiskanen T, Niskanen L, Lyytikainen R, et al. Metabolic syndrome in patients with schizophrenia. J Clin Psychiatry 2003; 64: 575-9.

8. Kinder LS, Carnethon MR, Palaniappan LP, et al. Depression and the metabolic syndrome in Young Adults: Findings from the Third National Health and Nutrition Survey. Psychosom Med 2004; 66: 316-22.

9. McCaffery JM, Niaura R, Todaro JF, et al. Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute Twin Study. Psychosom Med 2003; 65: 490-7.

10. Bermudes RA, Keck PE, Welge JA. The prevalence of the metabolic syndrome in psychiatric inpatients with primary psychotic and mood disorders. Psychosimatics 2006; 47: 491-7.

11. Goldbacher EM, Bromberger J, Matthews KA. Lifetime history of major depression predicts the development of the metabolic syndrome in moddle-aged women. Psychosom Med 2009; 71: 266-72.

12. Guerdjikova AI, McElroy SL, Kotwal R, Keck PE. Comparison of obese men and women with binge eating disorder seeking weight management. Eat Weight Disord 2007; 12: e19-23.

13. Roehrig M, Masheb RM, White MA, Grilo CM. The metabolic syndrome and behavioral correlates in obese patients with binge eating disorder. Obesity 2009; 17: 481-6.

14. Zhy S, St-Onge M-P, Heshka S, Heymsfield SB. Lifestyle behaviors associated with lower risk of having the metabolic syndrome. Metabolism Clinical and Experimental 2004; 53: 1503-11.

15. Бутрова С.А. Современные возможности и перспективы терапии метаболического синдрома. Трудный пациент 2007; 5: 31-4.

16. Bosello O, Zamboni M. Visceral obesity and metabolic syndrome. Obes Rev 2000; 1: 47-57.

17. Сидоренко Е.В. Методы математической обработки в психологии. СПб: Речь 2007; 350 с.

18. Cameron AJ, Bojko EJ, Sicree RA, et al. Central obesity as precursor to the metabolic syndrome in the AusDiab Study and Mauritius. Obesity 2008; 16: 2707-16.

19. Mohammed BS, Cohen S, Reads D, et al. Long-term effects of large-volume liposuction on metabolic risk factors for coronary heart disease. Obesity 2008; 16: 2648-51.