Dynamics of serotonin levels and management of eating disorders during of medical rehabilitation
Patients and methods. We examined 42 women with primary obesity, who earlier did not receive medication therapy (mean age 38.4 ± 2.0 y., body mass index (BMI) 27–43 kg/m2). These patients comprised two treatment groups: the treatment course in group 1 (n = 20) consisted in administration of 15 sessions of reflex therapy (RT), low-calorie diet (3360–4602 kJ (800–1100 kcal) per day) in combination with physical exercise and subsequent one-day fast once a week. The treatment course
in group 2 (n = 22) was the same but did not include RT. RT consisted of everyday corporeal and auricular acupuncture, superficial needling by the scheme 11 II, 36III, 7V, 41XI, 60VII; 34, 25, 22, 18, 55. The control group consisted of 12 practically healthy women with normal BMI. In patients of all groups blood serum serotonin levels were tested, Spielberger’s test was performed to assess the levels of reactive and personal anxiety, Beck’s test to assess depressive reaction, DEBQ test was used
to assess the type of eating disorder.
Results. In groups 1 and 2, a significantly lower serum serotonin value was noted in the aggregate as compared with control – 173.3 ± 60.8 and 223.9 ± 90.4 ng/ml, respectively (р < 0.05). In group 1 a significant decrease of anthropometric parameters was noted after a 2-week course of RT: BMI from 33.7 ± 4.5 to 29.2 ± 4.05 kg/m2 (р = 0.002); WC from 88.7 ± 6.86 to 82.2 ± 6.51 cm (р = 0.004); HC – from 111.8 ± 8.81 cm to 103.5 ± 8.38 cm (р = 0.004). The patients’ body weight decreased on average by 9.8% (р = 0.013). WC has been found to correlate with HC (r = 0.68; р = 0.011) and BMI
(r = 0.77; р = 0.02). A statistically significant increase of serum serotonin levels by 69.5% as compared with baseline has been obtained (р = 0.0057) and statistically significant correlations between BMI and serum serotonin concentrations (r = –0.23; р = 0.04), between HC and serotonin (r = –0.37; р = 0.032). In group 2, against the background of therapy, a statistically significant difference has also been obtained in BMI: decrease from 33.9 ± 4.2 to 31.2 ± 4.4 kg/m2 (р = 0.043), WC – decrease from 88.4 ± 6.9 to 82.3 ± 6.53 cm (р = 0.0044) and a statistically insignificant decrease of HC from 112.0 ± 8.86 cm to 108.4 ± 8.62 cm (р = 0.18). Body weight decreased on average by 7.4% (p = 0.051). As has been found, WC in this group also correlated with BMI (r = 0.72; р = 0.04). A tendency of serum serotonin levels in patients of this group to increase by 34.4% from baseline was found (р = 0.031). In group 1, normal level of eating behaviour was established in 55% of patients (in group 2 – in 9%), mixed type – in 25% of patients (in group 2 practically without dynamics as compared with findings of baseline examination – 55%), restrained – in 10% (in group 2 – in 22%), external – 5% (in group 2 – in 9%), the emotional type of eating disorder was observed by two time less frequently than before the course of medical rehabilitation and with equal frequency in both groups – 5%.
Conclusions. We have found initially low serum serotonin levels in obese patients. Diet therapy in combination with RT using auricular and corporeal acupoints has resulted in a marked increase of serum serotonin levels, which leads to decrease of appetite and permits patients to significantly easier adhere to a low-calorie diet.
Key words: medical rehabilitation, obesity, eating behaviour, reflector therapy, serotonin.
For citation: Kurnikova I.А., Nikishova Т.V. Dynamics of serotonin levels and management of eating disorders during of medical rehabilitation. Vopr. dietol. (Nutrition). 2018; 8(2): 16–21. (In Russian).