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(19) OXYTOCIN AND EMOTIONAL DYSREGULATION IN OBESE PATIENTS: A PILOT STUDY


Authors:

Rossella Tozzi, MD – Fellow, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Carla Lubrano, MD, PhD – Professor, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Stefania Mariani, MD – Medical Doctor, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Sabrina Basciani, Dr. – Researcher, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Alessandra Caputi, MD – Fellow, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Elena Gangitano, MD – Resident, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Lucio Gnessi, MD, PhD – Full Professor, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Daniela Costantini, MD – Fellow, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Mikiko Watanabe, MD – PhD student, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Francesca De Giorgi, MD – Fellow, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy

Abstract:

Objective :

Oxytocin (OXT) is a neuropeptide known for its peripheral effects, mainly connected to childbirth and lactation. In the last years there have been increased evidences for its involvement in social behavior, emotional functioning, regulation of food intake and induction of weight loss. Obesity can associate to social and emotional dysregulation. The aim of this study was to evaluate the possible relationship between serum OXT, emotive dysregulation and weight loss in a population of obese patients.

Methods :

Patients were recruited among subjects referring to the High Specialization Center for the Care of Obesity, Dept. of Experimental Medicine, Sapienza University of Rome. We enrolled 57 adult obese patients, evaluated by biochemical exams, antropometric measurements, body composition (DEXA), serum OXT (ELISA) and 3 psycometric tests: RAADS-R (Ritvo Autism and Asperger Diagnostic Scale Revised), BUT (Body Uneasiness Test) with Global Severity Index (GSI) and TAS 20 (Toronto Alexithymia Scale 20). Then a dietary intervention with very low kilojoule diet for 90 days was performed.

Results :

Circulating levels of OXT correlated with BMI and fat mass and were predictors of weight loss. 29 patients had pathological BUT (traits of corporeal dysmorphia); 17 pathological RAADS (autistic traits); 19 pathological TAS 20 (traits of alexithymia); 7 alterations in all of them. BUT-GSI correlated with OXT levels and weight loss.

Discussion :

The higher was the fat mass and the BMI, the higher was the OXT serum concentration, reflecting the OXT production in the fat tissue. OXT level correlated with weight loss, and it is consistent with the literature (oxytocin is tested as a potential therapy for obesity). In our study the incidence of psychological disturbances, especially dysmorphophobia (part of obsessive-compulsive disorder, OCD), was high (51%), and OXT level increased with the grade of psychological distress. This data are in contrast with the concept of OXT as the well-being hormone, but other recent studies already speculated a correlation with emotional behavior typical of caring and OCD. The association between BUT-GSI and weight loss can suggest that in obese patients dysmorphophobia traits could help the weight loss, probably thanks to the rituals and the pathological attention of OCD.

Conclusion :

OXT serum levels are good predictors of weight loss and are related to alterations of the body image. Patients with dysmorphophobia traits had bigger weight loss, probably for strict adherence to the therapy.The results of this pylot study seem to be interesting, but need to be confirmed with case-control study with a larger number of patients.

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