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

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.

Off-label prescriptions: how to identify them, frame them, announce them and monitor them in practice?

Following the Mediator crisis and the passage of the Health and Safety Law of December 2011, off-label prescriptions are a real concern shared by all those involved in healthcare system. Off-label, in the strictest sense of the term, is defined as all prescriptions that do not correspond to the summary of product characteristics (SPC), particularly those that fail to comply with the indications and dosage regimens defined by the marketing authorization (MA) for clear safety reasons. There are various rasons for off-label prescriptions, both conscious and unconscious.

[Micronutrient deficiency in obesity].

Obesity is frequently associated with micronutrient deficiency due to unhealthy diet, lack of antioxidants and polyunsaturated fat on one side and abundance of saturated fat on the other side. The micronutrients play an important role in inflammation, metabolic syndrome and insulin resistance and could influence the weight loss. The screening of micronutrient deficiency should therefore be systematic in order to improve the management of obesity.

[The endocannabinoid system in obesity].

The endocannabinoid system is involved in the regulation of energy balance and metabolism. Endocannabinoids have central effects with raising appetite and hunger. On the other hand, different components of the endocannabinoid system are also found in peripheral organs and tissues and they could impact the lipid and glucose metabolism.

Effect of obesity on growth-related oncogene factor-alpha, thrombopoietin, and tissue inhibitor metalloproteinase-1 serum levels.

We have recently identified several adipokines as oversecreted by omental adipose tissue (AT) of obese subjects: two chemokines (growth-related oncogene factor-alpha (GRO-alpha), macrophage inflammatory protein-1 beta (MIP-1 beta)), a tissue inhibitor of metalloproteinases-1 (TIMP-1), an interleukin-7 (IL-7) and a megakaryocytic growth-factor (thrombopoietin (TPO)). These adipokines are involved in insulin resistance and atherosclerosis. The objectives of this study were to determine whether the circulating levels of these adipokines were increased in obesity and to identify the responsible factors.

[Gut microbiota, responsible for our body weight?].

Obesity is a multifactorial disease and often considered as an imbalance between energy intake and energy expenditure. However, the gut microbiota could have an impact on the development of excess body weight. According to the type of diet, this black box of the bowel could contribute to modifications of both the caloric extraction and the energy expenditure.