RESUMO
BACKGROUND/OBJECTIVES: It is well established that combining a reduced calorie, low-fat diet with the lipase inhibitor orlistat results in significantly greater weight loss than placebo plus diet. This weight loss is accompanied by changes in adipose tissue (AT) distribution. As 60 mg orlistat is now available as an over-the-counter medication, the primary objective of this study was to determine whether 60 mg orlistat is effective as a weight loss option in a free-living community population with minimal professional input. METHODS: AT and ectopic lipid content were measured using magnetic resonance imaging and (1)H MR spectroscopy, respectively, in 27 subjects following 3 months treatment with orlistat 60 mg and a reduced calorie, low-fat diet. RESULTS: Significant reductions in intra-abdominal AT (-10.6%, P=0.023), subcutaneous (-11.7% P<0.0001) and pericardial fat (-9.8%, P=0.034) volumes and intrahepatocellular lipids (-43.3%, P=0.0003) were observed. These changes in body fat content and distribution were accompanied by improvements in plasma lipids and decreases in blood pressure and heart rate. CONCLUSION: These findings suggest that over-the-counter 60 mg orlistat, in combination with the type of advice a subject could expect to be given when obtaining 60 mg orlistat in a community setting, does indeed result in potentially clinically beneficial changes in body composition and risk factors for metabolic diseases.
Assuntos
Fármacos Antiobesidade/uso terapêutico , Inibidores Enzimáticos/uso terapêutico , Lactonas/uso terapêutico , Lipase/antagonistas & inibidores , Medicamentos sem Prescrição/uso terapêutico , Obesidade Abdominal/tratamento farmacológico , Gordura Abdominal/efeitos dos fármacos , Gordura Abdominal/patologia , Adiposidade/efeitos dos fármacos , Adulto , Fármacos Antiobesidade/administração & dosagem , Índice de Massa Corporal , Terapia Combinada , Dieta com Restrição de Gorduras , Inibidores Enzimáticos/administração & dosagem , Feminino , Humanos , Lactonas/administração & dosagem , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipídeos/sangue , Fígado/metabolismo , Masculino , Pessoa de Meia-Idade , Medicamentos sem Prescrição/administração & dosagem , Obesidade Abdominal/sangue , Obesidade Abdominal/dietoterapia , Obesidade Abdominal/patologia , Orlistate , Sobrepeso/sangue , Sobrepeso/dietoterapia , Sobrepeso/tratamento farmacológico , Sobrepeso/patologia , Redução de Peso/efeitos dos fármacos , Adulto JovemRESUMO
Self-complexity, a measure of the structure of cognition involving the self, was used to predict the persistence of depression in patients diagnosed with major depression. Self-descriptions offered by depressed patients were analyzed using a clustering algorithm to model cognitive structure. Indices of positive and negative self-complexity, derived from the resulting models, were used to predict depressive symptomatology 9 months after the onset of a major depression. Negative self-complexity uniquely predicted subsequent levels of depression even after the effects of initial levels of depression, self-evaluation, and dysfunctional attitudes were statistically removed. Highly complex negative self-representation appears to be associated with poor recovery from a major depressive episode. Future studies examining the relationship between cognition and psychopathology should investigate, in addition to its content, the formal and structural properties of cognition.
