The development of effective methods of obesity treatment with the goal of preventing many associated diseases is among the priorities of modern biomedical research. In 2016 glucagon-like peptide-1 analog (GLP-1) liraglutide 3 mg (Saxenda®) was approved in the Russian Federation for the treatment of obesity. This review presents literature data on the effects of GLP-1 and liraglutide on appetite and body weight as well as an analysis of the effectiveness and safety of drug Saxenda based on the results of major clinical trials.

Some studies support the involvement of vitamin D in modulating the inflammatory response and developing diabetes. Since the activation of inflammatory biomarkers, cytokines and pathways interferes with normal metabolism and disrupts proper insulin signaling and insulin resistance, it is hypothesized that vitamin D could influence lipid and glucose homeostasis by modulating inflammatory response and renin-angiotensin system. In this review discussed the mechanisms of the influence of vitamin D on metabolic disease.

Lipodystrophy syndromes form a heterogenous group of inherited or acquired rare disorders, characterized by total (generalized lipodystrophy) or partial fat loss (partial lipodystrophy), usually accompanied by different metabolic disorders. Based on etiology lipodystrophies can be inherited or acquired. As a result of a significant progress in molecular genetics 20 new genes, associated with different lipodystrophy syndromes, were discovered during the last 20 years. However according to the majority of researchers’ data mutations in these causative genes are not found in approximately half of the patients. This might mean the need for both further molecular-genetic studies and the search for autoimmune factors playing a role in lipodystrophy syndromes etiology.

The key structure in the regulation of energy homeostasis is the hypothalamus. The damage of the hypothalamic region can lead to imbalance of energy exchange with the development of obesity or cachexia. The most common metabolic disorders occur in case of craniopharyngiomas. The article presents two clinical observations of papillary craniopharyngioma in young women. Cases were accompanied by different disturbances of the energy balance, in one - with the development of obesity, in the other - cachexia.

Diabetes insipidus (DI) is a rare syndrome characterized by an excretion of abnormally large volumes of diluted urine and a corresponding increase in fluid intake. In the absence of treatment, patients with this disease experience significant difficulties due to the constant need to visit the toilet for urination and persistent thirst. Desmopressin, a synthetic analogue of the antidiuretic hormone, has been the treatment of choice for the central form of DI for many decades. Just like with any other hormone replacement therapies, the more accurately the dose is chosen for a particular patient, the better and safer the expected clinical response. In this article, we present a clinical case that demonstrates the clinical difficulties encountered in the treatment of a patient with central DI.

The presented paper is a third revision of the clinical recommendations for the treatment of morbid obesity in adults. Morbid obesity is a condition with body mass index (BMI) ≥40 kg / m2 or a BMI ≥35 kg / m2 in the presence of serious complications associated with obesity. The recommendations provide data on the prevalence of obesity, its etiology and pathogenesis, as well as on associated complications. The necessary methods for laboratory and instrumental diagnosis of obesity are described in detail. In this revision of the recommendations, the staging of prescribing conservative and surgical methods for the treatment of obesity are determined. For the first time, a group of patients with obesity and type 2 diabetes mellitus is selected, in whom metabolic surgery allows a long-term improvement in the control of glycemia or remission of diabetes mellitus.

Background: With the increasing prevalence of obesity in Iraq, an increasing trend towards better physical fitness has emerged among young adults. At the same time, an increasing number of dietary supplements is offered to improve fitness and shed the extra weight. Conjugated linoleic acid (CLA) is commonly used for such purpose.

Aim: The current study was designed to test if CLA can actually accelerate weight loss when combined with dieting and moderate exercise and to examine its effect on anthropometric measures of obesity.

Subjects & methods: Sixty young males enrolled willingly in the study and were put on a low-carbohydrate low-fat diet and moderate high intensity interval exercise (HIIT) program. Forty of them were given CLA (1000 mg/day) for 8 weeks while the remaining twenty served as control group. Body mass index (BMI), waist/hip ratio (WHR), sagittal abdominal diameter (SAD) and body adiposity index (BAI) were recorded as baseline and again after 4 and 8 weeks.

Results: The CLA-treated group showed significantly greater reduction in all four measures by the end of the study. The control group had significant but less decrease in BMI & SAD but not in WHR or BAI. The percent change difference between the first and second four weeks of the study also showed statistical difference among the two groups and for different measures. The most significant finding was that SAD dropped more rapidly during the first 4 weeks of the study indicating a preferential loss of visceral fat. Oppositely, WHR dropped during the second half of the study indicating loss of more abdominal fat stores.

Discussion: Regardless of the mode of action of CLA, its accelerative effect in weight loss is augmented by the combination with dieting and physical activity. It also corresponds to the natural body preference to losing the more metabolically active visceral fat prior to switching to the loss of subcutaneous fat. Whether or not this effect is sustainable requires further study.

Background. The phenomenon of "weight loss plateau" is not fully understood, and because of this practitioners may reasonably have difficulties in determining its truth or falsity; there is no clear boarders to identify this condition.

Aims. To generate diagnostic criteria of "weight loss plateau" phenomenon useful for estimating the rate of weight gain dynamics in the treatment of obesity.

Materials and methods. Statistical analysis of basal metabolism (BM) calculated level (the sample mean and sample standard deviation) on the basis of potential mathematically matched anthropometric data with subsequent determination of the proportion of these BM values difference in overweight and obesity patients, and numbers of the desired weight.

Results. Formation of a numeric array on theoretically inherent output, obtained the average proportion of the difference between present BM values and recommended indicators that are proposed to be guided to determine the phenomenon of "weight loss plateau" in the process of diet therapy of obesity.

Conclusions. Authors offer available for using algorithm, which allows establish the potential availability of "weight loss plateau" phenomenon and its truth or falsity on different stages of weight loss process in obesity. These arguments need further scientific dialogue and research.

Background. The role of the hormones in eating behavior in the regulation of appetite has been well studied, but their relationship with various types of eating behavior has not been established.

Aims. To study the frequency of different types of eating behavior, hunger/satiety feeling estimated by the visual analog scale and levels of leptin and gastrointestinal tract hormones that are involved in appetite regulation, fat and carbohydrate metabolism (ghrelin and glucagon-like peptide 1) in patients with diabetes mellitus type 2 and obesity.

Materials and methods. The study included 35 people with obesity (BMI>35 kg/m2) and diabetes mellitus type 2 (T2DM) who received the stable sugar-lowering therapy, the median body mass index (BMI) was 40,1 [36,5; 49,6] kg/m2, the median age was 58 [52,5; 64] years. Blood tests for insulin, leptin, ghrelin, glucagon-like peptide-1, C-peptide, glucose, glycated hemoglobin and lipids profile were done in all cases, also HOMA-IR and HOMA-β were calculated. All patients completed questionnaires determining eating behavior type and hunger/satiety feeling severity.

Results. In patients with T2DM and obesity a high frequency of combination of different types of eating behavior were found, it was 54,3%. Among the isolated types, restrictive eating behavior was more common – in 40%. In patients with different types of eating behavior the tendency to difference in the level of hormones regulating appetite was found, but it was not significant. High frequency of an appropriate reduction of postprandial ghrelin level was found in patients with restrictive type of eating behavior. Correlation between the level of hormones regulating appetite and hunger/satiety feeling was weak, it might reflect the resistance to these hormones in patients with severe obesity and T2DM. At the same time the relationship between the ghrelin level and the β-cells functional state parameters was significant.

Conclusions. The severity of leptin and ghrelin resistance correlated with each other in T2DM and obesity patients; the severity of ghrelin resistance was associated with the beta cells functional state; according to our data postprandial ghrelin level may have opposite changes in patients with T2DM and obesity and its adequate reduction is more common for patients with restrictive type of eating behavior.