Eine prospektive, kontrollierte Studie zur Wirksamkeit einer komplementären Adipositastherapie

Aktuelle Studien zeichnen ein alarmierendes Bild in Bezug auf Übergewicht und Adipositas der deutschen Bevölkerung. Neben den individuellen Belastungen für jeden Einzelnen sind auch die ökonomischen Auswirkungen auf das Gesundheitssystem als Ganzes signifikant. Adipositas hat sich in den letzten Ja...

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Bibliographic Details
Main Author: Louis, Janina Kristin
Contributors: Tebbe, J.J. (PD Dr. med.) (Thesis advisor)
Format: Doctoral Thesis
Language:German
Published: Philipps-Universität Marburg 2010
Subjects:
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Current studies draw an alarming picture concerning the overweight and obese trends within the German population. The impact for each individual as well as the economic effects on the health system as a whole, are significant. In recent year obesity has developed to become a serious illness and developing effective forms of therapy is more important than ever. Evidence- based drugs used in obesity therapy, whose active mechanisms have been demonstrated in many studies, are facing a steadily growing competitive pressure from complementary obesity therapies. This area of the market is constantly flooded by new promising drugs and diets. While a demonstrable effect of these therapies is often missing, the therapy costs for patients remain surprisingly high. The aim of this study was to examine the active mechanism of a complementary obesity therapy. Therefore CM3-Alginat ® (alginate based) and Matricur ® (collagen based), two weight-loss supplements, were selected. The manufacturers claim, that satiation is reached by a volume expansion within the stomach. They are purported to induce a prolonged feeling of satiation and a delay in gastric emptying, thus promoting weight loss. In the scope of our prospectively designed study was the products’ effect on the stomach motility, the regulation of neuropeptides as well as the subjective feeling of satiation. Twenty healthy test subjects were examined over a seven hour period on each of three days in randomized order. The test subjects (F/M=1; 20-30 years) received a standardised test meal after 10-hours of fasting. They received no treatment as the control on day 1, the weight-loss supplement Matricur ® on day 2 and the weight-loss supplement CM3-Alginat® on day 3. One possible effect on the stomach motility was examined using the individual gastric emptying time. The data of the gastric emptying kinetics were collected using the C13 octanoic acid breath test. The results of this study demonstrate a significant increase of the gastric emptying time after consumption of the weight-loss supplement. Simultaneously a short-term, reinforcing influence on the subjective satiation feeling was recognized. The hypothesis of participation of the endogenous, neuropeptides in these effects was examined by the concentration of the plasma peptides CART and Ghrelin. The data of the CART and Ghrelin concentration were generated with a commercial radioimmunoassay. The results demonstrate that both weight-loss supplements lead to a significant decrease in the postprandial Ghrelin levels. No significant influence could be found on the plasma concentration of CART. The subjective satiety level was documented using a visual analogous scale (VAS). The consumption of Matricur ® and CM3-Alginat ® significantly prolonged the subjective feeling of satiation. However, hints for a presatiation or an increase of the satiation level (feeling of being “fuller”), both effects claimed by the manufacturers, could not be demonstrated by the study data. The aim of this study was to examine the active mechanism of a complementary obesity therapy. The results demonstrate that using these weight loss supplements lead to a prolonged feeling of satiation. This coincides with the manufacturers’ statement. This along with a lower Ghrelin level indicates that the weight loss supplements have an impact on the endogenous regulation of neuropeptides. This is contrary to the manufacturers’ claim, that satiation is reached by a volume expansion within the stomach only. The active mechanisms of the weight loss supplements haven’t been demonstrated in many studies yet. But the results of this study coincide with other studies, indicating that lowering of Ghrelin levels lead to a decrease in appetite and are correlated with a reduction of the gastric emptying time. Further studies are required to examine the long term effect of the weight-loss supplements on obese adults, before these products can be recommended in the treatment of obesity. The development of a controlled Adiposis management program could lead to a long term relief of the health and social systems in Germany.