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Eating Behavior and Psychopathology in Non-HIV Lipodystrophic Patients

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Hidden and Lesser-known Disordered Eating Behaviors in Medical and Psychiatric Conditions

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Abstract

Lipodystrophic disorders are a heterogeneous group of rare syndromes characterized by an abnormal physical appearance, due to a generalized or partial loss of subcutaneous adipose tissue. Due to the reduction of physiological sites of energy stores, triglycerides of exogenous and endogenous origin are accumulated in ectopic organs such as the liver, skeletal muscle, heart, kidneys, and pancreas, predisposing to the development of insulin resistance and its complications: diabetes mellitus, dyslipidemia, hepatosteatosis, acanthosis nigricans, and polycystic ovary syndrome.

Leptin is a hormone produced only by the adipose tissue, and in lipodystrophic patients there is a characteristic state of hypoleptinemia, which can be mild (as in some partial forms) or complete (as in generalized forms). Leptin is a fundamental hormone in the regulation of hunger, and hypoleptinemia is responsible for hyperphagia that characterizes the more severe forms of lipodystrophy.

Recently there has been a renewed interest in the study of psychiatric comorbidities in affected patients: lipodystrophic patients have an increased prevalence of mood, anxiety, pain, and eating disorders that must be effectively researched and treated. Indeed, both the European and American guidelines recommend the assessment of the psychopathological profile of lipodystrophic patients, to refer them to mental health professional for psychiatric and psychological support, if needed. Evaluating psychological distress, even when mild, appears to be very important, and improving it can indeed impact positively on the other comorbidities. Hypoleptinemia is likely an important driver for food craving and an important player in the pathogenesis of depression in lipodystrophic patients.

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Authors and Affiliations

  1. Obesity and Lipodystrophy Center, Endocrinology Unit, University Hospital of Pisa, Pisa, Italy

    Federica Ferrari, Pasquale Fabio Calabrò, Giovanni Ceccarini & Ferruccio Santini

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  1. Federica Ferrari
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  2. Pasquale Fabio Calabrò
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  3. Giovanni Ceccarini
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  4. Ferruccio Santini
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Correspondence to Ferruccio Santini .

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Editors and Affiliations

  1. Private Hospital "Salus" of Ferrara, University of Ferrara, Ferrara, Italy

    Emilia Manzato

  2. Formerly Sapienza University of Rome, Founding Editor of Eating and Weight Disorders, Campiglia Marittima, Livorno, Italy

    Massimo Cuzzolaro

  3. Experimental Medicine Department, Sapienza University of Rome, Editor-in-Chief of Eating and Weight Disorders, Roma, Roma, Italy

    Lorenzo Maria Donini

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Ferrari, F., Calabrò, P.F., Ceccarini, G., Santini, F. (2022). Eating Behavior and Psychopathology in Non-HIV Lipodystrophic Patients. In: Manzato, E., Cuzzolaro, M., Donini, L.M. (eds) Hidden and Lesser-known Disordered Eating Behaviors in Medical and Psychiatric Conditions . Springer, Cham. https://doi.org/10.1007/978-3-030-81174-7_35

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  • DOI: https://doi.org/10.1007/978-3-030-81174-7_35

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