Beneficial effects of leptin substitution on impaired eating behavior in lipodystrophy are sustained beyond 150 weeks of treatment

Aim Metreleptin treatment in lipodystrophy patients improves eating behavior with increased satiety and reduced hunger. However, no data are available whether effects are maintained beyond 52 weeks of treatment. Methods: A prospective study with measurements at baseline and at > 150 weeks of metreleptin treatment was performed. Five female lipodystrophy patients with indication for metreleptin were included. Behavioral aspects of hunger- and satiety regulation were assessed by validated eating behavior questionnaires and visual analog scales assessing hunger and satiety feelings before and after a standardized meal. Results: Hunger rated on visual analog scales at 120 min after the meal significantly decreased from 46 +/- 10 mm at baseline to 17 +/- 6 mm at long-term assessment. Furthermore, satiety at 5 and 120 min after the meal significantly increased from baseline to long-term assessment (5 min: 70 +/- 7 mm to 87 +/- 3 mm; 120 min: 43 +/- 10 mm to 79 +/- 8 mm). On the Three Factor Eating Questionnaire, the mean value of factor 3 (hunger) significantly decreased from 9.2 +/- 0.2 at baseline to 2.6 +/- 1.5 at long-term assessment. In the Inventory of Eating Behavior and Weight Problems Questionnaire, mean values for scale 2 (strength and triggering of desire to eat) and scale 7 (cognitive restraint of eating) significantly decreased from baseline (31.6 +/- 4.8 and 11.4 +/- 2.2, respectively) to long-term assessment (14.0 +/- 2.1 and 10.0 +/- 1.9). Conclusion: First evidence is presented that long-term metreleptin treatment of > 150 weeks has sustained effects on eating behavior with increased satiety, as well as reduced hunger and hunger-related measures.