In the world the problem of obesity is an important aspect in the non-infectious diseases progression. It is known, that 95% of the pathogenic factor for the obesity development depends on the changes caused by neurochemical, hormonal and metabolic mechanisms that occur by depression, anxiety, eating disorders, circadian rhythms and sleepiness. The objective: to determine the psychosocial features and their relationship with clinical and pathogenetic changes in obese patients of working age. Materials and methods. 75 patients with obesity of the 1st and 2d degrees (39.03±0.93 years old) and 75 practically healthy persons of the corresponding age (36.84±0.96 years old) were examined. Waist circumference (WC), hip circumference (HC), body surface area (BSA), waist/hip ratio (WHR), conicity index (ConI), a body shape index (ABSI), abdominal volume index (AVI), blood pressure, blood levels of glucose, insulin, index HOMA, cholesterol, lipidogram indicators, serotonin, and leptin were determined in the patients. The psychological status was assessed by Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAM-A), the Dutch Eating Behavior Questionnaire (DEBQ), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), the patient’s quality of life – by 36-Item Short Form Survey (SF-36). The statistical analysis was conducted by IBM SPSS Statistics, Statistica 12, descriptive statistics Excel 2010. Results. The patients of the studied group, unlike the control group, had significantly higher indices of WC, HC, BMI, WHR, ConI, ABSI, AVI, HOMA index, blood pressure, glucose, insulin, total cholesterol, lipidogram, leptin and the lower level of serotonin. This was accompanied with clinically expressed anxiety of depression which led to eating disorders (a tendency “to eat emotions”, to overeat when food is available, a habit to eat without restrictions), sleep disorders (excessive day time sleepiness, low quality of sleep) and reduced quality of life. The results of correlation analysis indicate a strong or moderate positive correlation between obesity indices, glucose level, lipidogram, atherogenicity index, HOMA index, scores of depression and anxiety scales, as well as strong negative correlation with ABSI index, high density lipoproteins, serotonin. In addition, a positive correlation was found between leptin level and scores of depression and anxiety scales, scores of eating behavior, sleepiness, and a negative correlation was determined between these indices and serotonin level. Conclusions. The patients of the studied group (100.0 %) had abdominal obesity. Among the anthropometric indices ABSI and AVI ones were the most significant and informative for determination of abdominal obesity in gender aspect, this can be an alternative for MRI diagnosis of visceral obesity at the level of primary medical care. A close relationship between abdominal obesity with psycho-emotional disorders, disorders of sleep and eat behavior, metabolic disorders, leptin and serotonin levels was determined. Taking into account these interrelationships in a patient-centered management in persons with obesity will improve the quality of medical care.

Obesity is a predictor of a significant number of non-communicable diseases. Reduction of body weight by 5–10 % in 6 months, has a positive effect on the prognosis of life and is one of the goals of treatment. To achieve such goals, there is a need for a patient-oriented approach, where the degree of individualization corresponds to the personal risks and needs of the patient with his involvement in the process of choosing a treatment strategy and forming new flexible life habits through the use of motivational counseling. The objective: is to determine the effectiveness of motivational counseling for lifestyle modification in obese patients of prime working age using a patient-oriented approach. Materials and methods. 37 patients with obesity I (27 people) and II (10 people) degree, aged 38.03±1.27 years (20 women and 17 men) were examined. Patients were given motivational counseling according to the «5 As» system, the patient-oriented approach included recommendations regarding the regime and caloric content of food, physical activity (monitoring with a pedometer), compliance with sleep hygiene, correction of psycho-emotional disorders. Clinical laboratory examination in dynamics after 1 month, 3 months and 6 months included measurements of BMI, waist and hip circumference, body surface area, waist/hip ratio, conicity index, body shape index, abdominal volume index, blood pressure, levels of blood glucose, insulin, HOMA index, cholesterol, lipidogram indicators, serotonin and leptin. In addition, surveys were conducted using the HADS hospital anxiety and depression scale, Beck’s scale, Hamilton scale, Dutch Eating Behavior Questionnaire, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Questionnaire, SF-36, The International Physical Activity Questionnaire, The Finnish Diabetes Risk Score. Statistical analysis was performed using IBM SPSS Statistics, Statistica 12, descriptive statistics Excel 2010. Results. During 6 months of observation, patients lost more than 5 % of their body weight (p<0.05), which was accompanied by a significant decrease in BMI (p<0.01) and an increase in the level of physical activity (p<0.001). The levels of lipid and carbohydrate metabolism exceeded the recommended values and had a positive tendency to decrease during treatment (p>0.05). Assessments of the manifestations of anxiety and depression according to the HADS depression and Hamilton scales, eating disorders, serotonin and leptin levels, quality of sleep, quality of life of patients improved. The prediction of the risk of developing diabetes had significant positive dynamics (p<0.05). Conclusions. The obtained results make prove that the application of of motivational counseling according to the step-bystep system «5 As» with a patient-oriented approach in patients of working age with obesity is an effective method, which is confirmed by reliable positive results and allows to reduce body weight by more than 5 % in 6 months, reduce levels of metabolic disorders, blood pressure, increase physical activity, reduce the manifestations of depression and anxiety, eating disorders, improve the quality of sleep and life of patients, improve the prognosis and reduce the risk of non-infectious diseases. If it is necessary to achieve stricter targets of indicators in obese patients and/or in a shorter time, it is necessary to carry out a further search for effective measures and consider the additional use of pharmaceutical products in prevention.