Obesity that results in various metabolic disorders is one of the central concerns of modern healthcare system. Only 4% to 5% of patients with metabolic syndrome achieve favorable outcomes without any additional pharmacotherapy. Therefore, many patients require weight-loss drugs in addition to non-pharmacological treatments. The endocannabinoid system and the drugs that affect its functions receive a widespread attention of medical society due to its effects on behavioral and cerebral functions and its potential use as a therapeutic “target” in various peripheral and neurological psychiatric disorders. Among known to date cannabinoid receptors, type 1 receptors play a role in the development of obesity. It was demonstrated that the blockade of these receptors in the hypothalamus reduces appetite, inhibits adipocyte activation in peripheral tissues, prevents lipogenesis, and increases the level of adiponectin. The result is the decreased levels of atherogenic lipoproteins and improved insulin resistance. This article addresses the results of fundamental and clinical studies on Dietressa, a drug composed of affine-purified antibodies to cannabinoid receptor 1. Case report of a patient with obesity that analyzes pharmaceutical and non-pharmaceutical treatment approaches is described.KEYWORDS: obesity, metabolic syndrome, diet, endocannabinoid system, cannabinoids, cannabinoid receptors, affine-purified antibodies.FOR CITATION: Dudareva V.A., Maksimov M.L., Djadikova I.G. et al. Role of endocannabinoid system in the pathogenesis of obesity: how can we help a patient? From theory to practice. Russian Medical Inquiry. 2020;4(6):382–389. DOI: 10.32364/2587-6821-2020-4-6-382-389.

Childhood obesity is an acute problem in the European Region, including countries participating in the World Health Organization's European Childhood Obesity Surveillance Initiative. According to their data, the proportion of overweight children reaches 43%. Overweight and obesity, as well as related diseases, are largely preventable. For this reason, the prevention of childhood obesity should be given top priority. Adolescence obesity has reached epidemic proportions worldwide, with the prevalence of complicated obesity increasing at least fourfold over the past 35 years. Most obese adolescents also have excess body fat mass in adulthood, which increases the risk of obesity-related complications, such as type 2 diabetes and cardiovascular disease, and negatively affects social and psychological health. In modern conditions the prevention of the overweight and obesity formation among schoolchildren is not systemic: no attention is paid to the identification of possible risk factors, no unified approaches exist among specialists of various levels to the methodology for preventing the overweight and obesity formation, rational hygienic measures for preventing obesity are not always implemented, the causes of late diagnostics of overweight and obesity among schoolchildren by pediatricians are not fully analyzed, the motivation of children and parents to change their lifestyle in order to fight overweight are not sufficiently studied. The systemic implementation of such preventive measures could help to reduce the number of overweight schoolchildren and improve the health of the child population.

The article presents modern reviews, meta-analyses, and studies on the issues of nutritional stress correction and the contribution of some nutritional factors to its development. The role of a diet low in saturated fatty acids and high in polyunsaturated fatty acids, the Mediterranean diet, supplementation of folic acid and other B vitamins, as well as the role of a healthy diet model in the prevention of stress and its consequences are considered.

Purpose of researh was making recommendations on diet for students in self-isolation mode, taking into account the analysis of their nutrition. Methods. A representative group was formed by random sampling. The study involved 40 students (23 women and 17 men) of Rostov State Medical University, average age 22.5 years ± 1 year (group 1). To create the database, we used the human nutritional analysis program, version 1.2.4., Registered by the Russian Agency for Patents and Trademarks 02/09/04 No. 2004610397 GUNII Nutrition RAMS. Comparison of the results was carried out with a similar group outside the conditions of self-isolation caused by the pandemic covid-19 (control group). Results. In the group of women surveyed, the energy value of the diet was 1832.77 kcal. The daily amount of incoming protein is 66.6 g, fat — 97.3 g (45 % more than the recommended amount), carbohydrates — 167.87 g (42 % lower than normal). The content of trace elements: sodium — 124 % more than normal, phosphorus — 43 %. At the same time, the content of other trace elements and vitamins is less than necessary: calcium — by 18 %, magnesium — by 39 %, vitamin B1 — by 55 %, vitamin B2 — by 35 %, niacin — by 45 %. In the group of men surveyed, the energy value of the diet was 1848.24 kcal; the amount of protein consumed — 66.93 g, fat — 97.7 g (20 % higher than normal), carbohydrates — 169.6 g (53 % less than the recommended amount). The content of trace elements: sodium — 123 % more than normal, phosphorus — 46 %. There is a lack of intake of many trace elements and vitamins: calcium — 15 % less than recommended, magnesium — 38 %, vitamin B1–54 %, vitamin B2–32 %, niacin — 45 %. Conclusion. In general, we can conclude that the nutrition of the students surveyed does not correspond to the current situation. Although the energy value of the daily diet is optimal, the ratio of macro- and micronutrients is violated. Recommendations are given to reduce the consumption of foods containing fats and phosphorus, in favor of foods containing complex carbohydrates, as well as vitamins B1, B2, niacin, magnesium and calcium. The need to minimize the consumption of salt, sugar, saturated and trans isomers of fatty acids is noted. It is also recommended in conditions of self-isolation to add specialized and fortified foods, as well as vitamin-mineral complexes, to the diet.