This thesis is on the study of eating disorders (ED) – binge eating disorder (BED) and night eating syndrome (NES) - in type 2 diabetic (T2D) patients with obesity or overweight, the specifics of their diagnosis and possible ways of treatment based on the study of the antidiabetic agents and their effects on the central mechanisms of eating behaviour. The thesis provides a new solution and theoretical rationale for an important task - improving the diagnosis and treatment of hyperphagic ED in individuals with T2D and obesity/overweight by improving diagnostic and therapeutic measures based on the study of changes in hormonal and metabolic indicators that control eating behaviour under the influence of antidiabetic agents. According to questionnaires, the prevalence of BED in people with T2D and obesity/overweight is 18%, NES – 13.1%. In most cases (62.7%), ED appear even before the onset of T2D, in 42.2% - in childhood or adolescence. In 38.2% of people, the trigger factor for the onset of ED is stress, and a third of people with ED (29.4%) choose simple carbohydrates during bouts of overeating. In subjects with type 2 diabetes with obesity/overweight and concomitant ED, a higher level of leptin was observed (13.7 ± 9 ng/ml, p < 0.05) compared to patients with type 2 diabetes with obesity/overweight, but without ED (6 .51 ± 4.3 ng/ml) or individuals with obesity/overweight without any disorders of carbohydrate metabolism and without ED (9.2 ± 5 ng/ml). The lowest ghrelin level was determined in subjects with type 2 diabetes mellitus with obesity/overweight and concomitant ED (17.1 ± 7.7 ng/ml, p < 0.05) compared to individuals with type 2 diabetes and obesity/overweight, but without ED (24.6 ± 15.8 ng/ml) and people with obesity/overweight without any disorders of carbohydrate metabolism and without ED (23.9 ± 7.2 ng/ml), as well as a higher leptin/ghrelin index (0 .32 vs. 0.78, p < .05). A decrease in body weight leads to the normalization of ED in 12.5% of patients, as well as a decrease in the level of leptin from 13.1 ± 7.8 ng/ml to 11.6 ± 6.5 ng/ml, p < 0.05 and an increase in the level ghrelin from 17.8 ± 10.5 ng/ml to 20.2 ± 11.4 ng/ml, p < 0.05. Dapagliflozin in combination with metformin has a positive effect on body weight and BMI, which is reflected by a statistically significant decrease in the above indicators (a decrease in body weight by an average of 2.6 kg and BMI by 1.5% from the initial, p < 0.05 for both indicators) . The use of liraglutide and metformin for 3 months reduces body weight by an average of 6.3 kg (p < 0.05) and BMI by 2.2% from the initial level (p < 0.05). Liraglutide in combination with metformin reduces the leptin level by an average of 3.1 ng/ml (p < 0.05), increases the ghrelin level (by 5.3 ng/ml, p < 0.05) and lowers the leptin/ghrelin index ( 0.81 vs 0.47, p < 0.05) during 3 months of use. The combination of liraglutide with metformin improves hyperphagic ED, as the results of the questionnaires demonstrated the absence of BED attacks in 40% of people and NES in 50% of cases after 3 months of use of the above-mentioned drugs.
