Parent reported inattention and hyperactivity/impulsivity as predictor of long-term weight loss after inpatient treatment in obese adolescents

Background: Deregulation of orexigenic and anorexigenic pathways occurs among adolescents with obesity. Alpha-melanocyte-stimulating hormone (α-MSH) is a key catabolic mediator of energy homeostasis and an important anorexigenic neuropeptide in the control of energy balance and thermogenesis. However, it was not well explored if α-MSH can modulate long-term weight loss therapy responses in a dependent manner according to its concentration. Our hypothesis is that a high α-MSH concentration at baseline promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents. Methods: One hundred ten post-pubertal obese adolescents (body mass index >95th percentile) were submitted to 1 year of interdisciplinary therapy (clinical, nutritional, psychological, physical exercise, and physiotherapy support). Body composition and plasma levels of α-MSH, neuropeptide Y (NPY), melanin-concentrating hormone, and agouti-related peptide (AgRP) were measured before and after therapy. The volunteers were grouped on the basis of Tertiles of α-MSH concentration: Low (<0.75 ng/mL), Medium (≤0.76 to ≥1.57 ng/mL), and High (>1.57 ng/mL). Significance was set as p < 0.05. Results: The treatment promoted a significant improvement in body adiposity and fat free mass for all groups. It is important to note that only in the high α-MSH group, a significant increase of the α-MSH/NPY ratio and decrease NPY/AgRP ratio post treatment were observed. Conclusion: The high α-MSH concentration promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents following long-term weight loss therapy and this is important in clinical practice.

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Association Between Physician Recommendation for Adolescents to Join a Weight Loss Program and BMI Change

Journal of Primary Care & Community Health ◽

10.1177/2150131911421202 ◽

2011 ◽

Vol 3 (2) ◽

pp. 83-87

Author(s):

Susan J. Woolford ◽

Bethany J. Sallinen ◽

Sarah J. Clark ◽

Heidi B. IglayReger ◽

Paul M. Gordon

Keyword(s):

Weight Loss ◽

Management Program ◽

Physician Recommendation ◽

Inclusion Criteria ◽

Obese Adolescents ◽

Weight Loss Method ◽

The Mean ◽

Loss Method ◽

Selection Of

Objective: To explore whether reasons for enrollment in a pediatric multidisciplinary weight management program (PMWMP) are associated with subsequent weight loss. Method: A retrospective analysis of obese adolescents (12-18 years old, body mass index [BMI] > 95th percentile) who enrolled in a PMWMP from April 2007 to March 2009, and had BMI measurements at weeks 1 and 12. Reasons for enrollment were obtained from parents’ responses to an enrollment questionnaire (which allowed selection of more than one reason). The most common reasons for enrollment were computed. Linear regression was used to explore associations between mean change in BMI and reasons for enrollment, controlling for demographic and anthropometric factors. Results: Most of the 90 adolescents who met the inclusion criteria were female (70%) and white (57%). Mean age was 14.5 years and mean initial BMI was 42 kg/m2. The most common reasons for enrolling in the PMWMP were due to concerns about adolescents’ physical health (96%), concerns about adolescents’ mental health (76%), and because of a physician recommendation (73%). The mean 12-week change in BMI showed a greater decrease for those who enrolled due to a physicians’ recommendation versus those who did not (−1.5 vs −0.5 kg/m2: P < .05). This finding remained significant even when controlling for the covariates of interest. Conclusions: A physician’s recommendation to join a PMWMP appears to be associated with greater weight loss among obese adolescents than other reasons for enrollment. Further research should explore how physician involvement affects long-term weight loss.

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