scholarly journals A dedicated nurse-led service for antipsychotic-induced weight gain

2004 ◽  
Vol 28 (5) ◽  
pp. 164-166 ◽  
Author(s):  
Ruth I. Ohlsen ◽  
Janet Treasure ◽  
Lyn S. Pilowsky

Aims and MethodTo evaluate a psychosocial intervention for patients treated with antipsychotics with body mass index (BMI) > 25. A total of 44 patients (mean age (s.e.) 37.6 (1.2); 28 female, 16 male) received dietary and exercise advice with motivational interviewing. Weight and BMI were measured at baseline and monthly thereafter. Patients were offered weight monitoring for 1 year.ResultsOverall mean weight loss was 3.1 kg (mean 3.22%). Modal (range) weight change was 74.2 (719.2 kg to +8.7 kg).Clinical ImplicationsOverall weight loss was not significant after 355.7 (32.5) (mean, s.e.) days. Determinants of response remain unclear. Avoiding weight gain in the first instance is critical. Further research will explore determinants of antipsychotic-induced weight gain and prevention strategies.

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242784
Author(s):  
Elaine Ku ◽  
Adrian M. Whelan ◽  
Charles E. McCulloch ◽  
Brian Lee ◽  
Claus U. Niemann ◽  
...  

High body mass index is a known barrier to access to kidney transplantation in patients with end-stage kidney disease. The extent to which weight and weight changes affect access to transplantation among obese candidates differentially by race/ethnicity has received little attention. We included 10 221 obese patients waitlisted for kidney transplantation prior to end-stage kidney disease onset between 1995–2015. We used multinomial logistic regression models to examine the association between race/ethnicity and annualized change in body mass index (defined as stable [-2 to 2 kg/m2/year], loss [>2 kg/m2/year] or gain [>2 kg/m2/year]). We then used Fine-Gray models to examine the association between weight changes and access to living or deceased donor transplantation by race/ethnicity, accounting for the competing risk of death. Overall, 29% of the cohort lost weight and 7% gained weight; 46% received a transplant. Non-Hispanic blacks had a 24% (95% CI 1.12–1.38) higher odds of weight loss and 22% lower odds of weight gain (95% CI 0.64–0.95) compared with non-Hispanic whites. Hispanics did not differ from whites in their odds of weight loss or weight gain. Overall, weight gain was associated with lower access to transplantation (HR 0.88 [95% CI 0.79–0.99]) compared with maintenance of stable weight, but weight loss was not associated with better access to transplantation (HR 0.96 [95% CI 0.90–1.02]), although this relation differed by baseline body mass index and for recipients of living versus deceased donor organs. For example, weight loss was associated with improved access to living donor transplantation (HR 1.24 [95% CI 1.07–1.44]) in whites but not in blacks or Hispanics. In a cohort of obese patients waitlisted before dialysis, blacks were more likely to lose weight and less likely to gain weight compared with whites. Weight loss was only associated with improved access to living donor transplantation among whites. Further studies are needed to understand the reasons for the observed associations.


2019 ◽  
Author(s):  
Ian Cook

Abstract Objectives To investigate the relationship between longitudinal weight-change and objectively-measured physical activity in a rural African setting in 143 adults, using data from two cross-sectional surveys, separated by approximately ten years. Participants who had data for age, sex, body mass and stature measured in two health surveys were categorised into three weight-change groups (Weight-loss: ≥25 kg.m-2→<25 kg.m-2; Weight-gain: <25 kg.m-2→≥25 kg.m-2; Weight-stability: remained <25 kg.m-2 or ≥25 kg.m-2). Daily ambulation and energy expenditure, measured in the 2005-7 health survey, was examined across the weight change groups. Using the daily energy expenditure data, the proportion of those in the weight-change groups, meeting or not meeting two physical activity guidelines (150- and 420 min.wk-1), was examined. Results Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+1.2 kg, p=0.1616). However, there was significant change in body mass in the weight-gain (+15.2 kg) and weight-loss (-10.8 kg) groups (p≤0.0011). Nearly 90% of those who gained weight met the 150 min.wk-1 guideline. A significantly greater proportion of the weight-stable group (<25 kg.m-2) met the 420 min.wk-1 guideline (p<0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (<25 kg.m-2) approached 15 000 steps.day-1.


2006 ◽  
Vol 30 (6) ◽  
pp. 982-987 ◽  
Author(s):  
M Kivimäki ◽  
J Head ◽  
J E Ferrie ◽  
M J Shipley ◽  
E Brunner ◽  
...  

2019 ◽  
Author(s):  
Ian Cook

Abstract Objectives: To investigate the relationship between longitudinal weight-change and objectively-measured physical activity (PA) in a rural African setting in 143 adults (≥30 years), using data from two cross-sectional surveys, separated by approximately ten years. Participants were categorised into three weight-change groups (Weight-loss: ≥25 kg.m-2→<25 kg.m-2; Weight-gain: <25 kg.m-2→≥25 kg.m-2; Weight-stability: remained <25 kg.m-2 or ≥25 kg.m-2). Daily ambulation and activity energy expenditure (AEE), measured in the 2005-7 health survey, was examined across the weight-change groups. Using the daily AEE data, the proportion of those in the weight-change groups, meeting or not meeting two PA guidelines (150- and 420 min.wk-1), was examined. Results: Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+1.2 kg, p=0.1616). However, there was significant change in body mass in the weight-gain (+15.2 kg) and weight-loss (-10.8 kg) groups (p≤0.0011). Nearly 90% of those who gained weight met the 150 min.wk-1 guideline. A significantly greater proportion of the weight-stable group (<25 kg.m-2) met the 420 min.wk-1 guideline (p<0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (<25 kg.m-2) approached 15 000 steps.day-1. There was an inconsistent and weak association between PA and weight-change in this group.


2019 ◽  
Author(s):  
Ian Cook

Abstract Objectives: To investigate the relationship between longitudinal weight-change and objectively-measured physical activity (PA) in a rural African setting in 143 adults (≥30 years), using data from two cross-sectional surveys, separated by approximately ten years. Participants were categorised into three weight-change groups (Weight-loss: ≥25 kg.m-2→<25 kg.m-2; Weight-gain: <25 kg.m-2→≥25 kg.m-2; Weight-stability: remained <25 kg.m-2 or ≥25 kg.m-2). Daily ambulation and activity energy expenditure (AEE), measured in the 2005-7 health survey, was examined across the weight-change groups. Using the daily AEE data, the proportion of those in the weight-change groups, meeting or not meeting two PA guidelines (150- and 420 min.wk-1), was examined. Results: Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+1.2 kg, p=0.1616). However, there was significant change in body mass in the weight-gain (+15.2 kg) and weight-loss (-10.8 kg) groups (p≤0.0011). Nearly 90% of those who gained weight met the 150 min.wk-1 guideline. A significantly greater proportion of the weight-stable group (<25 kg.m-2) met the 420 min.wk-1 guideline (p<0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (<25 kg.m-2) approached 15 000 steps.day-1. There was an inconsistent and weak association between PA and weight-change in this group.


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Ian Cook

Abstract Objectives To investigate the relationship between longitudinal weight-change and objectively-measured physical activity (PA) in a rural African setting in 143 adults (≥ 30 years), using data from two cross-sectional surveys, separated by approximately 10 years. Participants were categorised into three weight-change groups (Weight-loss: ≥ 25 kg m−2→ < 25 kg m−2; Weight-gain: < 25 kg m−2→ ≥ 25 kg m−2; Weight-stability: remained < 25 kg m−2 or ≥ 25 kg m−2). Daily ambulation and activity energy expenditure (AEE), measured in the 2005–2007 health survey, was examined across the weight-change groups. Using the daily AEE data, the proportion of those in the weight-change groups, meeting or not meeting two PA guidelines (150- and 420 min week−1), was examined. Results Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+ 1.2 kg, p = 0.1616). However, there was significant change in body mass in the weight-gain (+ 15.2 kg) and weight-loss (− 10.8 kg) groups (p ≤ 0.0011). Nearly 90% of those who gained weight met the 150 min week−1 guideline. A significantly greater proportion of the weight-stable group (< 25 kg m−2) met the 420 min week−1 guideline (p < 0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (< 25 kg m−2) approached 15,000 steps day−1. There was an inconsistent and weak association between PA and weight-change in this group.


2002 ◽  
Vol 57 (3) ◽  
pp. 98-102 ◽  
Author(s):  
Alfredo Halpern ◽  
Claudia Cozer Leite ◽  
Nathan Herszkowicz ◽  
Alfonso Barbato ◽  
Ana Paula Arruda Costa

This is a double-blind, placebo-controlled study of the efficacy, safety, and tolerability of sibutramine in the management of obese patients for a 6-month period. METHOD: Sixty-one obese patients (BMI >30, <40 kg/m2), aged 18-65 years were evaluated. In the first phase of the study (30 days), the patients were given a placebo. We monitored compliance with a low-calorie diet (1200 kcal/day) and to the placebo. In the next stage, the double-blind phase (6 months), we compared placebo and sibutramine (10 mg/day). The criteria for evaluating efficacy were weight loss, reduction in body mass index (BMI), and abdominal and hip circumferences. Tolerability was assessed based on reported side effects, variation in arterial blood pressure and heart rate, metabolic profile (fasting glucose, total cholesterol and its fractions, and triglycerides), laboratory tests (renal and hepatic functions), and flow Doppler echocardiogram. RESULTS: We observed a greater weight loss (7.3 kg, 8% vs 2.6 kg, 2.8%) and a reduction in body mass index (7.4% vs 2.1%) in the sibutramine group than in the placebo group. Classifying the patients into 4 subgroups according to weight loss (weight gain, loss <5%, loss of 5% to 9.9%, and loss >10%), we observed a weight loss of >5% in 40% of the patients on sibutramine compared with 12.9% in the placebo group. We also detected weight gain in 45.2% of the placebo group compared to 20% in the sibutramine group. The sibutramine group showed improvement in HDL- cholesterol values (increased by 17%) and triglyceride values (decreased by 12.8%). This group also showed an increase in systolic blood pressure (6.7%, 5 mmHg). There were no changes in echocardiograms comparing the beginning and end of follow-up, and side effects did not lead to discontinuation of treatment. DISCUSSION: Sibutramine proved to be effective for weight loss providing an 8% loss of the initial weight. Compliance to prolonged treatment was good, and side effects did not result in discontinuation of treatment. These data confirmed the good efficacy, tolerability, and safety profiles of sibutramine for treatment of obesity.


2019 ◽  
Author(s):  
Ian Cook

Abstract Objectives: To investigate the relationship between longitudinal weight-change and objectively-measured physical activity (PA) in a rural African setting in 143 adults (≥30 years), using data from two cross-sectional surveys, separated by approximately ten years. Participants were categorised into three weight-change groups (Weight-loss: ≥25 kg.m-2→<25 kg.m-2; Weight-gain: <25 kg.m-2→≥25 kg.m-2; Weight-stability: remained <25 kg.m-2 or ≥25 kg.m-2). Daily ambulation and activity energy expenditure (AEE), measured in the 2005-7 health survey, was examined across the weight-change groups. Using the daily AEE data, the proportion of those in the weight-change groups, meeting or not meeting two PA guidelines (150- and 420 min.wk-1), was examined. Results: Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+1.2 kg, p=0.1616). However, there was significant change in body mass in the weight-gain (+15.2 kg) and weight-loss (-10.8 kg) groups (p≤0.0011). Nearly 90% of those who gained weight met the 150 min.wk-1 guideline. A significantly greater proportion of the weight-stable group (<25 kg.m-2) met the 420 min.wk-1 guideline (p<0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (<25 kg.m-2) approached 15 000 steps.day-1. There was an inconsistent and weak association between PA and weight-change in this group.


Thorax ◽  
2020 ◽  
Vol 75 (4) ◽  
pp. 313-320 ◽  
Author(s):  
Gabriela P Peralta ◽  
Alessandro Marcon ◽  
Anne-Elie Carsin ◽  
Michael J Abramson ◽  
Simone Accordini ◽  
...  

BackgroundPrevious studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS).MethodsWe included 3673 participants recruited at age 20–44 years with repeated measurements of weight and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) in three study waves (1991–93, 1999–2003, 2010–14) until they were 39–67 years of age. We classified subjects into weight change profiles according to baseline body mass index (BMI) categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.ResultsIn individuals with normal BMI, overweight and obesity at baseline, moderate (0.25–1 kg/year) and high weight gain (>1 kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared with participants with baseline normal BMI and stable weight (±0.25 kg/year), obese individuals with high weight gain during follow-up had −1011 mL (95% CI −1.259 to −763) lower estimated FVC at 65 years despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<−0.25 kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline.ConclusionModerate and high weight gain over 20 years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.


2020 ◽  
Vol 38 (18) ◽  
pp. 2018-2027 ◽  
Author(s):  
Alyssa N. Troeschel ◽  
Terryl J. Hartman ◽  
Eric J. Jacobs ◽  
Victoria L. Stevens ◽  
Ted Gansler ◽  
...  

PURPOSE To investigate the association of postdiagnosis body mass index (BMI) and weight change with prostate cancer–specific mortality (PCSM), cardiovascular disease–related mortality (CVDM), and all-cause mortality among survivors of nonmetastatic prostate cancer. METHODS Men in the Cancer Prevention Study II Nutrition Cohort diagnosed with nonmetastatic prostate cancer between 1992 and 2013 were followed for mortality through December 2016. Current weight was self-reported on follow-up questionnaires approximately every 2 years. Postdiagnosis BMI was obtained from the first survey completed 1 to < 6 years after diagnosis. Weight change was the difference in weight between the first and second postdiagnosis surveys. Deaths occurring within 4 years of the follow-up were excluded to reduce bias from reverse causation. Analyses of BMI and weight change included 8,330 and 6,942 participants, respectively. RESULTS Postdiagnosis BMI analyses included 3,855 deaths from all causes (PCSM, n = 500; CVDM, n = 1,155). Using Cox proportional hazards models, hazard ratios (HRs) associated with postdiagnosis obesity (BMI ≥ 30 kg/m2) compared with healthy weight (BMI 18.5 to < 25.0 kg/m2) were 1.28 for PCSM (95% CI, 0.96 to 1.67), 1.24 for CVDM (95% CI, 1.03 to 1.49), and 1.23 for all-cause mortality (95% CI, 1.11 to 1.35). Weight gain analyses included 2,973 deaths (PCSM, n = 375; CVDM, n = 881). Postdiagnosis weight gain (> 5% of body weight), compared with stable weight (± < 3%), was associated with a higher risk of PCSM (HR, 1.65; 95% CI, 1.21 to 2.25) and all-cause mortality (HR, 1.27; 95% CI, 1.12 to 1.45) but not CVDM. CONCLUSION Results suggest that among survivors of nonmetastatic prostate cancer with largely localized disease, postdiagnosis obesity is associated with higher CVDM and all-cause mortality, and possibly higher PCSM, and that postdiagnosis weight gain may be associated with a higher mortality as a result of all causes and prostate cancer.


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