Ginger E Nicol1, Rachel P Kolko2, Monica Mills1, Thrudur Gunnarsdottir3, Michael D Yingling1, Julia A Schweiger1, Eric J Lenze1, John W Newcomer4, Denise Wilfley5. 1. Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis MO. 2. Department of Psychiatry, Western Psychiatric Institute, University of Pittsburgh Medical Center, Pittsburgh, PA. 3. Department of Psychology, University of Akureyri, Iceland. 4. Weight Management & Eating Disorders Program, Department of Psychiatry, Washington University School of Medicine, St. Louis MO. 5. Weight Management & Eating Disorders Program, Department of Psychiatry, Washington University School of Medicine, St. Louis MO; Department of Psychology, Washington University School of Medicine, St. Louis, MO; Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO; Department of Pediatrics, Washington University School of Medicine, St. Louis MO.
Abstract
BACKGROUND: Antipsychotic-treated youth have increased risk for the development of obesity and type 2 diabetes. Behavioral weight loss treatments show promise in reducing obesity and diabetes risk in antipsychotic treated adults, but have received no study in antipsychotic treated youth. OBJECTIVE: We describe a rationale for behavioral weight loss interventions in high-weight antipsychotic treated youth, and report behavioral, anthropomorphic, and metabolic findings from a case series of obese antipsychotic-treated adolescents participating in a short-term, family-based behavioral weight loss intervention. METHODS: We adapted the Traffic Light Plan, a 16-week family-based weight loss intervention that promotes healthy energy balance using the colors of the traffic light to categorize the nutritional value of foods and intensity of physical activity, adapting a social ecological framework to address health behavior change in multiple social contexts. The intervention was administered to three obese adolescents with long-term antipsychotic medication exposure. Efficacy of the intervention was evaluated with a battery of anthropomorphic and metabolic assessments including weight, body mass index percentile, whole body adiposity, liver fat content, and fasting plasma glucose and lipids. Participants and their parents also filled out a treatment satisfaction questionnaire upon study completion. RESULTS: Two males and 1 female (all aged 14 years) participated. All 3 participants attended all 16 sessions, and experienced beneficial changes in adiposity, fasting lipids and liver fat content associated with weight stabilization or weight loss. Adolescents and their parents all reported a high level of satisfaction with the treatment. CONCLUSIONS: Family-based behavioral weight loss treatment can be feasibly delivered and is acceptable to antipsychotic-treated youth and their families. Randomized controlled trials are needed to fully evaluate the effectiveness and acceptability of behavioral weight loss interventions in antipsychotic treated youth and their families.
BACKGROUND: Antipsychotic-treated youth have increased risk for the development of obesity and type 2 diabetes. Behavioral weight loss treatments show promise in reducing obesity and diabetes risk in antipsychotic treated adults, but have received no study in antipsychotic treated youth. OBJECTIVE: We describe a rationale for behavioral weight loss interventions in high-weight antipsychotic treated youth, and report behavioral, anthropomorphic, and metabolic findings from a case series of obese antipsychotic-treated adolescents participating in a short-term, family-based behavioral weight loss intervention. METHODS: We adapted the Traffic Light Plan, a 16-week family-based weight loss intervention that promotes healthy energy balance using the colors of the traffic light to categorize the nutritional value of foods and intensity of physical activity, adapting a social ecological framework to address health behavior change in multiple social contexts. The intervention was administered to three obese adolescents with long-term antipsychotic medication exposure. Efficacy of the intervention was evaluated with a battery of anthropomorphic and metabolic assessments including weight, body mass index percentile, whole body adiposity, liver fat content, and fasting plasma glucose and lipids. Participants and their parents also filled out a treatment satisfaction questionnaire upon study completion. RESULTS: Two males and 1 female (all aged 14 years) participated. All 3 participants attended all 16 sessions, and experienced beneficial changes in adiposity, fasting lipids and liver fat content associated with weight stabilization or weight loss. Adolescents and their parents all reported a high level of satisfaction with the treatment. CONCLUSIONS: Family-based behavioral weight loss treatment can be feasibly delivered and is acceptable to antipsychotic-treated youth and their families. Randomized controlled trials are needed to fully evaluate the effectiveness and acceptability of behavioral weight loss interventions in antipsychotic treated youth and their families.
Entities:
Keywords:
Antipsychotic; At-Risk Youth; Pediatric Obesity; Weight Loss Treatment
Authors: Denise E Wilfley; Tiffany L Tibbs; Dorothy J Van Buren; Kelle P Reach; Mark S Walker; Leonard H Epstein Journal: Health Psychol Date: 2007-09 Impact factor: 4.267
Authors: Christoph U Correll; Peter Manu; Vladimir Olshanskiy; Barbara Napolitano; John M Kane; Anil K Malhotra Journal: JAMA Date: 2009-10-28 Impact factor: 56.272
Authors: Andrea B Goldschmidt; Denise E Wilfley; Rocco A Paluch; James N Roemmich; Leonard H Epstein Journal: JAMA Pediatr Date: 2013-01 Impact factor: 16.193
Authors: Ginger E Nicol; Rachel Kolko; Eric J Lenze; Michael D Yingling; J Philip Miller; Amanda R Ricchio; Julia A Schweiger; Robert L Findling; Denise Wilfley; John W Newcomer Journal: J Child Adolesc Psychopharmacol Date: 2019-04-17 Impact factor: 2.576
Authors: Elizabeth Anne Bennett; Rachel Pearl Kolko; Lichun Chia; Jennifer Padden Elliott; Melissa Ann Kalarchian Journal: West J Nurs Res Date: 2017-03-28 Impact factor: 1.967
Authors: Kathryn A Richardson; Christine L McKibbin; Barbara S Dabrowski; Elizabeth L A Punke; Cynthia M Hartung Journal: Int J Environ Res Public Health Date: 2022-06-30 Impact factor: 4.614
Authors: Casper C L van der Esch; Sanne M Kloosterboer; Jan van der Ende; Catrien G Reichart; Mirjam E J Kouijzer; Matthias M J de Kroon; Emma van Daalen; Wietske A Ester; Rob Rieken; Gwen C Dieleman; Manon H J Hillegers; Teun van Gelder; Birgit C P Koch; Bram Dierckx Journal: Eur Child Adolesc Psychiatry Date: 2020-08-24 Impact factor: 4.785