Adiposity, Hepatic Triglyceride, and Carotid Intima Media Thickness During Behavioral Weight Loss Treatment in Antipsychotic-Treated Youth: A Randomized Pilot Study

Nicol, Ginger E.; Kolko, Rachel P.; Lenze, Eric J.; Yingling, Michael; Miller, J. Philip; Ricchio, Amanda; Schweiger, Julia; Findling, Robert L.; Wilfley, Denise E.; Newcomer, John W.

doi:10.1089/cap.2018.0120

Cited by 10 publications

(20 citation statements)

References 39 publications

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“…67 Due to the inclusion of all study designs, a high risk of bias was detected in at least one domain for all studies. [55][56][57][58][59][60][61][62][63][64][65][66][67] The main sources of bias were selection bias, as majority of the studies (n = 7) were before and after comparisons that did not randomly allocate participants; [55][56][57][58]61,62,64,67 and performance bias, due to lack of blinding of participants for lifestyle interventions. [55][56][57][58][59][60][61][62][63][64][65]67 The assessment of the methodological quality of each study is summarised in Supplementary File 3.…”

Section: Resultsmentioning

confidence: 99%

“…The combined initial and updated literature search identified 15 293 references from which 12 studies were identified from 13 publications (Supplementary File 2 PRISMA flow diagram). [55][56][57][58][59][60][61][62][63][64][65][66][67] One study reported both short-and long-term outcomes in two separate articles, results from both were included. 57,64 There were no systematic reviews or meta-analyses that met the eligibility criteria.…”

Section: Resultsmentioning

confidence: 99%

“…The combined initial and updated literature search identified 15 293 references from which 12 studies were identified from 13 publications (Supplementary File 2 PRISMA flow diagram) 55‐67 . One study reported both short‐ and long‐term outcomes in two separate articles, results from both were included.…”

Section: Resultsmentioning

confidence: 99%

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Weight management interventions that include dietary components for young people with chronic health care needs: A systematic review

Billich

Maugeri

Calligaro

et al. 2021

Nutrition & Dietetics

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Aims: To identify and describe weight management interventions that include a dietary component for young people with chronic healthcare needs and overweight or obesity and their effect on body mass index (BMI) or weight. Methods: Six databases were searched in 2017 and 2020 for experimental studies in English: Ovid MEDLINE, Ovid Embase, Ovid AMED, EBSCO CIN-AHL, Scopus and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Two independent reviewers conducted data extraction and quality assessment using the Cochrane Risk of Bias tool. Eligible studies included young people with chronic healthcare needs ≤18 years with overweight or obesity with an intervention that included a dietary component. Eligible outcomes were BMI or weight. Data were synthesised narratively. Results: The search identified 15 293 references, 12 studies were included (randomised controlled trials n = 5, before-after comparisons n = 7). Participant diagnoses were neurodevelopmental disabilities (n = 5) and mental illness (n = 1); survivors of cancers or tumours (n = 4); congenital heart disease (n = 1) and; migraine (n = 1). No studies addressed weight management in physical disabilities. Eight studies demonstrated a significant reduction in BMI or weight. Of these, most interventions used dietary counselling or an energy deficit, were family-focused, multicomponent and delivered by a multidisciplinary team including dietitians. A high risk of bias was detected across studies.Conclusions: There is limited high-quality evidence about effective dietary solutions for the management of overweight and obesity for young people with chronic healthcare needs. While more research is required, dietary management appears to be important to manage weight in these populations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Weight management interventions that include dietary components for young people with chronic health care needs: A systematic review

Billich

Maugeri

Calligaro

et al. 2021

Nutrition & Dietetics

View full text Add to dashboard Cite

show abstract

“…The needs assessment in this study was anchored within a behavior change framework based on existing treatments [ 29 , 46 ] to provide the user exposure to an intervention upon which they could consider their needs and preferences. In contrast, more traditional usability assessments conducted at the end of an intervention, even when paired with utilization data, are subject to recall bias and do not capture how end users experience the app in real time [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

A Smartphone-Based Technique to Detect Dynamic User Preferences for Tailoring Behavioral Interventions: Observational Utility Study of Ecological Daily Needs Assessment

Nicol

Ricchio

Metts

et al. 2020

JMIR Mhealth Uhealth

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Background Mobile health apps are promising vehicles for delivering scalable health behavior change interventions to populations that are otherwise difficult to reach and engage, such as young adults with psychiatric conditions. To improve uptake and sustain consumer engagement, mobile health interventions need to be responsive to individuals’ needs and preferences, which may change over time. We previously created an ecological daily needs assessment to capture microprocesses influencing user needs and preferences for mobile health treatment adaptation. Objective The objective of our study was to test the utility of a needs assessment anchored within a mobile app to capture individualized, contextually relevant user needs and preferences within the framework of a weight management mobile health app. Methods Participants with an iOS device could download the study app via the study website or links from social media. In this fully remote study, we screened, obtained informed consent from, and enrolled participants through the mobile app. The mobile health framework included daily health goal setting and self-monitoring, with up to 6 daily prompts to determine in-the-moment needs and preferences for mobile health–assisted health behavior change. Results A total of 24 participants downloaded the app and provided e-consent (22 female; 2 male), with 23 participants responding to at least one prompt over 2 weeks. The mean length of engagement was 5.6 (SD 4.7) days, with a mean of 2.8 (1.1) responses per day. We observed individually dynamic needs and preferences, illustrating daily variability within and between individuals. Qualitative feedback indicated preferences for self-adapting features, simplified self-monitoring, and the ability to personalize app-generated message timing and content. Conclusions The technique provided an individually dynamic and contextually relevant alternative and complement to traditional needs assessment for assessing individually dynamic user needs and preferences during treatment development or adaptation. The results of this utility study suggest the importance of personalization and learning algorithms for sustaining app engagement in young adults with psychiatric conditions. Further study in broader user populations is needed.

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“…A 52-week study found that standard (n = 102) or intense behavioral weight interventions (n = 103) did not reduce AEs of APs for adolescents (age range = 13-17, mean age = 15.8) with schizophrenia or bipolar I disorder receiving olanzapine (265). A 16-week intensive weekly family-based behavioral weight loss intervention in APtreated youth (n = 19, mean age = 13.35), compared to treatment as usual, resulted in decreased adiposity (p = 0.01) and hepatic fat (p = 0.04) that could support beneficial impacts on AIWG with long-term behavioral intervention (266). There is a need for large-scale pediatric studies to determine the most effective lifestyle interventions for weight gain and metabolic symptoms.…”

Section: Non-pharmacological Treatmentsmentioning

confidence: 99%

The Burden of Antipsychotic-Induced Weight Gain and Metabolic Syndrome in Children

Libowitz

Nurmi

2021

Front. Psychiatry

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Antipsychotic medications are critical to child and adolescent psychiatry, from the stabilization of psychotic disorders like schizophrenia, bipolar disorder, and psychotic depression to behavioral treatment of autism spectrum disorder, tic disorders, and pediatric aggression. While effective, these medications carry serious risk of adverse events—most commonly, weight gain and cardiometabolic abnormalities. Negative metabolic consequences affect up to 60% of patients and present a major obstacle to long-term treatment. Since antipsychotics are often chronically prescribed beginning in childhood, cardiometabolic risk accumulates. An increased susceptibility to antipsychotic-induced weight gain (AIWG) has been repeatedly documented in children, particularly rapid weight gain. Associated cardiometabolic abnormalities include central obesity, insulin resistance, dyslipidemia, and systemic inflammation. Lifestyle interventions and medications such as metformin have been proposed to reduce risk but remain limited in efficacy. Furthermore, antipsychotic medications touted to be weight-neutral in adults can cause substantial weight gain in children. A better understanding of the biological underpinnings of AIWG could inform targeted and potentially more fruitful treatments; however, little is known about the underlying mechanism. As yet, modest genetic studies have nominated a few risk genes that explain only a small percentage of the risk. Recent investigations have begun to explore novel potential mechanisms of AIWG, including a role for gut microbiota and microbial metabolites. This article reviews the problem of AIWG and AP metabolic side effects in pediatric populations, proposed mechanisms underlying this serious side effect, and strategies to mitigate adverse impact. We suggest future directions for research efforts that may advance the field and lead to improved clinical interventions.

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Adiposity, Hepatic Triglyceride, and Carotid Intima Media Thickness During Behavioral Weight Loss Treatment in Antipsychotic-Treated Youth: A Randomized Pilot Study

Cited by 10 publications

References 39 publications

Weight management interventions that include dietary components for young people with chronic health care needs: A systematic review

Weight management interventions that include dietary components for young people with chronic health care needs: A systematic review

A Smartphone-Based Technique to Detect Dynamic User Preferences for Tailoring Behavioral Interventions: Observational Utility Study of Ecological Daily Needs Assessment

The Burden of Antipsychotic-Induced Weight Gain and Metabolic Syndrome in Children

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