Lifestyle behaviors, metabolic disturbances, and weight gain in psychiatric inpatients treated with weight gain-associated medication

Abstract

Many psychiatric patients suffer from overweight/obesity and subsequent metabolic disturbances, where psychotropic medication is one of the main contributors. However, the magnitude of weight gain ranges individually, which leads to questioning the role of other contributors like lifestyle factors. The present study investigated several lifestyle factors among psychiatric inpatients, their relation to biological factors, and their predictive capability for weight gain during treatment. Using a naturalistic observational study design, psychiatric inpatients of all diagnoses were followed for 4 weeks from the start of treatment with weight gain-associated medication. N = 163 participants entered the study. Lifestyle factors were assessed by patient self-report questionnaires. Body weight change over time was calculated relative to baseline body weight. Our study provides three main findings: (1) Obesity and/or metabolic syndrome (metSy) were associated with emotional eating (disinhibition), craving for fast food and sweets, and weight cycling. (2) Patients without metSy and normal BMI experienced increased sweets craving (also for women), a more positive attitude towards drugs, and an improvement of affect (also for men). (3) Sex, presence of metSy and/or drug dosage interacted with disinhibition change, sweets craving change (trend), and fast food craving change to predict weight change over time. Furthermore, drug attitude change interacted with BMI, drug dosage, and presence of metSy to predict weight change. Lifestyle factors, especially eating behaviors, are related to metabolic disturbances and predict weight gain in interaction with clinical parameters.

Metabolic Syndrome and Adipokines Profile in Bipolar Depression

“…Moreover, patients taking antipsychotic medication have a higher risk of developing MS than antipsychotic-free patients [20,21]. Psychiatric patients are more likely to develop obesity and metabolic abnormalities than healthy people [21][22][23]. Factors that predispose psychiatric patients to MS include genetic, unhealthy lifestyle (e.g., smoking, excessive alcohol intake, poor sleep hygiene, physical inactivity, and unhealthy nutritional patterns), but also the use of psychotropic medication (antipsychotics, antidepressants, and mood stabilizers) [20][21][22][23].…”

A comprehensive approach to predicting weight gain and therapy response in psychopharmacologically treated major depressed patients: A cohort study protocol

“…Thus, microbiome composition may also contribute to predicting response and weight gain in antidepressant users. Other factors that have been associated with weight gain in previous studies are eating behavior, circadian rhythm, and genetic risk: Previous analyses show that eating behavior before the start of treatment was predictive for weight gain [ 31 , 32 ], while the increase of dysfunctional eating behavior (disinhibition of eating/ emotional eating) during treatment phase also predicted an increase of body weight after treatment, independently and in interaction with drug dosage [ 33 , unpublished observations]. Further, it is being proposed that the circadian system is involved in the development of drug-induced metabolic disturbances [ 34 ] and that disturbances of the circadian system and irregular food intake (against the individual circadian rhythm) pose risk factors for weight gain and metabolic disorders even without taking medication into account [ 35 – 37 ].…”

Introduction for the follow-up of the Eighth International Kraepelin Symposium at LMU Munich

“…Translation of new mechanisms in secondary prevention focus on family communication [ 5 ], cannabis patterns in first episode [ 6 ] or cognitive biases in metacognitive training [ 7 ] as well as on evidence advancing understanding and treatment in later phases of psychoses based on meta-analysis [ 8 ]. Pioneering psychoeducational groups in borderline personality disorder [ 9 ] and metabolic disturbances and weight gain in a transdiagnostic sample [ 10 ] are novel topics.…”

“…There was a significant decrease of burden, an increase of knowledge about the disorder and a positive feedback if the participants, however, quality of life did not change. Due to the magnitude of overweight ranges, Simon et al [ 10 ] questioned the role of medication and lifestyle factors in a transdiagnostic psychiatric sample assessing biological factors and their predictive capability for weight gain during treatment. In a naturalistic study 4-week follow-up study included 163 transdiagnostic in patients treated with weight gain-associated medication.…”