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

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

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Abstract

Objectives: The purpose of this pilot study was to evaluate changes in adiposity, carotid intima media thickness (CIMT), and hepatic fat content measured via magnetic resonance imaging-estimated hepatic proton density fat fraction (PDFF) in antipsychotic (AP)-treated youth versus nonpsychiatric (NP) participants during participation in a 16-week behavioral weight loss (BWL) intervention. Subjects/Methods: Overweight/obese AP-treated youth (n = 26) were randomized 2:1 to weekly treatment versus recommended care (RC) over 16 weeks. NP controls (n = 21) were assigned to weekly treatment. Dual-energy X-ray absorptiometry (DEXA)-measured adiposity, CIMT, and PDFF were measured at baseline and 16 weeks. Analyses assessed group differences in the effect of BWL on adiposity, CIMT, and PDFF. Results: BWL was well tolerated in both AP-treated and NP groups. DEXA-measured fat decreased significantly in the NP group (F[1,16] = 11.81, p = 0.003), with modest improvements in adiposity and hepatic fat in the AP-treated group, while an increase in adiposity was observed in the RC group. Significant differences in endpoint DEXA total fat (F[2,34] = 4.81, p = 0.01) and PDFF (F[2,30] = 3.60, p = 0.04) occurred across treatment groups, explained by larger improvements in NP versus RC youth in DEXA total fat (p = 0.03) and PDFF (p = 0.04). Conclusions: Intensive, family-based BWL treatment can improve whole-body adiposity and liver fat in obese youth, with decreases or attenuation of additional fat gain observed in AP-treated youth.

Original languageEnglish (US)
Pages (from-to)439-447
Number of pages9
JournalJournal of child and adolescent psychopharmacology
Volume29
Issue number6
DOIs
StatePublished - Aug 1 2019

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Keywords

  • antipsychotic
  • child psychiatry
  • obesity
  • weight loss

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)

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