-
The Journal of Clinical Psychiatry Oct 2010Psychotropic drugs often induce weight gain, leading to discomfort and discontinuation of treatment and, more importantly, increasing the risk of obesity-related... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Psychotropic drugs often induce weight gain, leading to discomfort and discontinuation of treatment and, more importantly, increasing the risk of obesity-related illnesses such as diabetes mellitus, hypertension, and coronary heart disease. There is evidence that antidepressant drugs may induce a variable amount of weight gain, but results are sparse and often contradictory.
DATA SOURCES
We performed a literature search using the MEDLINE, ISI Web of Knowledge, and Cochrane research databases for all publications available to January 2009. We used the following keywords: antidepressant, psychotropic drugs, body weight, weight gain, obesity, overweight, adverse event, side effects, SSRIs, tricyclic antidepressants, and the name of each antidepressant active compound together with body weight or other keywords. Studies reporting body weight changes during treatment with different antidepressants were selected for eligibility. Finally, 116 studies were included in the analysis.
DATA EXTRACTION
Weight change mean and standard deviation and size of each group were recorded. Missing means and standard deviations were directly calculated by using information available in the article when possible. Non-placebo-controlled studies were compared to a virtual placebo sample, whose mean and standard deviation were derived by the weighted mean of means and standard deviations of all placebo samples. Methodological quality of studies, heterogeneity, publication bias, and effect of treatment duration were systematically controlled.
DATA SYNTHESIS
Quantitative results evidenced that amitriptyline, mirtazapine, and paroxetine were associated with a greater risk of weight gain. In contrast, some weight loss occurs with fluoxetine and bupropion, although the effect of fluoxetine appears to be limited to the acute phase of treatment. Other compounds have no transient or negligible effect on body weight in the short term. However, the effect of each antidepressant may vary greatly depending on an individual's characteristics and generally became more evident in the long term to a variable degree across compounds.
CONCLUSIONS
Despite the fact that some analyses were done on only a few studies due to the difficulty of finding reliable information in literature, to our knowledge, this is the first comprehensive meta-analysis to allow comparison of different antidepressants as regards their impact on body weight. Data presented may be helpful for a more accurate treatment selection in patients at risk of obesity or related medical illness.
Topics: Antidepressive Agents; Body Weight; Clinical Trials as Topic; Humans; Time Factors; Weight Gain; Weight Loss
PubMed: 21062615
DOI: 10.4088/JCP.09r05346blu -
European Journal of Internal Medicine Nov 2021Weight regain following weight loss is frequent problem that people with obesity face. This weight recidivism is often attributed to the lack of compliance with... (Review)
Review
Weight regain following weight loss is frequent problem that people with obesity face. This weight recidivism is often attributed to the lack of compliance with appropriate food habits and exercise. On the contrary, it is known that body weight and fat mass are regulated by numerous physiological mechanisms, far beyond voluntary food intake and physical exercise. Thus, the aim of this paper is to review the main peripheral and central mechanisms involved in weight regain. Gut hormone secretion profiles impact upon predisposition to weight regain according to an individual variability, although it is recognised a usual pattern of compensatory changes: a reduction in anorectic hormones secretion and an increase in orexigenic hormone. These changes lead to both increased appetite and reward value of food leading to increased energye intake. In addition, resting energy expenditure after weight loss is lower than expected according to body composition changes. This gap between observed and predicted energy expenditure following weight loss is named metabolic adaptation, which has been suggested to explain partly weight regain. This complicated scenario, beyond patient motivation, makes weight regain a challenge in long-term management interventions in patients with obesity.
Topics: Body Weight; Energy Intake; Energy Metabolism; Humans; Obesity; Weight Gain; Weight Loss
PubMed: 33461826
DOI: 10.1016/j.ejim.2021.01.002 -
Nutrition in Clinical Practice :... Dec 2022Current healthcare is weight-centric, equating weight and health. This approach to healthcare has negative consequences on patient well-being. The aim of this article is... (Review)
Review
Current healthcare is weight-centric, equating weight and health. This approach to healthcare has negative consequences on patient well-being. The aim of this article is to make a case for a paradigm shift in how clinicians view and address body weight. In this review, we (1) address common flawed assumptions in the weight-centric approach to healthcare, (2) review the weight science literature and provide evidence for the negative consequences of promoting dieting and weight loss, and (3) provide practice recommendations for weight-inclusive care.
Topics: Humans; Overweight; Obesity; Weight Loss; Delivery of Health Care; Body Weight
PubMed: 35819360
DOI: 10.1002/ncp.10885 -
The New England Journal of Medicine Mar 1995No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. We... (Clinical Trial)
Clinical Trial Comparative Study
BACKGROUND
No current treatment for obesity reliably sustains weight loss, perhaps because compensatory metabolic processes resist the maintenance of the altered body weight. We examined the effects of experimental perturbations of body weight on energy expenditure to determine whether they lead to metabolic changes and whether obese subjects and those who have never been obese respond similarly.
METHODS
We repeatedly measured 24-hour total energy expenditure, resting and nonresting energy expenditure, and the thermic effect of feeding in 18 obese subjects and 23 subjects who had never been obese. The subjects were studied at their usual body weight and after losing 10 to 20 percent of their body weight by underfeeding or gaining 10 percent by overfeeding.
RESULTS
Maintenance of a body weight at a level 10 percent or more below the initial weight was associated with a mean (+/- SD) reduction in total energy expenditure of 6 +/- 3 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 5 kcal per kilogram per day in the obese subjects (P < 0.001). Resting energy expenditure and nonresting energy expenditure each decreased 3 to 4 kcal per kilogram of fat-free mass per day in both groups of subjects. Maintenance of body weight at a level 10 percent above the usual weight was associated with an increase in total energy expenditure of 9 +/- 7 kcal per kilogram of fat-free mass per day in the subjects who had never been obese (P < 0.001) and 8 +/- 4 kcal per kilogram per day in the obese subjects (P < 0.001). The thermic effect of feeding and nonresting energy expenditure increased by approximately 1 to 2 and 8 to 9 kcal per kilogram of fat-free mass per day, respectively, after weight gain. These changes in energy expenditure were not related to the degree of adiposity or the sex of the subjects.
CONCLUSIONS
Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure, which oppose the maintenance of a body weight that is different from the usual weight. These compensatory changes may account for the poor long-term efficacy of treatments for obesity.
Topics: Adult; Body Composition; Body Weight; Energy Intake; Energy Metabolism; Female; Food, Formulated; Humans; Male; Middle Aged; Obesity; Weight Gain; Weight Loss
PubMed: 7632212
DOI: 10.1056/NEJM199503093321001 -
Journal of the American Dietetic... May 2005Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the... (Review)
Review
Breakfast has been labeled the most important meal of the day, but are there data to support this claim? We summarized the results of 47 studies examining the association of breakfast consumption with nutritional adequacy (nine studies), body weight (16 studies), and academic performance (22 studies) in children and adolescents. Breakfast skipping is highly prevalent in the United States and Europe (10% to 30%), depending on age group, population, and definition. Although the quality of breakfast was variable within and between studies, children who reported eating breakfast on a consistent basis tended to have superior nutritional profiles than their breakfast-skipping peers. Breakfast eaters generally consumed more daily calories yet were less likely to be overweight, although not all studies associated breakfast skipping with overweight. Evidence suggests that breakfast consumption may improve cognitive function related to memory, test grades, and school attendance. Breakfast as part of a healthful diet and lifestyle can positively impact children's health and well-being. Parents should be encouraged to provide breakfast for their children or explore the availability of a school breakfast program. We advocate consumption of a healthful breakfast on a daily basis consisting of a variety of foods, especially high-fiber and nutrient-rich whole grains, fruits, and dairy products.
Topics: Achievement; Adolescent; Body Weight; Child; Cognition; Energy Intake; Feeding Behavior; Female; Humans; Male; Nutritional Status; Obesity; Weight Gain
PubMed: 15883552
DOI: 10.1016/j.jada.2005.02.007 -
Clinical Nutrition ESPEN Dec 2021The Ideal Body Weight (IBW) model has provided dietitians and researchers with a quick method of risk assessment but is known to be imperfect. IBW formulas were...
BACKGROUND & AIMS
The Ideal Body Weight (IBW) model has provided dietitians and researchers with a quick method of risk assessment but is known to be imperfect. IBW formulas were developed from anthropometric measurements of life-insurance policy holders obtained between 1885 and 1908, providing statistics of mortality, organized by sex and age. Actuaries of the U.S. life insurance companies published data on the impact of overweight/obese status and mortality risk. Research of the same era repeatedly revealed either no significance or an inverse relationship. The intent of this text is to draw attention to the complexity and overall discussion of utility of the IBW method.
METHODS
Reviewed relevant literature from the development of IBW through the recent findings in 2014.
RESULTS
Height, weight, and frame fail to consider comorbidities and genetics. IBW formulas assume that weight increases as a linear function of height. Weight has been shown to increase not just as a function of height, but also of volume: body width, trunk length, and musculature. Depending on standards of practice, several equations may be used.
CONCLUSIONS
The IBW model is utilized but not limited to creating enteral and parenteral feeding plans, avoiding malnutrition, aiding weight management, identifying transplant eligibility, and determining inclusion or exclusion from research studies. Socially, the significance around "ideal" can impact a weight-centric mentality and negatively affect a large portion of the population. Every individual has a distinct "ideal" body weight based on genetics, environment and lifestyle, which could be represented and assessed effectively with new tools.
Topics: Body Height; Body Weight; Humans; Ideal Body Weight; Obesity; Parenteral Nutrition
PubMed: 34857204
DOI: 10.1016/j.clnesp.2021.09.746 -
Current Obesity Reports Mar 2018There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include... (Review)
Review
PURPOSE OF REVIEW
There is an urgent need for effective weight management techniques, as more than one third of US adults are overweight or obese. Recommendations for weight loss include a combination of reducing caloric intake, increasing physical activity, and behavior modification. Behavior modification includes mindful eating or eating with awareness. The purpose of this review was to summarize the literature and examine the impact of mindful eating on weight management.
RECENT FINDINGS
The practice of mindful eating has been applied to the reduction of food cravings, portion control, body mass index, and body weight. Past reviews evaluating the relationship between mindfulness and weight management did not focus on change in mindful eating as the primary outcome or mindful eating as a measured variable. This review demonstrates strong support for inclusion of mindful eating as a component of weight management programs and may provide substantial benefit to the treatment of overweight and obesity.
Topics: Body Weight Maintenance; Feeding Behavior; Humans; Mindfulness; Obesity; Weight Gain; Weight Loss
PubMed: 29446036
DOI: 10.1007/s13679-018-0299-6 -
Nutrients Jun 2023Pasta is a staple carbohydrate across many cultures but has been implicated in overweight and obesity due to its position as a refined carbohydrate. Yet, the unique... (Review)
Review
Pasta is a staple carbohydrate across many cultures but has been implicated in overweight and obesity due to its position as a refined carbohydrate. Yet, the unique structure of pasta and its low glycemic response suggest it may contribute to a healthy body weight. The purpose of this review is to summarize the literature on the effects of pasta and dietary patterns high in pasta on body weight and body composition outcomes, and evaluate potential mechanisms by which pasta may influence body weight. A search of PubMed and CENTRAL identified 38 relevant studies examining pasta intake and body weight outcomes or potential mechanisms. Observational studies generally report no association or an inverse association of pasta intake with body weight/body composition outcomes. One clinical trial reported no difference in weight loss between a hypocaloric diet with high intake vs. low intake of pasta. Pasta may influence body weight via its low glycemic response, but evidence of effects on appetite, appetite-related hormones, and gastric emptying is limited and inconclusive. In conclusion, observational and limited clinical data suggest pasta is either inversely or not associated with overweight or obesity in healthy children and adults, and does not contribute to weight gain within the context of a healthy diet.
Topics: Adult; Child; Humans; Obesity; Overweight; Diet, Reducing; Dietary Carbohydrates; Body Composition; Hypoglycemia; Energy Intake; Body Mass Index; Body Weight
PubMed: 37375591
DOI: 10.3390/nu15122689 -
Philosophical Transactions of the Royal... Oct 2023Body weight is tightly regulated when outside the normal range. It has been proposed that there are individual-specific lower and upper intervention points for when the... (Review)
Review
Body weight is tightly regulated when outside the normal range. It has been proposed that there are individual-specific lower and upper intervention points for when the homeostatic regulation of body weight is initiated. The nature of the homeostatic mechanisms regulating body weight at the lower and upper ends of the body weight spectrum might differ. Previous studies demonstrate that leptin is the main regulator of body weight at the lower end of the body weight spectrum. We have proposed that land-living animals use gravity to regulate their body weight. We named this homeostatic system the and proposed that there are two components of the gravitostat. First, an obvious mechanism involves increased energy consumption in relation to body weight when working against gravity on land. In addition, we propose that there exists a component, involving sensing of the body weight by osteocytes in the weight-bearing bones, resulting in a feedback regulation of energy metabolism and body weight. The gravity-dependent homeostatic regulation is mainly active in obese mice. We, herein, propose the , including gravity-dependent actions (= gravitostat) at the upper end and leptin-dependent actions at the lower end of the body weight spectrum. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.
Topics: Animals; Mice; Leptin; Body Weight; Obesity; Homeostasis; Energy Metabolism
PubMed: 37661748
DOI: 10.1098/rstb.2022.0219 -
Experimental Gerontology Apr 2023The aim of this study was to determine the effectiveness of a six-week time-restricted eating (TRE) intervention in reducing body weight, fat loss, and visceral fat in... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to determine the effectiveness of a six-week time-restricted eating (TRE) intervention in reducing body weight, fat loss, and visceral fat in overweight, older adult men and women (age range = 65-74 years). Another objective was to determine the feasibility of widespread use of TRE in older women and men. The study randomly assigned 116 healthy, non-smoking participants to one of two conditions: TRE or educational control participants. Participants in the TRE group were instructed to not consume calorie containing beverages or food for 16 h per day, from 8:00 pm to 12:00 pm. Participants in the control group were instructed to follow a meal plan based on their previous habits. The changes in body weight and body composition were determined using a SECA mBCA 515 analyzer. The six-week TRE intervention resulted in a significant decrease in body weight in both men and women (-1.8 kg and-1.3 kg, respectively; p = 0.03). In men, a significant decrease in visceral fat mass (-0.54 l; p ≤ 0.001) and waist circumference (-2.9 cm; p ≤ 0.015) was observed. No significant changes in either visceral fat or waist circumference were observed in women. Additionally, no change in skeletal muscle mass was observed in either the control or TRE group. More than 99 % of female and 98 % of male participants were able to adhere to the prescribed time-restricted eating (16/8) plan, suggesting that this dietary approach could have beneficial effects on the body composition of overweight older men and may also reduce body weight in overweight, older women.
Topics: Aged; Female; Humans; Male; Body Composition; Body Weight; Intra-Abdominal Fat; Obesity; Overweight; Weight Loss
PubMed: 36739795
DOI: 10.1016/j.exger.2023.112116