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The potential role of appetite in predicting weight changes during treatment with olanzapine.

ABSTRACT: Clinically significant weight gain has been reported during treatment with atypical antipsychotics. It has been suggested that weight changes in patients treated with olanzapine may be associated with increased appetite.Data were used from adult patients for whom both appetite and weight data were available from 4 prospective, 12- to 24-week clinical trials. Patients' appetites were assessed with Eating Behavior Assessment (EBA, Study 1), Platypus Appetite Rating Scale (PARS, Study 2), Eating Inventory (EI, Study 3), Food Craving Inventory (FCI, Study 3), and Eating Attitude Scale (EAS, Study 4).In Studies 1 (EBA) and 4 (EAS), patients who reported overall score increases on appetite scales, indicating an increase in appetite, experienced the greatest overall weight gains. However, in Studies 2 (PARS) and 3 (EI, FCI), patients who reported overall score increases on appetite scales did not experience greater weight changes than patients not reporting score increases. Early weight changes (2-4 weeks) were more positively correlated with overall weight changes than early or overall score changes on any utilized appetite assessment scale. No additional information was gained by adding early appetite change to early weight change in correlation to overall weight change.Early weight changes may be a more useful predictor for long-term weight changes than early score changes on appetite assessment scales.This report represents secondary analyses of 4 clinical studies. Studies 1, 2, and 3 were registered at http://clinicaltrials.gov/ct2/home, under NCT00190749, NCT00303602, and NCT00401973, respectively. Study 4 predates the registration requirements for observational studies that are not classified as category 1 observational studies.

SUBMITTER: Case M

PROVIDER: S-EPMC2945973 | biostudies-literature | 2010 Sep

REPOSITORIES: biostudies-literature

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The potential role of appetite in predicting weight changes during treatment with olanzapine.

Case Michael M Treuer Tamas T Karagianis Jamie J Hoffmann Vicki Poole VP

BMC psychiatry 20100914

<h4>Background</h4>Clinically significant weight gain has been reported during treatment with atypical antipsychotics. It has been suggested that weight changes in patients treated with olanzapine may be associated with increased appetite.<h4>Methods</h4>Data were used from adult patients for whom both appetite and weight data were available from 4 prospective, 12- to 24-week clinical trials. Patients' appetites were assessed with Eating Behavior Assessment (EBA, Study 1), Platypus Appetite Rati ...[more]

PMID: 20840778

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Project description:BACKGROUND/OBJECTIVE:Diet-induced weight loss (WL) leads to a compensatory increase in appetite and changes in the plasma concentration of appetite-regulating hormones are likely to play a role. Whether these changes are transient or sustained remains unclear. This study aimed to assess if changes in subjective and objective appetite markers observed with WL are sustained after 1 year (1Y). SUBJECTS/METHODS:In total 100 (45 males) individuals with obesity (BMI: 37?±?4?kg/m2, age: 43?±?10 years) underwent 8 weeks (wks) of a very-low energy diet (VLED), followed by 4 wks refeeding, and a 1Y maintenance program. Fasting/postprandial subjective ratings of hunger, fullness, desire to eat, and prospective food consumption (PFC) were assessed, and plasma concentration of active ghrelin (AG), total peptide YY (PYY), active glucagon-like peptide 1, cholecystokinin (CCK), and insulin measured, at baseline, week 13 (Wk13) and 1Y. RESULTS:At Wk13, 16% WL (-18?±?1?kg, P?<?0.001) was associated with a significant increase in fasting and postprandial hunger ratings (P?<?0.01 and P?<?0.05, respectively), and postprandial fullness (P?<?0.01) combined with a reduction in PFC (P?<?0.001). These were accompanied by a significant rise in basal and postprandial AG concentrations (P?<?0.001, for both), a reduction in postprandial CCK (P?<?0.01) and in basal and postprandial insulin (P?<?0.001). At 1Y follow-up, with sustained WL (15%; -16?±?1?kg, P?<?0.001), fasting hunger and postprandial fullness ratings remained increased (P?<?0.05 for both), and postprandial PFC reduced (P?<?0.001). Basal and postprandial AG remained elevated and insulin reduced (P?<?0.001, for all), while postprandial CCK was increased (P?<?0.01) and PYY decreased (P?<?0.001). CONCLUSION:With a 15% sustained WL at 1Y, the drive to eat in the fasting state is increased, but this may be balanced out by raised postprandial feelings of fullness. To assist with WL maintenance, new strategies are required to manage increased hunger and drive to eat.

Project description:BackgroundDiet-induced weight loss (WL) is usually accompanied by increased appetite, a response that seems to be absent when ketogenic diets are used. It remains unknown if sex modulates the appetite suppressant effect of ketosis.ObjectiveThe aim of this study was to examine if sex modulates the impact of WL-induced changes in appetite and if ketosis alters these responses.MethodsNinety-five individuals (55 females) with obesity (BMI [kg/m 2]: 37 ± 4) underwent 8 wk of a very-low-energy diet, followed by 4 wk of refeeding and weight stabilization. Body composition, plasma concentration of β-hydroxybutyrate (β-HB) and appetite-related hormones (active ghrelin, active glucagon-like peptide 1 [GLP-1], total peptide YY [PYY], cholecystokinin and insulin), and subjective feelings of appetite were measured at baseline, week 9 in ketosis, and week 13 out of ketosis.ResultsThe mean WL at week 9 was 17% for males and 15% for females, which was maintained at week 13. Weight, fat, and fat-free mass loss were greater in males (P < 0.001 for all) and the increase in β-HB at week 9 higher in females (1.174 ± 0.096 compared with 0.783 ± 0.112 mmol/L, P = 0.029). Basal and postprandial GLP-1 and postprandial PYY (all P < 0.05) were significantly different for males and females. There were no significant sex × time interactions for any other appetite-related hormones or subjective feelings of appetite. At week 9, basal GLP-1 was decreased only in males (P < 0.001), whereas postprandial GLP-1 was increased only in females (P < 0.001). No significant changes in postprandial PYY were observed over time for either sex.ConclusionsKetosis appears to have a greater beneficial impact on GLP-1 in females. However, sex does not seem to modulate the changes in the secretion of other appetite-related hormones, or subjective feelings of appetite, seen with WL, regardless of the ketotic state. This trial was registered at clinicaltrials.gov as NCT01834859.

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The potential role of appetite in predicting weight changes during treatment with olanzapine.

Publications

The potential role of appetite in predicting weight changes during treatment with olanzapine.

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