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Naltrexone reduction of long-term smoking cessation weight gain in women but not men: a randomized controlled trial.

ABSTRACT: The opioid antagonist naltrexone has shown promise to reduce weight gain during active treatment, but longer-term studies have not been conducted. The goal was to examine effects of naltrexone on weight gain over long-term follow-up in men and women who quit smoking.Weight was examined at baseline and 6- and 12-month follow-up in the two largest randomized, double-blind, placebo-controlled trials of naltrexone in nicotine dependence. For 6-12 weeks after the quit date, participants were randomly assigned to receive naltrexone or placebo. Behavioral counseling and open-label nicotine patch were also included for the first 4-6 weeks. Of the 700 participants in the combined intent-to-treat sample, there were 159 (77 women) biochemically verified abstinent smokers at 6 months, and 115 (57 women) of them remained abstinent at 12 months. Changes in weight (in kilograms or in percentage) and body mass index from baseline to the follow-ups were assessed for these participants.Weight gain was significantly lower for women treated with naltrexone compared with placebo (6 months, 3.3 vs. 5.5 kg; 12 months, 5.9 vs. 7.4 kg, respectively). Increases in body mass index and percentage body weight gain were also significantly lower in women treated with naltrexone versus placebo. These effects were not observed in men.The results provide evidence for naltrexone as the first pharmacotherapy to reduce postsmoking cessation weight gain among women.

SUBMITTER: King AC

PROVIDER: S-EPMC3629005 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

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Naltrexone reduction of long-term smoking cessation weight gain in women but not men: a randomized controlled trial.

King Andrea C AC Cao Dingcai D Zhang Lingjiao L O'Malley Stephanie S SS

Biological psychiatry 20121122 9

<h4>Background</h4>The opioid antagonist naltrexone has shown promise to reduce weight gain during active treatment, but longer-term studies have not been conducted. The goal was to examine effects of naltrexone on weight gain over long-term follow-up in men and women who quit smoking.<h4>Methods</h4>Weight was examined at baseline and 6- and 12-month follow-up in the two largest randomized, double-blind, placebo-controlled trials of naltrexone in nicotine dependence. For 6-12 weeks after the qu ...[more]

PMID: 23177384

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Project description:Specific dietary and other lifestyle behaviors may affect the success of the straightforward-sounding strategy "eat less and exercise more" for preventing long-term weight gain.We performed prospective investigations involving three separate cohorts that included 120,877 U.S. women and men who were free of chronic diseases and not obese at baseline, with follow-up periods from 1986 to 2006, 1991 to 2003, and 1986 to 2006. The relationships between changes in lifestyle factors and weight change were evaluated at 4-year intervals, with multivariable adjustments made for age, baseline body-mass index for each period, and all lifestyle factors simultaneously. Cohort-specific and sex-specific results were similar and were pooled with the use of an inverse-variance-weighted meta-analysis.Within each 4-year period, participants gained an average of 3.35 lb (5th to 95th percentile, -4.1 to 12.4). On the basis of increased daily servings of individual dietary components, 4-year weight change was most strongly associated with the intake of potato chips (1.69 lb), potatoes (1.28 lb), sugar-sweetened beverages (1.00 lb), unprocessed red meats (0.95 lb), and processed meats (0.93 lb) and was inversely associated with the intake of vegetables (-0.22 lb), whole grains (-0.37 lb), fruits (-0.49 lb), nuts (-0.57 lb), and yogurt (-0.82 lb) (P?0.005 for each comparison). Aggregate dietary changes were associated with substantial differences in weight change (3.93 lb across quintiles of dietary change). Other lifestyle factors were also independently associated with weight change (P<0.001), including physical activity (-1.76 lb across quintiles); alcohol use (0.41 lb per drink per day), smoking (new quitters, 5.17 lb; former smokers, 0.14 lb), sleep (more weight gain with <6 or >8 hours of sleep), and television watching (0.31 lb per hour per day).Specific dietary and lifestyle factors are independently associated with long-term weight gain, with a substantial aggregate effect and implications for strategies to prevent obesity. (Funded by the National Institutes of Health and others.).

Project description:BACKGROUND:Phthalates are known endocrine disruptors and peroxisome proliferator-activated receptor (PPAR) activators, potentially capable of promoting an obesogenic effect. Pregnant women are especially vulnerable to phthalate exposure due to physiological and metabolic changes during pregnancy, including those related to the metabolism of xenobiotics. Phthalate exposure during pregnancy has been associated with early gestational weight gain, however, its effect on long-term weight gain remains unclear. The aim of the present study was to evaluate the association between phthalate exposure during pregnancy and long-term changes in weight among women. METHODS:Urinary phthalate concentrations, socioeconomic, anthropometry and information on diet and socioeconomic status were collected during pregnancy from 178 women from the Early Life Exposure in Mexico to Environmental Toxicants (ELEMENT) birth cohort. Maternal body weight and diet information was also collected up to 5 times in the first year postpartum and twice during follow-up visits 5.2-10.7 years later. A path analysis was performed to assess associations between urinary phthalate metabolite levels during pregnancy and change in weight (kg) per year after delivery, including age, education, living with/without partner, parity, daily energy intake and breastfeeding duration. RESULTS:The mean age at pregnancy was 27.3?±?5.9 years and mean body mass index during the first postpartum year was 27.07?±?4.22?kg/m2. On average, women gained 3.48?kg (0.52?±?0.84?kg/year). A unit increase in log-transformed mono-3-carboxypropyl phthalate (MCPP) was associated with 0.33?kg (95% CI: 0.09, 0.56) higher weight gain per year, and mono-benzyl phthalate (MBzP) with 0.21?kg (95% CI: -0.38, -0.03) lower weight gain per year. CONCLUSION:Exposure to certain phthalates during pregnancy may be associated with long-term weight change in women. More studies on the effects of phthalate exposure during pregnancy on women's long-term health are required.

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Naltrexone reduction of long-term smoking cessation weight gain in women but not men: a randomized controlled trial.

Publications

Naltrexone reduction of long-term smoking cessation weight gain in women but not men: a randomized controlled trial.

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