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Long-Term Weight Change after Initiating Second-Generation Antidepressants.

ABSTRACT: (1) OBJECTIVE: To examine the relationship between the choice of second-generation antidepressant drug treatment and long-term weight change; (2) METHODS: We conducted a retrospective cohort study to investigate the relationship between choice of antidepressant medication and weight change at two years among adult patients with a new antidepressant treatment episode between January, 2006 and October, 2009 in a large health system in Washington State. Medication use, encounters, diagnoses, height, and weight were collected from electronic databases. We modeled change in weight and BMI at two years after initiation of treatment using inverse probability weighted linear regression models that adjusted for potential confounders. Fluoxetine was the reference treatment; (3) RESULTS: In intent-to-treat analyses, non-smokers who initiated bupropion treatment on average lost 7.1 lbs compared to fluoxetine users who were non-smokers (95% CI: -11.3, -2.8; p-value < 0.01); smokers who initiated bupropion treatment gained on average 2.2 lbs compared to fluoxetine users who were smokers (95% CI: -2.3, 6.8; p-value = 0.33). Changes in weight associated with all other antidepressant medications were not significantly different than fluoxetine, except for sertraline users, who gained an average of 5.9 lbs compared to fluoxetine users (95% CI: 0.8, 10.9; p-value = 0.02); (4) CONCLUSION: Antidepressant drug therapy is significantly associated with long-term weight change at two years. Bupropion may be considered as the first-line drug of choice for overweight and obese patients unless there are other existing contraindications.

SUBMITTER: Arterburn D

PROVIDER: S-EPMC4850471 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Long-Term Weight Change after Initiating Second-Generation Antidepressants.

Arterburn David D Sofer Tamar T Boudreau Denise M DM Bogart Andy A Westbrook Emily O EO Theis Mary Kay MK Simon Greg G Haneuse Sebastien S

Journal of clinical medicine 20160413 4

(1) OBJECTIVE: To examine the relationship between the choice of second-generation antidepressant drug treatment and long-term weight change; (2) METHODS: We conducted a retrospective cohort study to investigate the relationship between choice of antidepressant medication and weight change at two years among adult patients with a new antidepressant treatment episode between January, 2006 and October, 2009 in a large health system in Washington State. Medication use, encounters, diagnoses, height ...[more]

PMID: 27089374

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Project description:The Weight Loss Maintenance Trial (WLM) compared two long-term weight-maintenance interventions, a personal contact arm and an Internet arm, with a no-treatment control after an initial six-month Phase I weight loss program. The Internet arm focused on use of an interactive website for support of long-term weight maintenance. There is limited information about patterns of website use and specific components of an interactive website that might help promote maintenance of weight loss.This paper presents a secondary analysis of the subset of participants in the Internet arm and focuses on website use patterns and features associated with long-term weight maintenance.Adults at risk for cardiovascular disease (CVD) who lost at least 4 kilograms in an initial 20-week group-based, behavioral weight-loss program were trained to use an interactive website for weight loss maintenance. Of the 348 participants, 37% were male and 38% were African American. Mean weight loss was 8.6 kilograms. Participants were encouraged to log in at least weekly and enter a current weight for the 30-month study period. The website contained features that encouraged setting short-term goals, creating action plans, and reinforcing self-management habits. The website also included motivational modules, daily tips, and tailored messages. Based on log-in and weight-entry frequency, we divided participants into three website use categories: consistent, some, and minimal.Participants in the consistent user group (n = 212) were more likely to be older (P = .002), other than African American (P = .02), and more educated (P = .01). While there was no significant difference between website use categories in the amount of Phase I change in body weight (P = .45) or income (P = .78), minimal website users (n = 75) were significantly more likely to have attended fewer Phase I sessions (P = .001) and had a higher initial body mass index (BMI) (P < .001). After adjusting for baseline characteristics including initial BMI, variables most associated with less weight regain included: number of log-ins (P = .001), minutes on the website (P < .001), number of weight entries (P = .002), number of exercise entries (P < .001), and sessions with additional use of website features after weight entry (P = .002).Participants defined as consistent website users of an interactive behavioral website designed to promote maintenance of weight loss were more successful at maintaining long-term weight loss.NCT00054925; http://clinicaltrials.gov/ct2/show/NCT00054925 (Archived by WebCite at http://www.webcitation.org/5rC7523ue).

Project description:Background/objectivesEnergy expenditure (EE), as reflective of body energy demand, has been proposed to be the key driver of food intake, possibly influencing weight change in humans. Variation in this energy-sensing link (overeating relative to weight-maintaining energy requirements) may lead to weight gain over time.Subjects/methodsSixty-one overweight otherwise healthy Native Americans (age: 34.0 ± 7.9 years, body fat: 39.7 ± 9.5%, 36 males) were admitted to our clinical research unit for measurements of body composition by dual-energy X-ray absorptiometry, and 24-h EE and respiratory quotient (RQ) in a whole-room indirect calorimeter during energy balance and weight stability. Following this, ad libitum food intake was assessed for three days using computerized vending machines. Body weight change under unrestricted free-living conditions was assessed at an outpatient follow-up visit (median follow-up time = 1.7 years).ResultsTotal ad libitum food intake (3-day average) was positively associated with 24-h EE (r = 0.44, p < 0.001), RQ (r = 0.34, p = 0.007), and fat free mass (r = 0.38, p = 0.002). A relatively greater food intake after accounting for 24-h EE, but not for RQ (p = 0.30) or for fat free mass (p = 0.23) nor total food intake (p = 0.16), predicted weight gain at the outpatient follow-up visit (r = 0.26, p = 0.04), such that overeating 100 Kcal/d above the food intake predicted by 24-h EE at baseline was associated with an average weight gain of 0.22 Kg over the follow-up period (95% CI: 0.01 to 0.42 Kg). This was due to relatively greater dietary fat intake (r = 0.32, p = 0.01), but not carbohydrate (p = 0.27) or protein (p = 0.06) intake.ConclusionThe individual propensity to overeating, particularly fat, in excess of the weight-maintaining energy requirements can be assessed and predicts long-term weight gain, suggesting that variation in energy sensing may influence appetite by favoring overeating thus promoting obesity development.

Dataset Information

Long-Term Weight Change after Initiating Second-Generation Antidepressants.

Publications

Long-Term Weight Change after Initiating Second-Generation Antidepressants.

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