Lack Of Weight Gain Research Articles

Interventions for Weight Gain in Adults Treated With Novel Antipsychotics.

BACKGROUND: Weight gain is a significant side effect associated with typical and atypical antipsychotic agents. It has the potential to add to the increased morbidity and mortality associated with schizophrenia and schizoaffective disorder. Because the newer antipsychotic medications have proved to be superior to traditional agents in controlling the positive and negative symptoms of schizophrenia, it is additionally critical to address the relationship of these newer agents to weight gain. METHOD: Prior to the availability of novel antipsychotic medication, we looked at a group of 17 residents, of whom 71% had significant weight gain on treatment with traditional antipsychotic medications between 1991 and 1994. This prompted our interest in weight gain, especially after the introduction of novel antipsychotic medications, and our decision to look closely at their diets and help them make changes that would minimize their weight gain. We monitored the effect of a comprehensive primary intervention strategy on controlling obesity in a retrospective study of 32 patients with DSM-IV schizophrenia or schizoaffective disorders. All patients were residents in an adult care facility for formerly homeless persons with serious mental illness. Intervention consisted of complete medical and psychiatric care; switch to a patient-optimal atypical drug; low-calorie, monitored diet; nutritional education; and supportive care. RESULTS: There was no significant change in mean body weight at 12 and 18 months after initiation of intervention. Weight gain was observed in only 30% of study patients after the intervention as opposed to 71% at the start of the study. In general, as the negative symptoms of schizophrenia improved, patients were found to become more receptive to education and to become proactive in their health care. The lack of weight gain was consistently seen with all 3 agents tested-clozapine, olanzapine, and risperidone. CONCLUSION: A patient's diet appears to be a better predictor of weight gain than the choice of novel antipsychotic medication. Clinicians might prescribe nutritional and lifestyle changes alongside medication with weight gain potential.

The unique human receptor binding profile may be related to lack of weight gain with ziprasidone

The unique human receptor binding profile may be related to lack of weight gain with ziprasidone

Steady state changes in mitochondrial electrical potential and proton gradient in perfused liver from rats fed a high fat diet.

In this work the protonmotive force (delta p), as well as the subcellular distribution of malate, ATP, and ADP were determined in perfused liver from rats fed a low fat or high fat diet, using density gradient fractionation in non aqueous solvents. Rats fed a high fat diet, despite an enhanced hepatic oxygen consumption, exhibit similar delta p to that found in rats fed a low fat diet, but when we consider the two components of delta p, we find a significant decrease in mitochondrial/cytosolic pH difference (delta pH(m)) and a significant increase in mitochondrial membrane potential (delta psi(m)) in rats fed a high fat diet compared to rats fed a low fat diet, which tend to compensate each other. In rats fed a high fat diet the concentration ratio of malate and ATP/ADP does not reflect the changes in delta pH(m) and delta psi(m), which represent the respective driving force for their transport. The findings are in line with an increase in substrate supply to the respiratory chain which is, however, accompanied by a higher energy turnover in livers from HFD rats. By this way the liver could contribute to the lack of weight gain from the high caloric intake in HFD rats.

Behavioral, Situational, and Temporal Effects of Treatment of ADHD With Methylphenidate

To determine the behavioral, situational, and temporal effects of 4 months of methylphenidate (MPH) treatment for attention-deficit hyperactivity disorder (ADHD). Ninety-one children with ADHD were randomly assigned to receive either MPH (titrated to a target dose of 0.7 mg/kg twice a day) or a placebo. Treatment effects were investigated with measures sensitive to various behaviors (core and associated symptoms), situations (home and school), time periods (morning and afternoon, after reaching the target dose, and after 4 months of treatment), and side effects. MPH treatment improved symptoms of ADHD and oppositional behavior at school, both in the morning and afternoon, but not at home. Side effects (increase in physiological and effective symptoms, lack of weight gain) were significantly more frequent with MPH than with placebo treatment. Benefit was evident after titration, but the onset of some side effects was delayed. Side effects were reported by parents but not by teachers. Positive effects of MPH on behavior are evident in the classroom, but with MPH given twice daily, parents do not report that MPH improves behavior at home. Greater impact on home behavior may require three times daily MPH and combined treatments.

Long-Term Treatment with Oral Torsemide and Its Effect on Body Weight and Fluid Balance in Patients with Chronic Renal Insufficiency.

Long-term treatment with oral torsemide was studied to determine its effectiveness in maintaining steady-state fluid balance in patients with chronic renal insufficiency by using a placebo-controlled, double-blind, random-off design. Patients with stable chronic renal insufficiency were initially titrated and then stabilized on torsemide. Once stabilized on torsemide, patients were randomly assigned in a double-blind fashion to continue on their titrated dose of torsemide or to receive a placebo. Of the 82 patients enrolled in the study, 68 were randomized to torsemide (n = 34) or placebo (n = 34). Patients who received the placebo showed a significantly greater (p < 0.001) mean increase in body weight (3.55 lb) than did patients who remained on torsemide (0.46 lb). Approximately two-thirds of the weight gain observed in the placebo group occurred during the first 3 days after randomization. Patients continued to receive treatment unless they developed fluid accumulation that was considered deleterious to their clinical state as determined by the investigator. In the placebo group a greater number of patients discontinued treatment because of weight gain or fluid accumulation. The mean number of days on treatment after randomization was significantly higher (p < 0.001) for patients who received torsemide (26 days) than for patients who received the placebo (16 days). The lack of weight gain in the torsemide group was associated with a higher percentage of patients who showed no change or an improvement in peripheral edema status (79%) than in placebo patients (35%). No patient was withdrawn from the study because of hyperkalemia or hypokalemia. The adverse effects reported during the study were as anticipated for patients with chronic renal insufficiency that is often complicated by other underlying illnesses.

The relationship of total copper 48-H LC50s toDaphnia magnadry weight

A study was conducted with Daphnia magna to determine the effect of neonate weight loss or lack of weight gain on experimentally derived copper 48-h LC50s. Standard unfed tests as well as algal-fed (Selenastrum capricornutum) tests were used to look at weight loss and gain. No significant relationship was found between amount of weight loss and copper LC50s. However, dry weight of unfed and algal-fed control organisms could be used to predict total copper LC50s.

Ascovirus infectivity and effects of infection on the growth and development of noctuid larvae

The infectivity per os and by inoculation of ascoviruses isolated from Heliothis zea, Spodoptera frugiperda, and Trichoplusia ni and the effects of infection by these viruses on host growth and development were studied in the species from which these viruses were originally isolated, or in the case of the H. zea isolate, in H. virescens. Mortality caused by all three viral isolates averaged <15% in third instars fed doses of 10 to 10 5 viral vesicles per larva incorporated into diet, whereas inoculation with as few as 10 viral vesicles consistently yielded mortality rates >90%. In tests where groups of 10 larvae were inoculated sequentially with a minuten pin that had been inserted into the hemocoel of an infected larva and then dried for up to 24 hr, mortality rates were consistently greater than 90%. The latter results suggest that ascoviruses in the field may be vectored by insect parasites. The studies of the effects of infection on larval growth and development demonstrated a marked loss of appetite and a decrease in weight gain within 24–48 hr of infection in all three isolates. Third instars inoculated at a weight of ca. 15 mg gained little weight after infection and had difficulty molting, but survived in an arrested state of development for 2–5 weeks. Controls pupated within 5–7 days after attaining weights, depending on the host species, in the range of 300–500 mg. Arrested development and lack of weight gain appear to be due to decreased feeding, whereas the long survival of infected larvae is likely due to the limited destruction of host tissues.

Lack of Weight Gain Associated with Short-Term Astemizole Treatment

The effect of treatment with astemizole for three weeks on weight was assessed in 44 patients with seasonal allergic rhinitis who participated in a randomized, double-blind, placebo-controlled clinical trial. Astemizole 10-mg tablets and identical placebo tablets were used. Compared with baseline, weight increased significantly in astemizole-treated patients (1.07 +/- 1.39 kg; p = 0.0004); however, the mean change in weight in astemizole-treated patients was not statistically significantly different than that seen in placebo-treated patients (0.85 +/- 1.68 kg). No relationship was found between changes in weight and age, sex, initial weight, percentage of obesity, and plasma astemizole concentrations.

Trazodone Treatment of Bulimia Nervosa

Thirteen consecutive referrals of bulimic patients who met DSM-III criteria for bulimia were treated in an open-label, flexible-dose study with trazodone. Three of the 13 dropped out before the fourth week of treatment, the minimum duration of treatment for evaluable subjects, and hence were not included in the analyses. For the 10 evaluable patients, the mean duration of treatment was 6.9 weeks and the mean maximum dose of trazodone was 410 mg (range, 250-600 mg). The number of binge eating and vomiting episodes was significantly decreased (p = 0.05 and 0.06, respectively). These episodes were reduced to zero in four patients and by 55-99% in two patients. Carbohydrate cravings and urges to binge eat were significantly diminished in intensity (p less than 0.02 and 0.008, respectively). The total score (p = not significant) and three subscale scores (p = 0.04, 0.09, and 0.10) of the Eating Disorders Inventory decreased. The mean Hamilton Depression Scale score fell from 10.4 to 3.3 (p = 0.002). Only mild side effects were noted: five subjects complained of morning drowsiness and two of headache. Mean weight was essentially unchanged: pretreatment, 58.5 kg; posttreatment, 57.3 kg. The lack of weight gain represents an advantage of trazodone over other currently prescribed antidepressants, particularly for this group of patients whose fear of becoming fat is a part of their basic pathology.

Effects of chronic sodium salicylate feeding on the impaired glucagon and epinephrine responses to insulin-induced hypoglycaemia in streptozotocin diabetic rats.

The potential role of endogenous prostaglandins in glucagon and epinephrine responses to insulin-induced hypoglycaemia was studied in streptozotocin-diabetic and age-matched control adult male rats. Rats made diabetic with a single intravenous injection of streptozotocin (65 mg/kg) developed impaired glucagon and epinephrine responses to insulin-induced hypoglycaemia by 80-100 days. Plasma glucagon levels in response to insulin-induced hypoglycaemia in streptozotocin-diabetic rats (167 +/- 67 pg/ml) were significantly lower (p less than 0.01) than those in control rats (929 +/- 272 pg/ml). Similarly, plasma epinephrine levels in hypoglycaemic state in streptozotocin-diabetic rats (11 +/- 8 pmol/ml) were also significantly lower (p less than 0.01) compared to control rats (37 +/- 13 pmol/ml). Streptozotocin-diabetic rats provided with sodium salicylate (25 mg/100 ml) in their drinking water from day one of diabetes exhibited prevention of the blunted glucagon and epinephrine responses to insulin-induced hypoglycaemia. About 80-100 days after the chronic sodium salicylate treatment in streptozotocin-diabetic rats, both plasma glucagon levels (1080 +/- 169 pg/ml) and plasma epinephrine levels (39 +/- 8 pmol/ml) were essentially identical to plasma glucagon levels (1074 +/- 134 pg/ml) and plasma epinephrine levels (37 +/- 5 pmol/ml) in control rats in hypoglycaemic state. These animals also exhibited an improvement in the diabetic state in that they had less severe hyperglycaemia and lack of weight gain. These results suggest that the blunted glucagon and epinephrine responses to insulin-induced hypoglycaemia may be related to altered prostaglandin levels in streptozotocin-diabetes.

Nonorganic failure to thrive in infancy: an update on nutrition, behavior, and growth.

Failure to thrive (FTT) has been defined in a number of ways, but most definitions include a weight less than the 5th percentile on the growth chart or a decreasing rate of weight gain. Nonorganic failure to thrive (NOFTT), i.e., FTT not due to organic disease, is the most common category of FTT in the United States and is associated with delayed growth and development and abnormal behaviors. Factors extrinsic to the infant are primarily responsible for NOFTT. That acute undernutrition may be a cause of the poor weight gain is suggested by anthropometric studies and by the observation that NOFTT infants often gain weight when food is supplied. Yet, decreased caloric intake has been documented in only a few infants, and not all infants immediately gain weight when given adequate calories. Current thinking attributes lack of weight gain in NOFTT to probably mixed interacting causes, including decreased nutrition, and abnormal hormonal mechanisms associated with abnormal behavior. That behavior and nutrition are related is recognized, but their interactions have not been adequately documented or explained. It is unknown whether behavior affects growth directly through nutrition or independently of nutrition. Until the cause or causes of poor growth and development in NOFTT are understood, permanently reversing the process will be difficult. This report reviews what is presently known about nutrition and growth in NOFTT.

A comprehensive approach to community welfare: growth monitoring and the role of women in Jamkhed.

The Comprehensive Rural Health Care Project at Jamkhed services 175 villages with a total population of almost 200000. The program actively encourages community participation self-help and integration of solutions to all types of problems within the community. The project started as a mobile clinic which periodically visited each village. Villagers participated in weighing and nutritionally assessing the children. Drought hit the area in 1972 and the lack of weight gain in children caused communities to establish special feeding programs for the poor children. Growth monitoring has helped villagers to understand growth-development relationships and has been an important tool for diagnosing illnesses in children with no apparent malnourishment problems. A comparison of mean weights between children in 1975 and 1985 was performed. In 1985 less than 6% of the children were moderately or severely malnourished whereas in 1975 30% were considered malnourished. Women villagers were strongly opposed to the cessation of this program. The most difficult problem has been to facilitate the realization among health workers that growth monitoring is an important tool. Also difficult was the introduction of weighing scales into a superstitious community. When given the responsibility of growth monitoring however communities rise to the challenge and participate fully.

Investigation of the nature of the “stretch response” in suckling rats

The “stretch response” in suckling rats has commonly been used as an index of milk ejection and milk intake. In the current study, we have compared the behavior of pups suckling on dams with either full, empty or ligated mammary glands. In response to an IV bolus of oxytocin, pups suckling on both full and empty nipples displayed the characteristic stretch behavior. Lack of milk release from the latter nipples was confirmed by lack of weight gain by the pups. In contrast to pups suckling on intact nipples, those suckling on ligated nipples did not display the stretch response. It is concluded that this behavior occurs in response to erection of the nipple and is not necessarily associated with milk release.

Lack of weight gain with gliclazide treatment for 30 months in type II diabetes.

A long-term follow-up study was carried out in 44 Type II diabetic patients to confirm the lack of effect of gliclazide on body weight as well as its hypoglycaemic efficacy and tolerance. Patients were assessed for up to 51 months. The results showed no overall significant change in body weight, 21 patients gaining weight (mean 3.59 +/- 2.6 kg), 20 patients losing weight (mean 3.39 +/- 2.6 kg) and 3 patients showing no weight change. Satisfactory hypoglycaemic control was achieved in all but 8 patients who were transferred to insulin. Clinical and biochemical tolerance was good.

Lack of weight gain of sheep following iodine supplementation in inland regions of the South Island.

Weight gain response to iodine supplementation was investigated in five groups of sheep in different seasons. In only one spring period in one trial was a significant response obtained.

Pancreatic atrophy in young Beagle dogs.

Six young Beagle dogs had non-inflammatory pancreatic atrophy associated with lack of weight gain and low serum protein levels. Histologically there was severe atrophy with loss of acinar architecture and absence of islets of Langerhans (type 1), or partial atrophy with ppreserved islets (type 2). The correlation between histological type and clinical severity was poor.

Recurrent folic acid deficiency in sickle cell disease.

We have intensively studied an apparently well-fed 10-year-old child with sickle cell disease who had four episodes of folic acid deficiency in 21/2 years. The first two episodes were characterized by megaloblastic changes in the blood cells. Lack of weight gain which occurred during all four episodes preceded hematological changes and correlated well with the biochemical indices of folic acid deficiency. Faulty intestinal absorption and excessive urinary excretion of folic acid were apparently not involved. The patient was on a dietary regimen which would have prevented the deficiency in a normal child.

Antenatal malnutrition: Its relationship to subsequent infant and child development

Congenitally malnourished animals have shown more severe changes than those whose malnutrition was begun after birth. Critical periods of development in the brains of animals and human seem well-established. Malnutrition between the tenth and thirtieth weeks of gestation may result in permanent changes in reflexes with the later-developing ones disappearing first. Clinical and electroencephalographic evidence shows that brain function in children is affected by states of malnutrition; this dysfunction may persist following correction of the deficit. Vitamins have been shown to be of developmental importance. Maternal undernutrition or lack of weight gain has been associated with small-for-dates infants who subsequently have a poor developmental prognosis. In a study on malnourished infants from homes where malnourishment among the parents before and during pregnancy was most likely revealed: 1) abnormalities of EEG (presence of theta waves low voltage alpha-waves) 2) low IQ 3) a pattern similar to brain-injured children with a deficit of visual motor ability and pattern perception. The timing severity and duration of malnutrition markedly influence the quality extent and degree of reversibility of observed deficits. Persistence of malnutrition across generations appears to worsen outcome and prognosis at least in animal studies.