Adiposity, Hepatic Triglyceride, and Carotid Intima Media Thickness During Behavioral Weight Loss Treatment in Antipsychotic-Treated Youth: A Randomized Pilot Study.

The purpose of this pilot study was to evaluate changes in adiposity, carotid intima media thickness (CIMT), and hepatic fat content measured via magnetic resonance imaging-estimated hepatic proton density fat fraction (PDFF) in antipsychotic (AP)-treated youth versus nonpsychiatric (NP) participants during participation in a 16-week behavioral weight loss (BWL) intervention. Overweight/obese AP-treated youth ( = 26) were randomized 2:1 to weekly treatment versus recommended care (RC) over 16 weeks. NP controls ( = 21) were assigned to weekly treatment. Dual-energy X-ray absorptiometry (DEXA)-measured adiposity, CIMT, and PDFF were measured at baseline and 16 weeks. Analyses assessed group differences in the effect of BWL on adiposity, CIMT, and PDFF. BWL was well tolerated in both AP-treated and NP groups. DEXA-measured fat decreased significantly in the NP group ([1,16] = 11.81,  = 0.003), with modest improvements in adiposity and hepatic fat in the AP-treated group, while an increase in adiposity was observed in the RC group. Significant differences in endpoint DEXA total fat ([2,34] = 4.81,  = 0.01) and PDFF ([2,30] = 3.60,  = 0.04) occurred across treatment groups, explained by larger improvements in NP versus RC youth in DEXA total fat ( = 0.03) and PDFF ( = 0.04). Intensive, family-based BWL treatment can improve whole-body adiposity and liver fat in obese youth, with decreases or attenuation of additional fat gain observed in AP-treated youth.