Cases reported "Weight Gain"

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1/34. Prescription medications: a modifiable contributor to obesity.

    BACKGROUND: While usually not the only factor in obese patients, prescription medications, which may increase appetite or body weight, can be important in some individuals. The cause of weight gain in such cases may go unrecognized or lead to cessation of medication with or without the practitioner's knowledge or approval. methods: We found illustrative cases among patients treated at the Johns Hopkins Weight Management Center, searched medline and the Micromedex Drug Information database, and organized this information by drug mechanism and indications for use. RESULTS: Most reports of medication-induced weight gain are anecdotal or gleaned from clinical trials. Notable offenders include hormones (especially corticosteroids and insulinotropic agents), and psychoactive medications (especially tricyclic antidepressants, lithium, and some antipsychotics). CONCLUSIONS: Medication-related increases in appetite and body weight are under-recognized and cause noncompliance with pharmacotherapy. A high index of awareness of the known mechanisms by which medications can lead to weight gain has the potential to prevent most medication-related contributions to weight gain and obesity.
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2/34. Progressive muscle pain, weight gain, fatique and unusual body shape change.

    Multiple symmetrical lipomatosis (MSL) is a rare syndrome characterized by symmetric unencapsulated lipomas around the axial region and frequently associated with neurological involvement, particularly myopathy and neuropathy (Klopstock et al., 1994). Here we present a typical image of a patient with MSL, explaining this disease for neurologists who might care for these patients in an average day at the neuromuscular consultation unit.
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3/34. serum leptin, gonadotropin, and testosterone concentrations in male patients with anorexia nervosa during weight gain.

    amenorrhea in female patients with anorexia nervosa is associated with low leptin secretion, thus suggesting a causal link. In an attempt to address the hypothesis that leptin also influences the hypothalamo-pituitary-gonadal function in males, we studied three male patients with acute anorexia nervosa longitudinally. serum levels of leptin, LH, FSH, testosterone, and SHBG were measured on a biweekly basis during weight gain. leptin levels at low body mass index values were below the 5th percentile. During weight gain, leptin levels reached or surpassed the 95th percentile. The temporal dynamics of body mass index and fat mass were closely related to those of leptin concentrations in serum. leptin increments were paralleled by increments of gonadotropins, testosterone, and the free androgen index (FAI). In each of the patients, serum concentrations of leptin were positively correlated with those of testosterone (P = 0.0001, P = 0.01, P = 0.07, respectively) and FAI (P = 0.0001, P = 0.0001, P = 0.09, respectively). In addition, in the combined data set of all patients changes of leptin over time were positively correlated with changes in LH (P = 0.01), FSH (P = 0.0001), testosterone (P = 0.002), and FAI (P = 0.002). In conclusion, these data suggest that leptin might also play an important role in the regulation of the hypothalamo-pituitary-gonadal axis and fertility in underweight males as has previously been shown in underweight females.
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4/34. Severe orthostatic hypotension following weight reduction surgery.

    Surgical interventions for morbid obesity are common practice in many countries, especially when other treatment options have failed or when rapid weight loss is desired. The association between weight and blood pressure is well established, especially the paradigm of obesity-related hypertension. We describe a 45-year-old obese woman with a medical history of hypertension and type 2 diabetes mellitus who lost 57 kg within a few months after a weight reduction surgery. She suffered from severe orthostatic hypotension, which probably resulted from sympathetic nervous system dysfunction. Our patient's clinical status improved with pharmacological interventions, but her symptoms resolved completely after she gained weight following a surgical reversal of the gastric partitioning owing to a local complication. autonomic nervous system activity does change with the changes in body weight, but after evaluation of this patient, we believe that rapid weight loss may impair sympathetic function and blood pressure control. Although losing weight is a known treatment option for hypertension, exaggerated reversal of obesity-related hypertension might result in orthostatic hypotension.
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5/34. Olanzapine induces remarkable weight gain in adolescent patients.

    We present here clinical case reports of three adolescents, aged 14-17 years, who were treated with olanzapine. The daily dose was 10 mg. Prior to olanzapine, the patients were unsuccessfully treated with other antipsychotic drugs. The response to olanzapine for psychotic symptoms was clinically significant in all three patients. The major adverse effect was excessive weight gain. The increases in body mass index (BMI) were 9, 8 and 5 kg/m2. One of the patients later lost the additional weight. Especially in adolescents obesity is a serious side effect and potential consequences include numerous health problems.
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6/34. obesity in transplant patients: case report showing interference of orlistat with absorption of cyclosporine and review of literature.

    OBJECTIVE: To report a case of an obese patient who had undergone renal transplantation and who had subtherapeutic levels of serum cyclosporine after treatment with orlistat. methods: The clinical and laboratory findings are presented, and the few cases reported in the literature are reviewed. RESULTS: A 29-year-old woman had subtherapeutic plasma levels of cyclosporine after orlistat treatment (360 mg/day) was initiated. The subtherapeutic levels persisted even though orlistat was administered the recommended 2 hours before ingestion of cyclosporine and even though the dosage of orlistat was decreased to only 240 mg/day. Because an increase of body weight is common after organ transplantation, treatment with orlistat has been used. In such patients, however, six cases of reduced therapeutic plasma levels of cyclosporine have been reported. Although a drug-drug interaction has been suggested, this case suggests that the decreased plasma cyclosporine levels are due to reduced absorption of fats rather than a drug-drug interaction. Because this patient was unable to adhere to a low-fat diet, she experienced severe diarrhea, a factor that may have dramatically diminished the absorption of cyclosporine. CONCLUSION: Adherence to a low-fat diet should be strongly recommended if orlistat is prescribed to patients taking cyclosporine. Moreover, strict surveillance of the plasma concentration of cyclosporine is important.
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7/34. Serial body composition by bioimpedance analysis in a diabetic subject with rapid insulin-induced weight gain--a case report.

    insulin treatment is well known to induce progressive body weight gain. However, rapid weight increase due to transient fluid accumulation is rare. Bioelectrical impedance analysis (BIA) is a convenient method for determining body composition and water content. We report an 18-year-old diabetic female with rapid insulin-induced weight gain due to excessive body water retention, found by serial BIA measurement. The patient was admitted to our hospital due to uncontrolled diabetes. She had an initial body weight of 55 kg and height of 165 cm. However, a weight gain of 6.5 kg was noted one week after starting insulin injections and further increased to 8 kg after the second week. Finally a net weight increase of 4 kg from fat and lean mass was attained after two months. The weekly BIA data showed that most of the initial weight gain came from water retention, peaking on day 14 and recovering afterwards. Rapid weight gain shortly after insulin therapy may be due to excessive but reversible water retention, detected by repeated BIA measurements.
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8/34. Continuous insulin infusion: promoting growth in low birth weight infants.

    Development of improved technologies in neonatal care has yielded increasing numbers of surviving low birth weight (LBW) infants who have challenged methods of supportive care. As researchers and practitioners have focused on respiratory, cardiac, and other body system requirements, nutritional support has been low on the priority list. Support for growth and maximized neurologic development, rather than simply for survival, has been the challenge in care of small and sick newborns. Use of insulin to enhance glucose tolerance in LBW infants, and thereby maximize growth, is a management modality that can be initiated early in the infant's course and is facilitated by implementation of clear and consistent policies and procedures. Continuous insulin infusions have been demonstrated to enhance glucose uptake and utilization--facilitating neonatal growth and in turn enhancing brain growth and developmental outcome.
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9/34. Severe weight gain induced by combination treatment with risperidone and paroxetine.

    Successful combination therapy with atypical antipsychotics and selective serotonin reuptake inhibitors has been reported for several psychiatric conditions. However, great attention should be paid to the possible adverse effects. In this retrospective chart review, we focused on the drug-drug interaction of paroxetine and risperidone. Retrospectively, we identified two patients treated with a combination of risperidone and paroxetine therapy, and analyzed their medical records. During a 3-month period of monotherapy with risperidone, the changes in body weight were /- 0.0 kg in Patient 1 and -2.0 kg in Patient 2. In contrast, during combination therapy with paroxetine and risperidone, the body-weight changes were 14.0 kg in Patient 1 (after 4 months) and 13.5 kg in Patient 2 (after 5 months). In addition, diabetes mellitus was observed in Patient 2. Regarding the mechanism of severe weight gain in these two patients, we speculate a drug-drug interaction involving inhibition of the cytochrome P450 enzyme 2D6 (CYP4502D6) by paroxetine.
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10/34. amantadine treatment of psychotropic-induced weight gain in children and adolescents: case series.

    OBJECTIVE: The purpose of this study was to explore whether amantadine would slow or reverse significant weight gain in children and adolescents treated with antipsychotics and/or mood stabilizers that may promote increases in weight. methods: Eight boys and one girl ages 9-16 years and their parents consented to an open trial of amantadine 100 mg po bid or tid for weight gain in children. Side effects and body mass index were determined at baseline and during amantadine treatment. RESULTS: A mean weight gain of 10.5 kg (19.9% mean increase in body weight) occurred from baseline to the beginning of amantadine treatment. amantadine trial length averaged 14.5 weeks (range 4-33 weeks). A planned comparison using repeated measures analysis of variance demonstrated strong support for a "slowing weight gain" mechanism (p = 0.001) for weight gain and body mass. weight loss was strongly correlated with length of amantadine treatment (p = < 0.05). One child experienced orthostatic hypotension with concomitant stimulant medication. No other side effects or exacerbation of psychiatric symptoms was reported. CONCLUSIONS: amantadine appears to stabilize weight gain related to psychotropic medications. Decreased weight and body mass index may occur with continued amantadine usage. Controlled trials of amantadine in children and adolescents taking weight-gain-inducing psychotropics are warranted.
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