Antipsychotic treatment increases body fat and decreases insulin sensitivity in youth

The prevalence of childhood obesity has more than tripled from 1971 to 2011 and is now at epidemic proportions, contributing to rising rates of type 2 diabetes in youths. A new study is the first to show that even short-term treatment with antipsychotic medications commonly prescribed off-label to treat nonpsychotic disorders associated with disruptive behavior, such as attention deficit hyperactivity disorder (ADHD), in youths can increase body fat and decrease the body’s sensitivity to insulin, important early steps in the development of risk for diabetes.

Researchers from Florida Atlantic University and Washington University in St. Louis, conducted a randomized prospective clinical trial of children aged 6 to 18 years to test the hypothesis that antipsychotic treatment adversely increases body fat and decreases insulin sensitivity – important stages in the development of type 2 diabetes. While antipsychotic treatment is known to increase risk for diabetes, the mechanism underlying this risk has been unclear, as most prior studies did not directly measure key factors like changes in body fat and insulin sensitivity. In addition, prior studies have almost always been conducted in adults with years of prior antipsychotic exposure, making it difficult to attribute observed changes only to the medications under study and leaving unanswered questions about the effects of treatment in children.

The study, published in JAMA Psychiatry, is the first to use gold-standard methods to directly measure changes in whole body and abdominal fat as well as insulin sensitivity together in children taking antipsychotics for the first time, providing the researchers with a “clean slate” on which to measure the effects of the medications they studied.

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