Mitigating Weight Gain Side Effects by Reducing Sugar-Sweetened Beverage Consumption in Youth Newly Prescribed Second-Generation Antipsychotic Medication

Abstract

Background: Antipsychotic medication (APM) can cause weight gain, insulin resistance, dyslipidemias, and an increased risk of developing type-2 diabetes and cardiovascular disease among youth. The study sought to increase water consumption, reduce sugar-sweetened beverage (SSB) intake, and prevent unhealthy weight gain via a healthy lifestyle intervention among youth newly started on a second-generation APM for psychiatric treatment. Methods: This randomized controlled trial enrolled 148 Medicaid-insured youth (ages 8–17) recently starting APM. The treatment group received both a biweekly home-delivery of bottled water and parental phone support from a family navigator. In-home visits conducted at baseline, three months, and six months assessed the participants’ height/weight and dietary intake. All participants received basic healthy lifestyle education emphasizing increased water intake and decreased SSB consumption. Longitudinal linear mixed models were conducted to examine between-group and within-group changes in BMI z-scores, and water/SSB intake. Results: No significant between-group differences in BMI z-score were found at three (p = 0.908) and six months (p = 0.919). However, the within-group increase in BMI z-score in the control group was significant from baseline to three months (p = 0.029). A between-group comparison found the treatment group significantly increased their water intake at three (p = 0.006) and six months (p = 0.002). No between-group differences were identified at three and six months for the reduction in SSB, although the treatment group did demonstrate a decrease from baseline to three months (p = 0.004). Conclusions: Neither group experienced unhealthy increases (>0.5%) in BMI z-score over the six months. Providing a safe/free water supply showed a superior improvement in water consumption in the treatment group, and an initial decrease in SSB. Further studies are needed to identify feasible, effective, and sustainable lifestyle interventions tailored to this at-risk population.