title: Role of apathy in the effectiveness of weight management programmes.
abstract: OBJECTIVE
  Obesity, which is at epidemic proportions in the USA, is associated with a higher risk of several co-morbid diseases including, cardiovascular disease, cancer and sleep apnea. Weight loss and weight maintenance programmmes are difficult to sustain for long term. Mental health problems such as apathy may be a major factor in patients unsuccessful in adhering to weight loss programmes. We propose that treating apathy will result in better weight loss in obese patients.
  
  
  METHODS
  This was a randomized prospective pilot study. Obese patients (n = 101) were randomized in a 1:2:2 ratio to either (i) standard nutrition counselling; or (ii) the Department of Veterans Affairs weight loss programme called 'motivate obese veterans everywhere ' (MOVE); or (iii) methylphenidate treatment plus the MOVE programme together. The intervention was for 6 months (26 weeks).
  
  
  RESULTS
  For the within groups analysis, the absolute changes in weight (kg) are as follows, for MOVE (mean: -1.84; 95% confidence interval (CI): -4.56 to 0.87; p = 0.25), Methylphenidate (mean: -4.61; 95% CI: -7.90 to -1.33; p = 0.04), standard nutrition counselling (mean: -0.60; 95% CI: -2.59 to 1.39; p = 0.21), which indicates that although all three groups lost weight, only the methylphenidate group achieved statistical significance. The between group differences of the relative change in weight were not statistically different. The apathy evaluation score and the patient activation measure improved in all groups.
  
  
  CONCLUSIONS
  Together these data suggest that treating apathy might be an important factor in the success of weight management programmes.
authors.affiliation: Omaha VA Medical Center, Omaha, NE, USA. cdesouza@unmc.edu
authors.forename: C V
authors.initials: CV
authors.lastname: Desouza
authors.forename: P R
authors.initials: PR
authors.lastname: Padala
authors.forename: G
authors.initials: G
authors.lastname: Haynatzki
authors.forename: P
authors.initials: P
authors.lastname: Anzures
authors.forename: C
authors.initials: C
authors.lastname: Demasi
authors.forename: V
authors.initials: V
authors.lastname: Shivaswamy
mesh_terms: D057565:Apathy / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D037001:Directive Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy / Q000523:psychology*; D010865:Pilot Projects; D011446:Prospective Studies; D014481:United States; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate