Variability and Change Over Time of Weight and BMI Among Adolescents and Adults with Prader-Willi Syndrome: A 6-month text-based observational study

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background:</jats:bold> Prader-Willi syndrome (PWS) is a rare neurodevelopmental disorder in which hyperphagia (excessive appetite) is a hallmark feature. Understanding how weight changes over time in this population is important for capturing the contemporary natural history of the disorder as well as assessing the impact of new treatments for hyperphagia. Therefore, we aimed to determine the feasibility of a remote assessment of weight change over time in PWS. <jats:bold>Methods:</jats:bold> We developed a text message-based, prospective cohort study of adolescents and adults with PWS to assess changes in weight and body mass index (BMI) over a six-month period. Weight was collected weekly, while changes in height, living situation, access to food, activity level, and medication were collected at three-month intervals. <jats:bold>Results:</jats:bold> One hundred and sixty-five participants enrolled in the study, with a mean age of 19.7 years (range 12 - 48). There was considerable variability in weight across participants (range: 76.8 – 207.7 kg). Thirty-three percent of the participants were normal weight, while 15% were overweight and 52% were obese. Overall, the weight of the study participants increased over the study period (mean weight change +2.35%), while BMI was relatively stable, albeit high (mean BMI of 31.4 at baseline, mean BMI percent change + 1.42%). Changes in living situation, activity, food access, and medication had limited impact on weight and BMI changes. Multivariable analysis found that time, sex, age, and percentage of life on growth hormone (GH) therapy were statistically significant fixed effects. Participants submitted more than 95% of possible weight data points across the 26 weeks of the study. <jats:bold>Conclusions:</jats:bold> This remote, observational study of weight change in PWS showed small increases in weight and BMI over a six-month period. Participants were highly compliant with this text message-based study, suggesting that mobile technology-based data collection was manageable for the participants. We anticipate that the results of this study will inform clinical trials for hyperphagia/obesity related therapies in PWS and provide a basis for understanding the efficacy of new therapies for hyperphagia in the real-world setting.</jats:p>

Demographics and medical comorbidities among hospitalized patients with Prader–Willi Syndrome: A National Inpatient Sample analysis

“…Obesity codes were diagnosed during 230 (42.6%) of PWS hospitalizations, and 51.8% of hospitalizations involving individuals aged 4 or older. This is comparable to the 52% obesity rate found in a 6‐month observational study of 165 PWS patients in the United States (mean age 19.7 years; Vrana‐Diaz et al, 2020), and the 58.2% obesity rate in cross‐sectional study of 292 PWS adults in the United States (Dudley et al, 2008). These rates are higher than the prevalence of obesity in the general population, with 42.4% among US adults aged 20 and older being obese in 2018 (Fryar et al, 2020), and 16.1% of matched non‐PWS hospitalizations including a diagnosis of obesity.…”