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Weight gain, adiposity, and eating behaviors among adolescent females on depot medroxyprogesterone acetate (DMPA)

  • Andrea E Bonny
    Correspondence
    Address correspondence to: Andrea E. Bonny, MD, Case Western Reserve College of Medicine, Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA
    Affiliations
    1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio; 2University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Maria T Britto
    Affiliations
    1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio; 2University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Bin Huang
    Affiliations
    1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio; 2University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Paul Succop
    Affiliations
    1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio; 2University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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  • Gail B Slap
    Affiliations
    1Division of Adolescent Medicine, Children's Hospital Medical Center, Cincinnati, Ohio; 2University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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      Abstract

      Objective

      To identify risk factors for weight gain and explore body composition and eating behaviors among adolescent females initiating depot medroxyprogesterone acetate (DMPA).

      Methods

      A longitudinal study was conducted in 43 adolescent females beginning DMPA. Data collection at baseline, 3, and 6 months included structured interview; measurement of height, weight, and percent body fat; and assessment of dietary restraint, disinhibition, and appetite.

      Results

      Black and white subjects did not differ in baseline weight or body composition. At 6 months, black subjects had a 4.2% increase in weight (mean weight gain = 2.9 kg; P = 0.003) and a 12.5% increase in body fat (mean fat gain  = 2.5 kg; P<0.001). In contrast, white subjects had a 1.2% increase in weight (mean weight gain = 0.9 kg; P = 0.32) and a 1.2% increase in body fat (mean fat gain of 0.5 kg; P = 0.54). Baseline weight (P<0.001), study visit (P = 0.005), age (P = 0.006), eating restraint (P = 0.005), eating disinhibition (P<0.001), and other medications (P<0.001) were predictive of weight gain in black subjects. Only baseline weight (P<0.001) was predictive in white subjects. Higher baseline weight (adjusted odds ratio (AOR) = 1.2, 95% confidence interval (CI) = 1.1,1.3) was a risk factor for gaining >2.2 kg the first 3 months. Black race (AOR = 7.8, 95% CI = 1.5, 66.2) and younger age at menarche (AOR = 0.6, 95% CI = 0.3, 0.9) were risk factors for gaining >2.2 kg the second 3 months. Appetite decreased in the study sample reaching statistical significance in black subjects.

      Conclusions

      Our data suggest that black and white adolescents differ in the quantity, timing, and predictors of weight gain on DMPA. DMPA-associated weight gain is paralleled by increases in total body fat, while appetite decreases on DMPA.

      Keywords

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