Relationships between food-related behaviors, obesity, and medication use in individuals with Smith-Magenis syndrome

Authors: GANDHI, ANUSHA - Baylor College Of Medicine; WILSON, THERESA - Baylor College Of Medicine; SISLEY, STEPHANIE - Children'S Nutrition Research Center (CNRC); ELSEA, SARAH - Baylor College Of Medicine; FOSTER, REBECCA - Washington University School Of Medicine

Submitted to: Research in Developmental Disabilities
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/29/2022
Publication Date: 5/18/2022
Citation: Gandhi, A.A., Wilson, T.A., Sisley, S., Elsea, S., Foster, R.H. 2022. Relationships between food-related behaviors, obesity, and medication use in individuals with Smith-Magenis syndrome. Research in Developmental Disabilities. 127. Article 104257. https://doi.org/10.1016/j.ridd.2022.104257.
DOI: https://doi.org/10.1016/j.ridd.2022.104257

Interpretive Summary: Smith-Magenis syndrome (SMS) is a complex disorder which includes learning disabilities, sleep disruption, obesity and food-seeking behaviors. The complexity of the syndrome often results in individuals being placed on multiple medications, some of which can cause an increase in body weight. It is not known if medication use is associated with food-related behaviors or weight. In this study we found, that individuals with SMS and overweight or obesity had worse food-related problems. These included more difficulty feeling full, maladaptive eating behaviors, inappropriate responses to food, and increased hunger. Individuals who were prescribed medications for anxiety or depression also had more detrimental food-related behaviors. Last, males with SMS had greater maladaptive eating behaviors and hunger than females. Thus, our research shows an association of weight status and medication use with detrimental food-related behaviors. More research is needed to determine how medications interact with behavior in SMS and also highlights the need to choose medications with their weight-related side effects in mind in this population.

Technical Abstract: Smith-Magenis syndrome (SMS) is a complex neurodevelopmental disorder that includes obesity and food-seeking/satiety-related behaviors. This study examined associations between food-related/hyperphagic behaviors, weight, and medication use in individuals with SMS. Caregivers of individuals with SMS in the Parents and Researchers Interested in SMS (PRISMS)Patient Registry completed a demographic/medication questionnaire, the Hyperphagia Questionnaire for Clinical Trials, and the Food Related Problems Questionnaire. Among 49 participants (Mage = 16.41 +/- 12.73 years, range = 4-69 years, 55% girls/women), individuals with SMS with overweight/obesity (n = 22) had worse overall food-related problems including greater impaired satiety (p < 0.05), maladaptive eating behaviors (p < 0.05), inappropriate response (p < 0.01), and hyperphagia (p < 0.01) compared to individuals of normal/underweight (n = 27). Those taking anti-depressants/anxiolytics (n = 16) had greater maladaptive eating behaviors (p < 0.05), hyperphagic behaviors (p < 0.05), and hyperphagic severity (p < 0.05) than those not taking anti-depressants/anxiolytics (n = 33). Boys/men with SMS had greater maladaptive eating behaviors (p < 0.05), inappropriate response (p < 0.05), and hyperphagic drive (p < 0.01) than girls/women with SMS. Maladaptive food-related behaviors were higher in individuals with SMS with overweight/obesity, taking anti-depressants/anxiolytics, or who were male. Medications in this population should be chosen with weight-related side effects in mind.