A Program for Managing Weight Gain Associated With Atypical Antipsychotics

Abstract

This study assessed the efficacy of a weight control program for patients taking atypical antipsychotics. Thirty-one patients with schizophrenia or schizoaffective disorder participated in a 12-week weight control program that incorporated nutrition, exercise, and behavioral interventions. Changes in patients' weight and in body mass index (BMI) were recorded and compared with those of 15 patients in a control group. The intervention group had a mean weight loss of 2.7 kg (six pounds) and a mean reduction of.98 BMI points, compared with a mean weight gain of 2.9 kg (6.4 pounds) and a mean gain of 1.2 BMI points in the control group. These data suggest that the intervention was effective in this group of patients. Professionals treating persons who are taking atypical antipsychotics should encourage them to engage in weight control activities.

Lifestyle Interventions for Adults With Serious Mental Illness: A Systematic Literature Review

“…However, the average weight loss in these ten studies varied by study design. The mean weight loss for the three single-group studies (20,31,24) was 8.2±5 pounds, whereas the three quasi-experimental studies (24,25,28) and four randomized controlled trials (21–23,35) showed more modest average weight loss (6.2±.4 pounds and 3.4±2.9 pounds, respectively). The mean for the randomized controlled trials reviewed falls below the mean weight loss reported in meta-analyses of randomized controlled trials of lifestyle interventions tested in the general population, which was eight to 11 pounds (44,45).…”

“…Four studies did not specify medication inclusion criteria, but they did enumerate in a general manner (for example, second-generation antipsychotic medications) the type of medications that participants were taking at the time of enrollment (18,23,30,33). The rest of the studies specified medication inclusion criteria that were either restricted to monotherapy with one antipsychotic medication at the time of enrollment (26,27) or combination treatment of one antipsychotic with other psychotropics (16,20,21,24,25,31,32,36). Three studies restricted their intervention to patients taking olanzapine (17,19,22).…”

“…Intervention formats featured individual sessions (29) and group sessions (16,17,19,21,23,26–28,31–34,36,37), with some integrating both approaches (20,22,24,25,38). Interventions were delivered by a range of staff, including registered nurses, exercise physiologists, registered dieticians, trained fitness instructors, case managers, and master's- and doctoral-level health care practitioners.…”

Obesity and psychiatric disorders: Commonalities in dysregulated biological pathways and their implications for treatment

“…In a meta-analysis on randomised, controlled, cognitive-behavioural weight loss trials, Bonfioli et al (2012) concluded that in patients with psychosis, a weight loss of 0.98 points in BMI (corresponding to a loss of 3.12% of initial weight) was demonstrated from pooled data. Weight loss programs can also prevent weight gain associated with antipsychotic use and even promote weight loss (Chen et al, 2009, Gabriele et al, 2009, Menza et al, 2004, Vreeland et al, 2003. In a study by Zhang et al (2012), patients with psychotic spectrum disorders experienced a greater percent baseline weight loss at 12 months, and greater percent BMI loss at 9 and 12 months than people suffering from other psychiatric disorders and no psychiatric disorder.…”

Assessment of physical activity in middle-aged and older adults with schizophrenia

“…Although weight control programs have been tested in this population, few experimentally evaluate PA interventions, and many only address diet and nutrition (McDevitt et al, 2005;Littrell et al, 2003;McCreadie et al, 2005;Evans et al, 2005;Menza et al, 2004). When PA is addressed, studies typically measure it using simple self-reports of time engaged in PA, usually walking (Vreeland et al, 2003). Recently, however, there have been a few reports assessing the reliability and validity of PA self-report measures in persons with SPMI.…”