Schizophrenia and weight management: a systematic review of interventions to control weight

Objective: Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. Method: A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. Results: Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (< 5% baseline body weight). All behavioural ( including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. Conclusion: Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modi. cation programme is necessary for sustained weight control.