Behavioural management of antipsychotic-induced weight gain: a review

Objective: Although psychiatrists are aware of weight gain induced by atypical antipsychotics, only few studies on behavioural interventions in this patient group are published. T his review aims to summarize the evidence on effectiveness of behavioural interventions for weight gain in the general population and in-patients treated with atypical antipsychotics. Method: Medline and Cochrane databases search for evidence on effectiveness of behavioural interventions. Results: In general, behavioural approaches including, diet, exercise and drug treatments may be effective. There were only 13 studies of behavioural interventions for patients taking antipsychotic medication. No study met the criteria for a RCT. Calorie restriction in a controlled ward environment, structured counselling combined with cognitive behavioural therapy and counselling on life style and provision of rewards may potentially lead to weight loss. Conclusion: Currently only limited, methodologically. awed, evidence is available that behavioural interventions in overweight patients treated with antipsychotics, although intuitively appealing, actually work.