Reversal of Antipsychotic-Associated Weight Gain
J Clin Psychiatry 2003;64(8):907-912
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Given growing concern about weight
gain associated with treatment with antipsychotic agents, we
performed a retrospective chart review of patients who reversed
weight gain associated with antipsychotic treatment to determine
the prevalence of reversal and both the course and methods used.
Method: Prevalence of weight gain reversal was
determined by surveying clinicians. Of 53 patients who gained
>= 20 lb (9 kg) during antipsychotic treatment, an initial
sample of 12 patients (23%) who subsequently lost >= 10 lb (5
kg) was identified. These 12 patients were combined with
additional patients, identified by the authors, who met the same
criteria for reversal of antipsychotic-associated weight gain to
form a total sample of 35 patients. Course and methods of weight
loss were determined by reviewing these patients' charts.
Information about interventions and both antipsychotic and other
medications was collected.
Results: At the point of maximum weight gain,
the total sample of 35 patients had gained a mean of 29.36 kg
(64.73 lb) over a mean of 33 months. At the point of greatest
weight loss (56 months), these patients were a mean of 10.86 kg
(23.94 lb) over their baseline weight. The most recent weight for
patients (63 months) indicated they were 14.81 kg (32.65 lb) over
baseline. The most frequent weight loss interventions were
regular dietician visits (42.9% [N = 15]), self-directed diet
(28.6% [N = 10]), and weight loss as a treatment goal (25.7% [N =
9]). The least frequent interventions were no intervention (5.7%
[N = 2]), psychiatrist addressing weight loss (5.7% [N = 2]), and
surgery (2.9% [N = 1]). No significant change in medications
prescribed was found.
Conclusion: Some patients who gain weight while
taking antipsychotic medications are able to stop gaining and
lose weight over time, largely through behavioral interventions.
While patients' weight fluctuated, this group sustained a loss of
approximately half their initial gain. Dietary interventions
appear promising and should be explored further to prevent and
reverse weight gain.