Intervention for weight gain in schizophrenia

One well-known side effects of antipsychotic medication for schizophrenia is weight gain. However, other factors related to schizophrenia, such as an unhealthy lifetstyle that may have developed as a result of having the disease, or other genetic risk factors, can also mean that obesity is an unavoidable part of schizophrenia. Psychiatrists and other mental health professionals don’t want the weight gain side effect to be another burden on recovering patients with schizophrenia, especially if it means that they may not continue to take their medication, which can lead to a return of psychotic symptoms. Furthermore, poor physical health in patients with schizophrenia mean that they are more likely to suffer from other medical diseases and die earlier than the general population.

Weight gain is a serious side effect of antipsychotic medication.Photo: © Braendan | Stock Free Images

Weight gain is a serious side effect of antipsychotic medication.
Photo: © Braendan | Stock Free Images

A recent study published in BMC Psychiatry tested a six-month intervention program aiming to introduce healthy lifestyle habits to schizophrenia patients. This program included group discussions on things like healthy diet and exercise. The patients that completed normal recovery care plus the healthy lifestyle program lost weight on average, while a control group of patients that had normal care that didn’t include the healthy lifestyle program actually gained weight on average. This may seem obvious, but it’s a good start to show that a program like this may be beneficial as part of standard care for recovering schizophrenia patients.

The study also measured diet and physical activity at baseline and the three-month follow-up by giving the participants questionnaires, as well as blood pressure and cholesterol levels. I think what’s really interesting about this study is that all of those secondary measures did not differ between groups, and the groups did not differ in how much those measures, other than weight, changed over time. It is unusual to see a change in weight without other measures of health changing. I think there could be several reasons for this:

  • The secondary measures were only measured at baseline and three months, while weight was measured at baseline, three months, and sixth months. It’s possible that if they’d measured things like blood pressure and cholesterol they may have seen more of a change in the healthy lifestyle program group.
  • But weight had already decreased in that group as early as three months. Which could mean that weight changes more quickly than blood pressure and cholesterol.
  • However, I suspect there could be another mechanism for the weight change that may not involve blood pressure and cholesterol changes. It would have been interesting if this study had measured levels of inflammation. Decreased inflammation in the healthy lifestyle group could have been responsible for weight loss, as this has been shown in other research. And there could have been other reasons for the decrease in inflammation in turn, perhaps even psychosocial (less stress?) mechanisms, not due a healthier diet or increase in physical activity.

It’s interesting when studies raise more questions than they answer!

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