Abstract
Weight Loss Interventions for Patients with Schizophrenia
Author(s): Martin Strassnig, Rohan GanguliIntroduction: Obesity, metabolic syndrome, diabetes, hypertension, and other risk factors for cardiovascular disease occur in persons with schizophrenia at rates twice those in the general population. Epidemiologic studies also reveal that persons with schizophrenia are likely to have their lives shortened by as much as twenty percent. Since obesity is an independent risk factor for heart disease, dyslipidemia, and diabetes, interventions that decrease the rates and severity of obesity have the potential for reducing both morbidity and mortality in persons with schizophrenia. Methods: A selective electronic MEDLINE search of published articles to review tested pharmacological and nonpharmacological interventions to address obesity in patients with schizophrenia was conducted. Results: Antiobesity drugs, behavioural approaches, and in select cases, bariatric surgery, may all lead to clinically significant weight loss in obese individuals with schizophrenia. We found no published long-term, randomized, controlled clinical trials to determine whether weight loss achieved in short-term studies is maintained. There were also few studies of combinations of the best behavioural and pharmacologic approaches. Conclusion: Weight loss is difficult to achieve, but attainable for individuals suffering from schizophrenia. Even small amounts of weight loss may provide significant long-term health benefits, if sustained. Rigorous controlled trials of combined pharmacologic