Weight gain and antipsychotic medication.

Antipsychotic-treated patients, who tend to take combinations of psychotropic agents that may cause weight gain, are at special risk for the problems associated with being overweight or obese. Medical and psychiatric examinations should include periodic monitoring for weight change and an obesity assessment for weight-related medical illness. The assessment should involve evaluation of body mass index and waist circumference as well as medical history. Preventative strategies should be undertaken for patients who gain 5 lb (2.3 kg) or more within a 3-year period. A change in antipsychotics may be necessary for overweight patients who are unwilling or unable to lose weight. A treatment plan for overweight or obese patients should include periodic monitoring and recommendations for changes in diet and physical activity. Support groups and adjunct medication may also be helpful. The patient should be reminded of the benefits of even modest weight loss.