What is it about?
For many people living with a mental illness, medications are essential as part of a comprehensive care plan to not only alleviate symptoms but also to improve the quality of life and improve function. Unfortunately, for some medications in psychiatry, they have a risk of causing weight gain which is undesirable and understandably a reason why people do not want to begin treatment or stay on the treatment. Fortunately, in many cases, weight gain that is associated with psychiatric medication is preventable by changing diet, lifestyle, sleep patterns and engaging in exercise. In some cases, there are alternative psychiatric medications that are equally effective for select mental illnesses that could be considered if the initial medication prescribed is causing weight gain. In some circumstances, if the medication is really helpful for a mental illness but causes weight gain that is not responding/improving with to diet/lifestyle/behavioral modification, improvement in sleep and exercise, there are new treatment options that clinicians can discuss with their patients. These new treatment options may help reduce the likelihood of gaining weight and should be discussed as part of a shared decision process between the clinician and patient. This article summarizes the field on medication-related weight gain in people with a mental disorder, how to prevent it, and how to treat it.
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Why is it important?
Medication to treat psychiatric disorders are frequently prescribed in the general population with more than 15% of the general population currently taking some type of psychiatric medication. These medications are associated with weight increase and it is important for us to have an updated summary of the best science documenting the extent to which weight increase can occur and how we can prevent and treat it.
Perspectives
As a psychiatrist, an academic, and most importantly, as an advocate of people who live with mental illness, it is important that we have treatments that are helpful and do not cause problematic side effects like weight gain. Although some medications have a risk for weight gain, it may not be inevitable, and there are many things that we can do to prevent and treat it. I hope these strategies will increase the acceptability of the treatment, and consequently people will have a much better outcome which is what we all hope for. It is exciting that there are lots of new ways to treat and prevent weight gain with medication in psychiatry.
Roger McIntyre
Read the Original
This page is a summary of: Psychotropic Drug–Related Weight Gain and Its Treatment, American Journal of Psychiatry, January 2024, American Psychiatric Association,
DOI: 10.1176/appi.ajp.20230922.
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