By Boschert, Sherry
Clinical Psychiatry News , Vol. 31, No. 7
SAN FRANCISCO -- Schizophrenic patients lost weight during the course of two small, nonrandomized studies of weight-loss programs for patients on atypical antipsychotics, agents that tend to cause weight gain.
The results of these studies suggest that schizophrenic outpatients are willing to participate in weight-loss programs, and that simple dietary changes can help inpatients lose weight, investigators reported in separate poster presentations at the annual meeting of the American Psychiatric Association.
In the first study 31 overweight or obese outpatients on atypical antipsychotic monotherapy for schizophrenia or schizoaffective disorder enrolled in an intensive, 3-month program that incorporated twice-weekly group meetings and one individual 15-minute session per month.
Patients learned nutrition principles, physical fitness concepts, and behavioral techniques such as slower eating and differentiating between emotional and physiologic hunger. Opportunities to engage in aerobic walking were provided during the group sessions, and patients were encouraged to exercise three to five times per week.
Of 27 patients who completed the 12week program, 20 continued in a 6month maintenance program involving weekly group meetings and one individual 15-minute session per month. These patients were measured and tested at the end of 1 year.
The average body mass index decreased from 34 to 32 among patients who completed the study, but increased from 33 to 35 in a control group of 20 schizophrenic patients on atypical antipsychotics who received "usual care" without the weight-loss program, Dr. Matthew A. Menza said.
Patients in the intervention group lost 6 pounds on average, compared with an average gain of 8 pounds in the control group, said Dr. Menza, chief of clinical psychopharmacology at Robert Wood Johnson Medical School, Piscataway, NJ.
The most commonly used antipsychotic in each group was olanzapine (Zyprexa); also used were risperidone (Risperdal), clozapine, and quetiapine (Seroquel). …