Endocrine Abstracts

Background: Many antipsychotics are obesogenic and contribute to significant weight gain with serious implications on patients’ physical and mental well-being. However, patients on antipsychotics are often excluded from unmodified lifestyle-intervention weight management programmes and trials.

Objectives: To determine if weight loss is possible for antipsychotic-medicated obese patients when enrolled in an unmodified lifestyle-intervention weight management programme.

Methods: Data from 44 antipsychotic-medicated participants (AP) and 88 matched control participants (CP) were analysed to determine weight outcomes. Dietary and activity behaviours at baseline for an AP sub-cohort were also reported. Results were expressed as mean (95% CI); Mann–Whitney U test was used to assess differences between cohorts.

Results: Enrolment mean weight of AP was 139.8 kg (130.5–149.0 kg) compared with CP of 140.5 kg (134.4–146.6 kg; P=0.478). Enrolment BMI was 49.1 kg/m² (46.0–52.3) compared with 48.9 kg/m² (46.8–51.1; P=0.515). Twenty-five AP participants lost weight (mean weight loss: −9.1 kg). There was no difference in weight outcomes in AP compared to CP groups (−2.0 vs −2.4 kg; P=0.824). Also 9 (20.5%) AP participants lost 5% baseline weight compared with 18 (20.5%) in CP (P>0.99) while 5 (11.4%) in AP lost 10% weight compared with 6 (6.8%) in CP (P=0.373). At baseline, the AP group ate fast food 1.7±1.2 times/week, fresh fruit 1.0±1.4 times/day and reported 2.5±3.0 missed breakfasts/week. Baseline gait speed was lower in AP group (0.99±0.2 m/s vs 1.09±0.34 m/s in CP cohort) and improved slightly to 1.01±0.3 m/s.

Conclusion: Modest weight loss can be achieved in patients on long-term antipsychotics enrolled into an unmodified weight management programme designed for the general population. Typical dietary strategies such as encouraging breakfast consumption and reducing fast food and increased physical activities are relevant to this cohort of patients.