Several years ago, while I was in college, I drafted an article about schizophrenia and obesity. Throughout the years, I learned several interesting facts that I would like to share. Studies have shown that weight gain is by far the most common side effect of most antipsychotic medications. The type of medications used to treat mental illness plays a significant role in weight gain. Atypical antipsychotic medications like Olanzapine (brand name Zyprexa) and Clozapine (brand name Clozaril) are second-generation atypical antipsychotic medications that increase the risk for serious weight gain.

Aripiprazole (brand name Abilify), Ziprasidone (brand name Geodon), and Lurasidone (brand name Latuda) can help prevent serious weight gain. The other critical area to remember with any antipsychotic medications is to consider an individual’s metabolism. One must understand that genetics plays a huge role in an individual’s body structure. It is particularly important to understand that not everyone is the same. Everyone can react to the same type of drug but in a separate way. What works for one individual to maintain a healthy weight may not work for someone else.

Sadly, it is more so for individuals who are diagnosed with schizophrenia and schizoaffective disorder than for any other individual diagnosed with other mental illnesses. According to research, weight gain is the primary cause of other major health problems and obesity in individuals with schizophrenia and schizoaffective disorders. It is a known factor that antipsychotic medications can cause very rapid weight gain that leads to obesity and other major health problems. Many individuals who are seriously obese are prone to skin breakdown, which leads to serious skin infections, and that is just one example.

 I am fully aware that individuals with schizophrenia /schizoaffective disorders who are obese increase their risk for many other life-threatening diseases, such as cardiovascular heart disease, diabetes, hypertension, sleep apnea, and cerebrovascular accidents. That is just some of the health problems that can arise from not monitoring their weight regularly. Unfortunately, this has increased the cost of care for individuals with schizophrenia and schizoaffective disorder, and for society to provide care for them especially if they are unstable.

There are way too many individuals with a mental illness who do not have a dedicated support system. This leads to unsupervised care in a home environment setting. “Abdominal obesity contributes to increased health risk of those with schizophrenia.” {Van Gaal,2006.} “A major risk for all of these, and one that is amenable to lifestyle intervention is abdominal obesity.” {Meyer et.al., 2005. This plays a leading factor in most individuals diagnosed with any type of mental illness.

 “Most persons with schizophrenia do not understand the risk involved in not eating a proper, nutritious diet and exercising every day. A simple diet must consider the cognitive limitations of clients with schizophrenia. People with schizophrenia may not understand the relationship between weight and diet or may not understand how to improve their eating habits. {Dixon ,2003}. “Studies have documented that persons with schizophrenia consume more saturated fats.” {Ryan, Collins, & Thakore,2003.

  As well as more “refined sugar than healthy persons, and probably less fiber than people with no mental illness.” {Stokes &Peet, 2003}. This is why it is particularly important for each person to have the care necessary to monitor their weight gain. Primary care providers, spouses, other family members, caretakers, adult children, and even close friends can help. I worked in the medical field for years with clients who were severely obese and had no support other than a medical care provider. These are the individuals who fall between the cracks. I have family members who were diagnosed with a mental illness.

The challenge facing the medical field today is understanding the importance and risk factors involved with antipsychotic medications. Because some individuals with mental illness tend to be less active and have poor diet habits. That is why it is so important to find a good primary care provider, psychologist, and counselor. I am a firm believer that not everyone in the different areas of the medical field need to be there. Throughout the years that I have worked in the medical field I have questioned several medical providers about their own decisions as to how they treated their patients / clients.

 The most important thing to remember is finding someone who really listens and who you feel comfortable talking   with them. One needs to remember as well that it is especially important to be honest with the medical providers that care for you. If you have concerns about your care do not be afraid to ask questions. Therefore, I will continue to believe it is especially important for individuals to learn about their medications and their side effects. Every individual knows their own body better than anyone else. I encourage you to learn to look out for yourself.

And again, I will state this is why it is also even more important for everyone who is on antipsychotic medication to learn to monitor their own weight, if possible, by incorporating positive eating habits. One must remember that there are many diverse types of antipsychotic medications. Individuals with schizophrenia, schizoaffective disorder or for that matter, anyone who may exhibit any type of mental illness should understand how important it is to choose one that will help stabilize and control the symptoms, but also not create a serious weight gain.

If one medication causes a lot of weight gain but does an excellent job in controlling the symptoms associated with the mental illness diagnosed, there needs to be a diet change put in place. The outcome for controlling symptoms and controlling serious weight gain will depend on the individual. Providers need to make sure everyone receives the correct care. What works for one individual with schizophrenia / schizoaffective disorder may not work for another individual with the same diagnosis. The same applies with individuals diagnose with other types of mental illness.

 Everyone is different. It is equally important for healthcare providers to screen and monitor weight again closely. “Most of the antipsychotic medications will increase weight gain and play an important factor in causing further health problems for a person with schizophrenia.” {Beebe,2005. This is why teaching plays an important part in helping individuals to learn about antipsychotic medications. An individual will not understand the danger involved in serious weight gain unless someone takes the time to collaborate with them and explain the outcome.

I had a gentleman who once told me that he believed his young daughter, who was 20 years old and weighed over 350 pounds, did not have enough sense to understand choices concerning her diet change. He said that he believed due to her mental state, that she was stupid. I strongly disagreed with him. I politely explained to him that the lack of strong family support, frequent consumption of fast foods, unstable living conditions and poor diet habits contributed a lot to obesity in many individuals that had a mental illness. But again, that is not true in all cases.

Eventually, this young woman was removed from her family home, due to the lack of a strong family support system, into a more supported environment. And within a period of 2 years, she ended up losing two hundred pounds. She did this by attending classes provided by a local church on learning to create healthy food choices and to be more involved in her own self-care routine. Furthermore, she decided to engage in art painting classes. I spoke with her after art class and was incredibly happy to learn that she had found a positive way to help her cope with stress. She was maintaining her weight by eating a lot better, attending different classes or sessions on mental illness, and healthy lifestyles, taking her prescribed medications that worked for her. She displayed a lot more confidence in herself. An interesting book to read is “Schizophrenia: Understanding Symptoms Diagnosis & Treatment.” by author Anthony Wilkenson.

Unfortunately, several individuals that work within the medical field, which do not provide direct patient care and are not fully aware that psychiatric medications have a great deal to do with the large amount of weight gain for people with schizophrenia. And can cause weight gain with individuals suffering from other mental illness issues. The author Beebe stated that, “Inventions to increase confidence and include education, appropriate equipment, footwear, and the like. Memory prompts of earlier physical competence, and discussion of other activities in which the client is proficient.” {Beebe,2008. She believed inventions played a crucial role in self-care for persons with a mental illness.

Mostly individuals diagnosed with schizophrenia and schizoaffective disorder are not the only individuals that suffer from serious weight gain on antipsychotic medications. I have known several medical providers that prescribed antipsychotic medications to treat other diverse types of mental illness. And these individuals also struggle with serious weight gain as well until they take responsibility for maintaining a healthy weight or they have family support to encourage them to eat healthier.

Remember: The main goal for anyone diagnosed with any type of mental illness is to be involved in the outcome of your own healthcare by learning about your illness, medications, side effects, choices, and dietary factors that will lead to a healthy lifestyle. I like this magnet, “Magnet Schizophrenia Awareness No One Walks Alone Tomorrow Needs You Magnetic ,” so check it out today!

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References

1.Van Gaal, L.F. 2006} Long term health considerations in schizophrenia. Metabolic effects and the role of abdominal adiposity. European Neuropsychopharmacology, Suppl.3} S142-S148.

2.Meyer, J.M., Nasrallah., McEvoy J.P., Golf, D.C., Davis, S.M., Chakos, M., ET AL. 2005. The Clinical Antipsychotic Trails of Intervention Effectiveness {CATIE} schizophrenia trail. Clinical comparison of subgroups with and without the metabolic syndrome, Schizophrenia Research, 9-18.

3.Dixon, I.B. 22003.Diabetes and mental illness. Factors to keep in mind. Consultant, 3. 337-348

4.Ryan, M.C., Collins, P., & Thakore, JH. 2003. Impaired glucose tolerance in first episode, drug naïve patients with schizophrenia. American Journal of Psychiatry, {2}, 384-289.

5.Strokes, C., & Peet, M. 22003.Dietary sugar and polyunsaturated fatty acid consumption as predictors of severity of that schizophrenia symptoms. Nutrition and Neuroscience, 7,{4}, 247-249.

6.Beebe, Lora Humphrey {2008, Jan. Obesity in Schizophrenia: Screening, Monitoring, and Health Promotion. Perspectives in Psychiatric Care, 1, 25-31.