Obesity due to psychotropic drugs – a multidisciplinary treatment approach

Weight gain and metabolic syndrome are common side effects of psychotropic drugs. Increased appetite and rapid weight gain occur early after starting drug therapy. Patients mental health usually does not allow treatment of these serious and persistent consequences in the acute phase. Research on outcome of obesity therapy has proven a multidisciplinary approach including dietetic treatment and exercise therapy combined with behavioural therapy most effective. In cooperation with AOK Bayern, we established a multidisciplinary treatment regimen addressing drug induced obesity and metabolic syndrome in mentally stable psychiatric outpatients. Patients participate in either 3 or 6 weeks of treatment in our day clinic, followed by ambulant treatment lasting 6 months, or solely in an ambulant treatment period of 6 months. Outcome is monitored by detailed protocol of eating behaviour and diet, cardiovascular parameters during training, metabolic syndrome features, endocrine parameters, and body composition (BIA). Up to now, n=12 patients, most of whom suffered from schizophrenic disorders (mean age 45.7±11.1, 28–60yr, 7f:5m, drug induced weight gain 23.5±8.8kg) finished the treatment period. Preliminary data analysis revealed that most patients improved their eating behaviour though weight loss was only subtle. Crucial to therapy was maintaining motivation for long-term changes in eating and exercise habits, and avoiding short-term or rapid weight loss at the cost of stability.