Schizophrenia and Obesity: Impact of Antipsychotic Medications

Obesity is an epidemic in this country and much of the rest of the developed world. It is a majorcontributor to a range of metabolic disorders responsible for much of the medical morbidity and mortalitythat burden our society. The combination of the costs to society of the chronic illness of schizophreniawith the costs of obesity and the chronic illnesses associated with it, e.g., metabolic disorders,diabetes, dyslipidemias, and cardiovascular disease, represents a major public health problem. Obesityin schizophrenia is accentuated even further largely through illness-related factors, like poor dietaryconditions and more sedentary lifestyles, and particularly because many of the psychiatric medications(antipsychotics, mood stabilizers, and antidepressants) used to combat this devastating illnessthemselves result in weight gain that, if untreated, may result in the usual obesity-associated morbidityand mortality. This article is intended to review some of the physiology of obesity and obesity-relatedmetabolic disorders, the risks to schizophrenia patients engendered by obesity, the evidencefor weight gain associated with the antipsychotic drugs, and the possible mechanisms involved inantipsychotic medication-associated weight gain.