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Psychosocial Interventions for Weight Management

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Several clinical trials have investigated pharmacological and cognitive-behavioral treatments that may attenuate or reverse antipsychotic-related weight gain and lipid, glucose, and insulin changes (10). Several recently published randomized, controlled trials investigating psychoeducation and behavioral interventions for weight loss for individuals with schizophrenia found support for modest weight loss (mean weight loss across seven studies was 5.8 lbs) (11,73–81). Moreover, recent reviews and meta-analyses further support the use of a psychoeducation or cognitive-behavioral intervention to promote weight loss among individuals with schizophrenia who are overweight or have experienced antipsychotic-related weight gain (82–85). Two studies also found support for psychoeducation and behavioral interventions in the prevention of weight gain among individuals with schizophrenia who had recently begun taking antipsychotic medications (86,87). Despite these positive findings, it should be noted that retention of weight loss was either not measured or problematic in many of the aforementioned investigations. Moreover, there is marked variability across studies in terms of treatment modality and length and format of treatment. It appears that individuals with schizophrenia can successfully participate in weight loss interventions. Future investigations should target weight loss retention strategies and weight prevention interventions.

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