Beyond physical health problems, what are the impacts of obesity in schizophrenia?

Obesity is associated with many physical health problems including type 2 diabetes, coronary, artery disease, hypertension, osteoarthritis, chronic pain, and dementia. In addition, obesity has been associated with several other problems outside physical health. These include medication non-compliance and increased depression and psychotic symptoms. One study in a sample of individuals with schizophrenia found BMI status (normal, overweight, obese) and subjective distress from weight gain to be predictors of medication non-compliance. Obese individuals, specifically, were more than twice as likely as those with a normal BMI to report missing their medication. A comprehensive model indicated the primary mediator of non-compliance was distress from weight gain. Another study querying a large sample of individuals with schizophrenia found a greater number of current medical problems independently contributed to worse perceived physical health status and more severe psychosis and depression. The problems with obesity can impact both physical and mental health problems as well as medication compliance. Weight loss programs for those with serious mental illness have been found to be effective and SMI Adviser has a manualized tailored weight program that you could use with your patients.

REFERENCES

Alvarez-Jimenez, M., Hetrick, S.E., Gonzalez-Blanch, C., Gleeson, J.F., & McGorry, P.D. (2008). Non-pharmacological management of antipsychotic-induced weight gain: Systematic review and meta-analysis of randomised controlled trials. British Journal of Psychiatry, 193, 101-107.

Dixon, L., Postrado, L., Delahanty, J., Fischer, P.J., & Lehman, A. (1999). The association of medical comorbidity in schizophrenia with poor physical and mental health. The Journal of Nervous and Mental Disease, 187(8), 496-502.

Weiden, P.J., Mackell, J.A., & McDonnell, D.D. (2004). Obesity as a risk factor for antipsychotic noncompliance. Schizophrenia Research, 66(1), 51-57.

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