Antipsychotics and Weight Gain

Unsplash/Laurynas Mereckas

Weight gain is a notorious side effect of taking antipsychotics. It disturbs the livelihood of patients with schizophrenia so much that patients often report a significant reduction in self-esteem and confidence related to dating and body image.

In fact, when 286 patients on antipsychotics responded to a life-quality survey, the results revealed that the more weight they gained, the lower their reported quality of life was.

Physicians and researchers often fail to acknowledge the aspiration for beauty in treating patients with schizophrenia, and as a result, the superficial yet vital needs and desires of patients concerning beauty remain neglected in research for the development of new drugs.

While some researchers may think treating schizophrenia’s hallucinations and delusions is a bigger priority, the fact remains that patients with schizophrenia also desire to be beautiful and healthy. Maintaining a “normal” level of appearance helps to integrate patients with schizophrenia with socialization and society.

Weight Gain Among Specific Antipsychotics

A 2021 meta-analysis study conducted research into which antipsychotics produced the most weight gain in patients with schizophrenia. They found that clozapine produced the most significant levels of weight gain (3.29kg over a 6-week period), followed by olanzapine.

Ziprasidone was among the top medications that actually produced weight loss in a medication switch after clozapine and olanzapine, and remains to be one of the antipsychotics that produces the least amount of weight gain.

If the patients showed a high baseline of BMI, they didn’t gain as much weight as the lower-BMI patients if they took aripiprazole, clozapine, haloperidol, and olanzapine. But in patients on risperidone or a placebo, this was not true.

Weight gain on antipsychotics appears universally, regardless of diagnosis. This means that people who take antipsychotics as mood stabilizers without a psychotic disorder are just as prone to weight gain as those with schizophrenia.

Overall, the people most at risk for weight gain were those who were younger and leaner, to begin with. Universally, all tested antipsychotics showed a significant amount of weight gain. Those who did not have any previous experience with antipsychotics were at higher risk of gaining weight than those who merely switched antipsychotics.

Is it fair to say that patients with schizophrenia fail to have decent standards for holistic health? I think so. It is quite unfair for patients with psychotic disorders to experience a reduction in livelihood merely due to the rarity and stigma of our disorder. Patients with serious mental illness deserve to have access to holistic healthcare as much as any other patient. Hopefully, the more that patients can organize and use their voices in the research on schizophrenia studies, the less neglected we will be.