Abstract

The article reviewed recent studies on life style and pharmacological treatments of obesity in patients with psychiatric disorders, by examining metaanalysis studies and studies that were not included in the meta-analyses. Dietary and behavioral treatments appear to be modestly effective. As for pharmacological treatments, evidence is strongest for augmentation treatment with metformin and topiramate. Switching of antipsychotic is another option, although there is risk of worsening psychiatric symptoms. Barriers and ways to overcome the barriers to implementing the various evidence-based interventions are discussed. The article proposes an algorithmic approach to management of obesity in patients with severe mental illness.

Keywords: Life style intervention, metabolic syndrome, metformin, obesity, severe mental ill, topiramate, weight gain, weight loss.