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Non-pharmacological interventions reduce antipsychotic-associated weight gain in outpatients

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Question: What are the effects of non-pharmacological interventions on antipsychotic-associated weight gain and metabolic abnormalities?

Outcomes: Primary outcomes: body weight and body mass index (BMI). Secondary outcomes: waist circumference, body fat percentage, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, systolic sitting blood pressure and all-cause discontinuation.


Design: Systematic review and meta-analysis.

Data sources: PsycInfo, MEDLINE, PubMed, CINAHL and the Cochrane Library (search date not reported). Reference lists of relevant articles were also searched for additional studies.

Study selection and analysis: Randomised controlled trials (RCTs) of non-pharmacological interventions which aimed to prevent or reduce antipsychotic-associated weight gain were included. All data were extracted by one author and verified by a second author. Data were pooled using random effects models in Review Manager 5.0.24 software. Study heterogeneity was measured using the I2 statistic. Sensitivity analyses were carried out to assess the effects of potential moderators.

Main results

Of the 17 RCTs meeting inclusion criteria, 7 trialled cognitive behavioural therapy and 10 assessed nutritional and/or exercise interventions. The intervention duration ranged …

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  • Correspondence to: Lawrence Maayan, New York University School of Medicine Child Study Center, New York, NY, USA;

  • Sources of funding Zucker Hillside Hospital National Institute of Mental Health (NIMH) Advanced Center for Intervention and Services Research for the Study of Schizophrenia, and Stanley Medical Research Institute Award.


  • Competing interests FG has a family member with professional links to GSK and Lilly, and has received funding from various different pharmaceutical companies.

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