Pay attention to weight management in patients with schizophrenia | World Mental Health Day

Schizophrenia is a group of severe mental disorders with unknown etiology, often manifested as abnormalities in perception, thinking, emotion and behavior, accompanied by psychotic symptoms such as auditory hallucinations and delusions. Currently, the main treatment for schizophrenia is the use of atypical antipsychotics, however, these drugs often lead to weight gain or obesity. The physical discomfort caused by obesity and the resulting negative emotions such as inferiority and anxiety may reduce patients' compliance with treatment, and even lead to interruption of treatment and recurrence of psychotic symptoms. Therefore, weight management is crucial to improving the prognosis of patients with schizophrenia, preventing relapses and improving their quality of life.

The success of weight management depends on the understanding and cooperation of patients, so health education is particularly important. Through simple and easy-to-understand methods, such as "control your mouth and move your legs" and other jingles, patients can be helped to better understand and implement them in daily activities. Secondly, non-drug interventions have shown good results in weight management, mainly including diet management and exercise intervention. In terms of diet management, daily energy intake can be controlled according to the individual situation of the patient, and it is generally recommended to be between 1500 and 1800 kcal. At the same time, the dietary structure can be adjusted, such as a low-carbohydrate diet, a high-protein diet, or intermittent fasting strategies. Exercise intervention can be aerobic exercises such as slow walking and jogging, as well as daily housework and commuting activities.

In addition, support and supervision from family, friends, medical staff and social groups are also beneficial to patients. For those schizophrenia patients who are severely obese and have comorbidities, medication or weight loss surgery is a necessary option. When using lipid-lowering drugs, antihypertensive drugs and hypoglycemic drugs, it is necessary to carefully consider the interaction with the original psychotropic drugs to avoid inducing new adverse reactions or increasing the risk of recurrence of psychotic symptoms.

(Author: Tang Haoyun, Department of Psychiatry, Shanghai Mental Health Center)