title: Obesity in adults with serious and persistent mental illness: a review of postulated mechanisms and current interventions.
abstract: BACKGROUND
  An epidemic of overweight and obesity in the United States has had profound effects on the health of the general population, with consequent development of metabolic syndrome and related morbidity and mortality. However, these effects have been more widespread among adults with serious and persistent mental illness.
  
  
  METHODS
  A literature search was conducted using the PubMed and Ovid databases. Terms used, in varying combinations, were schizophrenia, schizoaffective disorder, bipolar disorder, obesity, atypical antipsychotic, diabetes mellitus, hyperlipidemia, and metabolic syndrome. Of 103 articles generated, 71 were deemed pertinent to the current study. One reference was decided upon based on personal communication.
  
  
  RESULTS
  Both nonpharmacologic and pharmacologic factors contribute to obesity development in adults with serious and persistent mental illness. Consequently, similarly targeted nonpharmacologic and pharmacologic interventions have been used to mitigate against body weight gain. Although the results obtained thus far are promising, effect sizes only in the low to medium range have been realized, with nonpharmacologic interventions demonstrating slight superiority.
  
  
  CONCLUSIONS
  Improved therapeutic methods are needed to address the effects of obesity on individuals with serious and persistent mental illness. Factors that will likely contribute to such advancement are a better understanding of the mechanisms involved, earlier intervention, and adequately powered, randomized controlled trials of sufficient duration, with baseline body weight as a covariate.
authors.affiliation: Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA. MegnaJ@upstate.edu
authors.forename: James L
authors.initials: JL
authors.lastname: Megna
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Schwartz
authors.forename: Umar A
authors.initials: UA
authors.lastname: Siddiqui
authors.forename: Mariela
authors.initials: M
authors.lastname: Herrera Rojas
mesh_terms: D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology*; D001835:Body Weight / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000139:chemically induced / Q000453:epidemiology; D020407:Internet; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology*; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012984:Software
chemical_list: D014150:Antipsychotic Agents