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8 lifestyle fixes to help patients lose weight

Patients may need help setting appropriate goals because reaching their ideal weight may not be realistic.

Vol. 7, No. 9 / September 2008

Psychiatric patients are at high risk of becoming obese—with rates up to 63% in schizophrenia and 68% in bipolar disorder.1 Moreover, weight gain from psychotropics is associated with medication nonadherence.

Psychiatrists can suggest and encourage lifestyle changes that will help patients lose weight. The 8 behaviors described below can help patients become more active and take steps toward a healthier lifestyle.

Keep a food diary. Ask patients to keep a written record of everything they eat or drink in a day. Encourage them to learn about healthy foods and look up the calories of common foods using food packaging, pocket books listing calorie counts, and online sources.

Start walking. Pedometers could motivate patients to exercise regularly and reach goals of taking a certain number of steps each day. A physically healthy individual should walk approximately 10,000 steps per day. Scheduling daily walks also provides structure for your patients.

Plan meals and eat mindfully. Advise your patients to schedule meals and eat mindfully. This means keeping your full attention on eating by noticing the smell, taste, and texture of food. Encourage patients to eat slowly, enjoy every bite, and avoid eating while watching television or when occupied by another activity.

Have a healthy snack before a meal. Eating a serving of boiled vegetables or a piece of fruit such as an apple before a meal can satisfy hunger and reduce food intake.

Increase fluid intake. Feeling hungry might be a signal that the body needs more fluid. Advise patients to drink water, avoid beverages that contain sugar, and limit fruit juice to 4 to 8 ounces per day.

Obtain support from family and friends. Loved ones can reinforce a patient’s weight loss efforts by not eating high-calorie food in front of the patient and buying only healthy snacks such as fruits and vegetables.

Improve nutrition. Advise patients to:

  • eat at least 3 meals and 2 to 3 healthy snacks per day
  • choose lean meats and whole grains
  • eat 5 servings of fruits and vegetables daily
  • avoid eating after 7 Pm or 3 to 4 hours before bedtime.

Monitor weight regularly. Digital scales give more precise measurements, which can prompt patients to reduce food intake when they notice weight gain. Frequent feedback can help facilitate behavior changes necessary for weight loss.

Patients often need help setting appropriate weight loss goals because achieving their ideal weight may not be possible. Losing 10% of body weight usually is a realistic goal that can improve their health.


1. Kolotkin RL, Corey-Lisle PK, Crosby RD, et al. Impact of obesity on health-related quality of life in schizophrenia and bipolar disorder. Obesity (Silver Spring) 2008;16:749-54.

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