Most antipsychotic weight gain happens in the first months of treatment, and it is far easier to prevent than to reverse. Weight, waist circumference, blood pressure, HbA1c or fasting glucose and lipids at baseline, then again at about 12 weeks, catch the people who need action early.
A gain of 5% or more of baseline weight is a practical trigger to reconsider the antipsychotic, add lifestyle support, and discuss an adjunct such as metformin.
- Baseline: weight, waist, blood pressure, HbA1c or fasting glucose, lipids.
- Repeat at about 12 weeks and then at least yearly.
- 5% or more gain from baseline is a trigger to act.
- Record the numbers where the next prescriber will see them.
Why it matters
Early weight gain predicts later metabolic disease and is the window where intervention is most effective.
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