Antipsychotic weight gain is fastest in the first weeks, and young people starting their first antipsychotic gain the most. A baseline is what lets you see it early enough to act.
Record weight, waist circumference, blood pressure, fasting glucose or HbA1c and lipids before starting, then weigh regularly in the first three months. Agree with the patient what change would prompt a review.
- Record weight, waist, blood pressure, glucose or HbA1c and lipids before the first dose.
- Weigh weekly or fortnightly for the first six weeks, then at three months.
- Treat a gain of about 5% of body weight early in treatment as a signal to act.
- Ask about family history of diabetes and heart disease at the same visit.
Why it matters
Without a baseline, weight gain is noticed months late, when it is hardest to reverse.
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