Weight gain and metabolic change on antipsychotics start early, often within the first weeks, and are hardest to reverse once established. Record weight, waist circumference, blood pressure, fasting glucose or HbA1c and a lipid profile before starting, then recheck weight regularly over the first three months and the bloods at around three months and yearly after that. Early, rapid weight gain is a signal to act — through lifestyle support, a switch to a lower-liability agent, or adjunctive treatment — rather than to wait.
- Record weight, waist, blood pressure, glucose or HbA1c and lipids before starting an antipsychotic.
- Recheck weight frequently during the first three months.
- Repeat glucose and lipids at about three months, then at least yearly.
- Act on early rapid weight gain rather than waiting for it to plateau.
Why it matters
The first months are when metabolic harm is most preventable and least often measured.
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