Factors associated with clinically relevant weight loss in men and women with psychotic disorders

Weight gain presents a substantial problem for people with psychotic disorders. Three quarters of individuals are overweight or obese and those starting antipsychotics experience rapid weight gain in the first 6-12months of treatment and this weight gain does not appear to plateau. The high prevalence of modifiable lifestyle risk factors and antipsychotic medication use all contribute to the increased risk of weight gain and cardiovascular disease. Sex may also play a role in the amount of weight gained. Crucially, a 5-10 % reduction in weight has a positive impact on cardiovascular disease risk factors. This study aimed to investigate clinically relevant weight loss (CRWL) and its associated factors, separately by sex. This naturalistic longitudinal study examined the weight of 372 men and women with psychotic disorders at baseline and follow-up on average 3.3 years later and compared those who had lost ≥7 % of their baseline weight with those who had not. Results showed 20.3 % of men and 19.9 % of women had CRWL and a different set of factors were observed to be associated with CRWL for each sex. For men, older age, higher baseline weight, and stopping use of antipsychotics compared to use of antipsychotics with a high-risk of weight gain were associated with an increased odds of CRWL. For women, only better quality of sleep was associated with an increased odds of CRWL. Greater understanding of the factors associated with weight loss in men and women with psychotic disorders may inform the development and implementation of targeted strategies.