How to Reverse Weight Gain From Antipsychotics

What Are Antipsychotics?

Antipsychotics, also known as neuroleptics, are a class of medications primarily used to treat psychiatric conditions such as schizophrenia, bipolar disorder, and severe agitation or psychosis associated with certain medical conditions. These drugs work by targeting and modulating the brain’s neurotransmitter systems, particularly dopamine, and serotonin, which play key roles in regulating mood, emotions, and cognition.

There are two main categories of antipsychotic medications:

1.      Typical Antipsychotics (First-generation antipsychotics or FGAs): These were the first medications developed to treat psychosis, and they mainly target dopamine receptors in the brain. Some common examples of typical antipsychotics include haloperidol, chlorpromazine, and fluphenazine.

2.      Atypical Antipsychotics (Second-generation antipsychotics or SGAs): Atypical antipsychotics were developed later and have a broader mechanism of action, affecting not only dopamine but also serotonin and other neurotransmitters. They are generally considered to have a reduced risk of certain side effects compared to typical antipsychotics. Examples of atypical antipsychotics include risperidone, olanzapine, quetiapine, and aripiprazole.

Antipsychotic medications help reduce or control symptoms associated with psychotic disorders, including hallucinations, delusions, disorganized thinking, and agitation. They can be administered orally as tablets or liquid solutions, intramuscularly as injections for rapid symptom control in acute situations, or in long-acting injectable formulations for maintenance treatment

Antipsychotic medications have revolutionized the treatment of psychiatric conditions such as schizophrenia and bipolar disorder, significantly improving the lives of millions. However, one notable side effect that often accompanies the benefits is weight gain. Understanding the underlying mechanisms that contribute to this phenomenon is essential to provide better care for patients and minimize the impact of weight gain on their overall health. In this article, we delve into the reasons why antipsychotics cause weight gain and explore potential strategies to address this concern.

The Link Between Antipsychotics and Weight Gain

Numerous studies have shown that weight gain is a common side effect associated with both typical and atypical antipsychotic medications. While the exact mechanisms are not fully understood, researchers believe that several factors contribute to this phenomenon:

1.      Dopamine and Serotonin Receptors: Antipsychotics primarily works by blocking dopamine receptors in the brain, which helps alleviate symptoms of psychosis. However, this action can also lead to increased appetite and reduced satiety, potentially promoting overeating. Additionally, some atypical antipsychotics affect serotonin receptors, further contributing to appetite dysregulation and weight gain.

2.      Hormonal Changes: Antipsychotics can influence the body’s hormonal balance, leading to disruptions in various systems that control appetite, metabolism, and fat storage. For instance, some antipsychotics have been associated with increased levels of the hormone ghrelin, known as the “hunger hormone,” which can stimulate appetite.

3.      Metabolic Effects: Certain antipsychotics can interfere with glucose and lipid metabolism, leading to insulin resistance and increased fat accumulation. These metabolic changes can contribute to weight gain, particularly around the abdomen.

4.      Sedation and Reduced Physical Activity: Some individuals experience drowsiness and lethargy as side effects of antipsychotic medications. This sedative effect may lead to decreased physical activity levels, resulting in reduced energy expenditure and potential weight gain.

How to Reverse Weight Gain From Antipsychotics

Although weight gain is a common side effect experienced by individuals taking antipsychotic medications, there are proactive steps that individuals can take to reverse weight gain while continuing their antipsychotic treatment. In this section, we explore various strategies to help individuals on antipsychotics regain control of their weight and improve their overall well-being.

1.      Consult Your Healthcare Provider: The first step in addressing weight gain from antipsychotics is to discuss your concerns with your healthcare provider. Your doctor can assess your overall health and determine if any medical conditions or lifestyle factors may be contributing to the weight gain. Additionally, they can evaluate whether adjusting your medication regimen is possible or suggest alternative medications with lower weight gain potential.

2.      Adopt a Balanced Diet: Making healthier food choices is essential in reversing weight gain. Focus on consuming a well-balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoid excessive intake of processed foods, sugary snacks, and high-calorie beverages. Consider working with a registered dietitian who can help create a personalized meal plan tailored to your nutritional needs and weight loss goals.

3.      Monitor Portion Sizes: Be mindful of portion sizes to control calorie intake. Eating smaller, more frequent meals can help regulate blood sugar levels and prevent overeating. Mindful eating practices, such as paying attention to hunger and fullness cues, can also aid in preventing mindless eating.

4.      Engage in Regular Exercise: Incorporating regular physical activity into your daily routine is crucial for weight management. Choose exercises that you enjoy, whether it’s walking, cycling, swimming, or dancing, to make it a sustainable habit. Aim for at least 150 minutes of moderate-intensity aerobic activity per week, along with muscle-strengthening activities on two or more days.

5.      Manage Stress: Stress can trigger emotional eating and disrupt hormonal balance, leading to weight gain. Engage in stress-reducing activities such as meditation, yoga, deep breathing exercises, or spending time in nature. Adequate sleep is also essential for stress management and overall well-being.

6.      Avoid Alcohol and Sugary Beverages: Alcoholic beverages and sugary drinks are high in empty calories and can contribute to weight gain. Opt for water, herbal teas, or naturally flavored water infused with fruits and herbs to stay hydrated without added sugars.

7.      Stay Hydrated: Drinking enough water throughout the day can help control appetite and support proper digestion. Sometimes, thirst can be mistaken for hunger, leading to unnecessary snacking. Carry a water bottle with you to remind yourself to stay hydrated.

8.      Consider Mind-Body Techniques: Practicing mindfulness and mindful eating can help create a positive relationship between food and eating. Mind-body techniques like meditation, yoga, or tai chi can assist in managing stress, emotional eating, and improve body awareness.

9.      Keep a Food Journal: Maintaining a food journal can help you track your eating habits, identify triggers for overeating, and stay accountable to your weight loss goals.

10.    Gradual Weight Loss: Focus on gradual, sustainable weight loss rather than quick fixes. Rapid weight loss can be harmful and difficult to maintain. Aim for a weight loss of about 1-2 pounds per week, which is considered safe and achievable.

11.    Seek Support: Weight loss and lifestyle changes can be challenging, especially when dealing with the effects of antipsychotic medications. Seek support from friends, family, or join support groups where you can connect with others who may be going through similar experiences.


Reversing weight gain from antipsychotic medications requires a comprehensive approach that encompasses healthy eating habits, regular physical activity, stress management, and mindful lifestyle choices. It is essential to remember that each individual’s journey is unique, and progress may vary. Consulting with healthcare providers, dietitians, and mental health professionals can provide invaluable guidance and support throughout the process. With dedication, patience, and a positive mindset, it is possible to manage weight gain effectively and achieve a healthier, balanced life while receiving the benefits of antipsychotic treatment for mental health conditions.


Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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