In Reply: In response to Dr Llewellyn and Mr Naughton, the aim of our study was to find an effective method to attenuate antipsychotic-induced weight gain and abnormalities in insulin sensitivity, not to treat obesity or overweight patients. In the study, all patients were first-episode schizophrenia patients with less than a year of illness. As we noted in discussing the study limitations, the patients were therefore young and few were obese. From the study, we concluded that metformin and lifestyle intervention were efficacious in attenuating antipsychotic-induced weight gain. In clinical practice, we would not recommend that patients be treated until or unless they were obese. It also remains important to investigate whether there would be the same efficacy of metformin and lifestyle intervention for treatment of antipsychotic-induced obesity.
Zhao J. Antipsychotic-Induced Weight Gain in Patients With Schizophrenia—Reply. JAMA. 2008;299(16):1898-1900. doi:10.1001/jama.299.16.1899-b