Weight gain and obesity as a side effect of such psychiatric drugs as antipsychotics or antidepressants is a crucial issue in health care. Excessive weight does not only bring discomfort to a patient’s everyday life, but also increases his or her chances of cardiovascular diseases, complications, and mortality. Another severe health outcome of obesity is its adverse effect on medication compliance. Many patients suffer from excessive weight and cannot achieve any result in reducing psychiatric symptoms, at the same time acquiring new health problems. Therefore, it is critical to find ways to prevent weight gain in psychiatric patients who use medication and minimize the burden of risk they encounter when adhering to the medication plan. In this paper, the article by Dayabandara et al. (2017) will be used to analyze available weight gain management and assistance nursing interventions.
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The implications of obesity and rapid gain of excessive bodyweight under the influence of antipsychotic drugs are broad and might have a long-term effect. Some of the medications are more likely to provoke obesity than others. According to Dayabandara et al. (2017), clozapine and olanzapine have a high propensity to cause weight gain, and chlorpromazine, quetiapine, risperidone, and paliperidone are of a moderate inclination. However, all of them expose patients to problems with weight. As for the timeline of the problem occurs, a rapid increase in body weight is usually observed within the first 2 or 3 weeks of psychiatric medication intake. However, the process continues throughout 1-4 years, which causes a spectrum of comorbidities for a patient (Dayabandara et al., 2017). Moreover, it has been identified that “patients who are obese are 13 times more likely to discontinue medication because of weight gain than non-obese patients” (Dayabandara et al., 2017, p. 2234). For that reason, specific nursing interventions need to be applied promptly to address the complicating issues arising with psychiatric medication use and help patients manage weight gain.
To assist a client in weight management and reduce obesity as a result of psychiatric drug intake, I would implement several interventions. Firstly, a strict but nutritious diet would be prescribed to assist in controlling body weight gain and reducing ultimate complications for the health. Secondly, I would initiate weighing a patient regularly under the same circumstances to track the progress and correct the diet plan if required. Such an approach is an effective way of encouraging a patient when he or she achieves some results and provides extra motivation to adhere to a nutritious diet. Finally, physical exercising as a substantial part of weight gain control will be suggested and explained to a patient, so that he or she can sustain a healthy physique. All these interventions are only a part of the possible ways to manage the adverse side effects of psychiatric medications.
As for the measures provided in the analyzed article, the first nursing intervention chosen for the analysis is of a non-pharmacologic type and is called adherence to a “behavioral lifestyle program” (Dayabandara et al., 2017, p. 2235). Within this strategy, a patient is encouraged to engage in healthy behaviors with a priority set on physical exercising and dieting. Nutrition knowledge in combination with the training of problem solving and self-control might be a powerful tool in managing weight gain. In such a manner, a person controls his or her eating habits being aware of the risk he or she is constantly exposed to when being treated with antipsychotics.
The second nursing intervention is the reduction of weight using antipsychotic switching. As the study suggests, a change from one medication to another can cause significant bodyweight reduction and should be considered as one of the leading strategies in drug-related obesity management (Dayabandara et al., 2017). The best results were achieved when a patient switched “from olanzapine to aripiprazole” which “resulted in a mean weight reduction of -2.55±1.5 kg” (Dayabandara et al., 2017, p. 2235). However, such an intervention needs precise analysis and studying of the side-effects of the medications being used as an alternative to eliminate the risk of problem aggravation.
Finally, pharmacological interventions might be applicable in a situation when non-pharmacological methods have no visible result. In such a case, a patient might be prescribed additional medication aimed at weight gain stabilization and ultimate elimination of adverse outcomes. Different medications influence particular processes in an organism, thus combating weight gain. One of the most effective drugs used for this purpose is metformin, which “improves insulin resistance,” thus preventing obesity (Dayabandara et al., 2017, p. 2236). When influencing insulin-related mechanisms, this drug suppresses appetite and eliminates eating problems. Metformin, as well as other adjunctive medications with the same effect, might be prescribed at the beginning of the psychiatric treatment course in combination with antipsychotics.
In conclusion, weight gain and obesity are identified as the main health impairments related to psychiatric medication intake. The majority of available antipsychotic drugs prescribed for patients with mental disorders are of high or moderate propensity to provoke rapid weight gain. Obesity causes cardiovascular diseases, complications, and discomfort in daily life, as well as significantly obstructs adequate mental treatment. It is critical to develop and use these interventions to ensure patients’ physical health quality in the process of mental disorder treatment. Some of the strategies used to manage weight gain include antipsychotic switching, engagement in non-pharmacological behavioral lifestyle programs, and prescription of adjunctive drugs regulating eating behaviors. Adequate implementation of these interventions or their combinations might be a useful tool in helping patients overcome the risk of obesity.
Dayabandara, M., Hanwella, R., Ratnatunga, S., Seneviratne, S., Suraweera, C., & de Silva, V. A. (2017). Antipsychotic-associated weight gain: Management strategies and impact on treatment adherence. Neuropsychiatric Disease and Treatment, 13, 2231-2241. Web.