Psychosocial processes influencing weight management among persons newly prescribed atypical antipsychotic medications

• Published in: Journal of psychiatric and mental health nursing 2012-04, Vol.19 (3), p.241-247
• Main Authors: XIAO, S., BAKER, C., OYEWUMI, L. K.
• Format: Article
• Language: English
• Subjects: Adult; Antipsychotic Agents - therapeutic use; atypical antipsychotic medications; Female; first-episode psychosis; grounded theory; Health Services Accessibility; Humans; Male; Mental Disorders - complications; Mental Disorders - drug therapy; Mental Disorders - psychology; Nursing; Patient Acceptance of Health Care; schizophrenia; Weight Gain; weight management; Young Adult
• ISSN: 1351-0126; 1365-2850
• DOI: 10.1111/j.1365-2850.2011.01773.x

Accessible summary •  The purpose of the study was to generate a theory related to the psychosocial processes of weight management among persons newly prescribed atypical antipsychotic medications, to develop better early intervention weight management programmes. •  Through 16 interviews with persons with first‐episode psychosis and schizophrenia, it was found that they faced a variety of barriers to weight management: inaccessibility of resources such as financial and geographical obstacles to healthier foods and exercise facilities, a lack of structure in their lifestyle, rapidity of weight gain following the initiation of the medication, insatiable hunger and a lack of supporting factors to increase their motivation. •  Many participants initially responded to the effects of weight gain by discontinuing their medications, choosing lower‐calorie foods, using walking in their daily activities as exercise, accepting their weight gain and trying to manage their weight but giving up. The consequences of these actions were that participants either contemplated but did not implement weight management, or did not attempt weight management at all. •  It is hypothesized that the theory developed through this study can assist with the understanding and management of weight gain among this population. The purpose was to generate a theory of the psychosocial processes influencing weight management among persons newly prescribed atypical antipsychotic medications. A grounded theory research design was used to guide the study. Semi‐structured interviews were the method of data collection, and analysis was performed using constant comparison. Using theoretical sampling, a sample of 11 participants with first‐episode psychosis prescribed atypical antipsychotics for at least 8 weeks, and five participants with a diagnosis of chronic schizophrenia prescribed atypical antipsychotic medication for at least 3 years were recruited from an outpatient psychiatric programme. Contextual factors influencing weight management were: accessibility to resources, unstructured lifestyle, and others' perception of weight. Conditions influencing weight management were: rapid weight gain, insatiable hunger and lack of motivation boosters. Participants' early responses to weight gain included discontinuing medications, choosing lower‐calorie foods, using walking in daily activities as exercise, accepting weight gain and trying to manage weight but giving up. The consequences revealed from