Early Intervention in the Real World Evaluating an individualized lifestyle and life skills intervention to prevent antipsychotic-induced weight gain in first-episode psychosis Jackie Curtis, 1,2 Andrew Watkins, 1,3 Simon Rosenbaum, 1,2,4 Scott Teasdale, 1,2 Megan Kalucy, 1,2 Katherine Samaras 5,6 and Philip B. Ward 2,7 1 Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, 2 School of Psychiatry, University of New South Wales, 3 Faculty of Health, University of Technology Sydney, 4 Musculoskeletal Division, The George Institute for Global Health, School of Public Health, Sydney University, Sydney, 5 Department of Endocrinology, St. Vincent’s Hospital, 6 Diabetes and Obesity Program, Garvan Institute of Medical Research, Darlinghurst, and 7 Schizophrenia Research Unit, South Western Sydney Local Health District, Liverpool, New South Wales, Australia Corresponding author: Associate Professor Philip B. Ward, School of Psychiatry, University of New South Wales, 26 Llandaff Street, Bondi Junction, NSW 2022, Australia. Email: p.ward@unsw.edu.au Received 31 July 2014; accepted 19 December 2014 Abstract Aim: Initiating antipsychotic medica- tion frequently induces rapid, clini- cally significant weight gain. We aimed to evaluate the effectiveness of a lifestyle and life skills intervention, delivered within 4 weeks of antipsy- chotic medication initiation, in attenuating weight gain in youth aged 14–25 years with first-episode psy- chosis (FEP). Methods: We undertook a prospec- tive, controlled study in two early psychosis community services. Inter- vention participants (n = 16) received a 12-week individualized intervention delivered by specialist clinical staff (nurse, dietician and exercise physi- ologist) and youth peer wellness coaches, in addition to standard care. A comparison group was recruited from a similar service and received standard care (n = 12). Results: The intervention group experienced significantly less weight gain at 12 weeks compared to stand- ard care (1.8 kg, 95% CI -0.4 to 2.8 vs. 7.8 kg, 4.8–10.7, P < 0.001). Thirteen per cent (2/16) of the intervention group experienced clinically signifi- cant weight gain (greater than 7% of baseline weight), while 75% (9/12) of the standard care group experienced this level of weight gain. Similar posi- tive effects of the intervention were observed for waist circumference. Conclusions: A lifestyle and life skills intervention delivered as part of standard care attenuated antipsy- chotic-induced weight gain in young people with FEP.The intervention was acceptable to the young people referred to the service. Such interven- tions may prevent the seeding of future disease risk and in the long- term help reduce the life expectancy gap for people living with serious mental illness. Key words: first-episode psychosis, lifestyle intervention, weight gain. INTRODUCTION People with severe mental illness suffer from a 20-year shortfall in life expectancy. 1 This disparity in life expectancy is largely due to premature cardio- vascular disease (CVD), underpinned by metabolic disorders including diabetes and hyperlipidaemia. This disparity in life expectancy has been termed a scandal for countries embracing the notion of equity in access and quality of medical attention for all citizens. 1 Moreover, the mortality gap has widened, suggesting this population has not gained the health benefits experienced by the general population from improved CVD treatment and health initiatives to reduce CVD risk and reduce smoking. 2 The antecedents to CVD appear early in the course of treatment with antipsychotic medica- tions. Young people with first-episode psychosis (FEP) commencing antipsychotic medications can Early Intervention in Psychiatry 2015; ••: ••–•• doi:10.1111/eip.12230 First Impact Factor released in June 2010 and now listed in MEDLINE! © 2015 Wiley Publishing Asia Pty Ltd 1