Introduction: weighing the evidence: weight management insights for treating major mental illness.

4 J Clin Psychiatry 2007;68 (suppl 12) econd-generation antipsychotics (SGAs), or “atypical” antipsychotics, have become the dominant treatand practical advice regarding weight gain associated with SGAs. The first article, “Treatment Decisions in Major Mental Illness: Weighing the Outcomes,” examines morbidity and mortality issues in people with serious mental illness and emphasizes a holistic treatment approach. A novel weight control program called “Healthy Living” is discussed in detail. The second article, “The Effectiveness Criterion: Balancing Efficacy Against the Risks of Weight Gain,” provides some additional background material regarding obesity and then uses the lens of “number needed to treat” to examine the results of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for schizophrenia. Predictors of weight gain and recommendations for increased monitoring of patients are also discussed. The supplement concludes with the article “Weight Gain With Atypical Antipsychotics: Evidence and Insights,” which examines energy balance, effects of SGAs and combination treatments on weight, interventions designed to reduce weight gain, and the relationship between SGAs and insulin resistance. Together these 3 articles provide valuable information that clinicians will find useful for the care of their individual patients.