The class of medications known as atypical antipsychotics - while highly effective - can sometimes cause problematic side effects, such as weight gain. Tara Arnold, Day Treatment Counselor at Skyland Trail (a comprehensive treatment facility in Atlanta, GA) knows all too well how much distress that can cause for her clients.

"Along with self-esteem problems that come with mental health problems, the weight gain issue really tends to make that dually problematic for them," she says. Some have gained as many as 30 pounds or more.

One of Ms. Arnold's clients at Skyland Trail is Theresa, a young woman grappling with severe depression - and significant weight gain caused in part by her prescribed medication. The Skyland Trail staff is helping Theresa deal with this problem through a combination of diet control, exercise, and a specific philosophy that takes the emphasis off the weight problem itself and places it on the client's relationship with food, exercise, and self.

Skyland Trail's holistic approach focuses more on health, energy, feeling good and self-confidence; and less on the issue of weight. In fact, says Tara Arnold, "We really try not to even say that word around here."

In response to her depression, Theresa's medical provider had prescribed Zyprexa, an atypical antipsychotic for which weight gain is a known potential side effect. According to Ms. Arnold, simply knowing that this drug can cause appetite increase often helps those taking it to prepare mentally for dealing with it.

Ms. Arnold notes that Theresa came to the Skyland Trail program with an attitude toward her weight problem that offers the best chance for success. The key to this attitude, says Ms. Arnold, is self-motivation. Simply put, the client should actively want to address his or her weight problem - and control it.

Theresa came to Skyland Trail with some definite ideas already in mind. For her, the issue of appetite was not the primary concern. She knew instead that a key to her personal weight management program would be the component of physical activity. And she knew that Skyland Trail - while also providing dietary assistance and counseling - would accommodate her desire for specific types of exercise.

"The best part for me," she says, "was the individualization that they're willing to do." As a professional performer, Theresa appreciated that the program allowed her to engage in the types of activities she feels most comfortable with - dance and yoga.

Theresa was also given constant encouragement and support by the Skyland Trail staff. She says that she never felt judged in any way because of her weight problem. "If anything, they've noticed when I started to lose a little bit of weight, and they've congratulated me on that," she says. "I've been encouraged that I don't look out of proportion, or I don't look unattractive just because I'm overweight."

This past January, Theresa required hospitalization. This ultimately helped her come to a realization that is perhaps the key lesson regarding weight management for any person with a mental illness. The road to this lesson opened up when she asked to be taken off her medication.

Although the switch was made because of her weight gain concerns, it didn't help her depression. So she switched back to Zyprexa.

Would this switch back to her original medication bring with it additional weight problems? Theresa found that the answer, to her pleasant surprise, was "No". And the experience also reinforced her belief that for her, the main ingredient in her weight control success was going to be physical activity. She is happy to report that she has been maintaining her weight, " and I know that is due to my increased exercise."

The combination of self-motivation, a team-based approach, Skyland Trail's weight management philosophy, and the right combination of diet and exercise has clearly brought about very positive results. Theresa has come a long way in dealing with both her mental illness and her weight problem.

For Theresa, the payoff is significant. For she is beginning to return to her previous life as a performer.

"I definitely think I'm feeling better about myself," she says. "And I also have more hope that I will be able to get down to a more healthy weight. Since I've been here, I've probably lost between 15 and 20 pounds, and I've been here for five months. I feel more comfortable in my body than I did when I was, like, 15 or 16."

So what was that "key realization" to which Theresa was led? Simply that the primary focus should be on controlling the mental illness - that is, getting better. Weight control can then be more effectively addressed, through an individualized combination of diet and exercise.

"My advice would be, focus on treating your illness first. And as you're treating your illness, taking care of yourself physically is going to come with it.

For a more detailed description of Skyland Trail's
"new paradigm" approach to weight control, Click Here >>