I just saw a chap who's got a diagnosis of F31.7 Bipolar affective disorder, currently in remission.
He's been stable whilst I've been looking after him, over the last few years, but had frequent relapses prior to this (necessitating frequent and lengthy hospital admissions) which caused a wake a devastation through his life each time he became manic. He was handed over to me stable after starting lithium and olanzapine.
Weight gain, how much should we do to address this?
We meet up, despite him being well for years now, simply because he's on lithium and wishes to see me rather than his GP. 6 months ago we had a conversation about weight, he'd been gaining substantial amounts of weight and was asking to stop his olanzapine. He lives with his brother. On talking through why he might be gaining weight, I felt his brother's splendid cooking and the 6 pints of ale a day with no exercise at all may contribute something to his weight gain. He agreed to eat his brother's meat pie just once a week at most but try for once a month and reduced the ale down to 3 pints a night on just 3 nights a week. He walks to the pub, and shops, to get some exercise too. Informant history and support workers corroborate that he's managed these sustained changes successfully over the 6 months, with a commensurate reduction in weight down to normal (for him) once again.
So there we have it. From pie and chips most days, with 84 units of alcohol a week, down to the odd piece of pie once a month and 18 units of alcohol a week, whilst being less sedentary, is successful. And has to be better than fiddling with the chemistry.