Graduation Semester and Year

Spring 2026

Language

English

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Kellie Kahveci, PhD, APRN, AGPCNP-BC, GNP-BC, CNE

Abstract

Antipsychotic-induced weight gain (AIWG) is a common, clinically significant adverse effect associated with second-generation antipsychotic medications and contributes to increased cardiometabolic risk among individuals with serious mental illness (SMI; Carolan et al., 2025; Hegde et al., 2024). Individuals experiencing homelessness or social instability often encounter additional barriers to maintaining healthy lifestyle behaviors and consistent engagement in healthcare, further increasing metabolic risks and treatment issues (Hamel et al., 2024; Kelly et al., 2025). This preventive care bundle, designed to reduce the risk of AIWG, was implemented in an outpatient behavioral health clinic serving an underserved urban Texas population.

As metformin may help mitigate antipsychotic-associated weight gain when introduced early in treatment (Carolan et al., 2025; Hegde et al., 2024), the preventive bundle included early initiation of metformin when clinically appropriate, lifestyle education (nutrition and physical activity), and routine monitoring of weight and body mass index (BMI). Data were collected during routine clinic visits. Descriptive analysis showed baseline to final visit changes in weight and BMI, as well as changes in patient knowledge related to lifestyle modification measured through a pre- and post-education assessment. Weight and BMI changes were minimal during the 8-week intervention period. Participants demonstrated improved lifestyle education scores after the intervention. Retention and consistent attendance were limited, reflecting the complex social and clinical challenges faced by the population served. Implementation of a preventive care bundle targeting AIWG was feasible in an outpatient behavioral health setting and may support long-term metabolic health in individuals with SMI.

Keywords

Antipsychotics, Metformin, Prevention, Severe mental illness, Weight gai

Disciplines

Community Health | Other Mental and Social Health | Psychiatric and Mental Health | Psychiatric and Mental Health Nursing | Public Health and Community Nursing

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