Co-Occurring Eating Disorders and Schizophrenia in the presence of Second-Generation Antipsychotics: A Review

Rachel Hechinger, BA

McLean Hospital – Research Assistant
Hechinger_Rachel poster

Scientific Abstract

Introduction: Weight gain and metabolic abnormalities are of significant concern when using second-generation antipsychotics to treat individuals with schizophrenia. However, less is known about the effects of comorbid eating disorders. Examining the overlap of eating disorders and schizophrenia could help create targeted interventions. The aim of this review is to gather information about the rates of comorbid eating disorders and schizophrenia, and to assess the efficacy of current interventions.

Methods: This literature search was conducted using PubMed and Medline.  Key words included “binge eating disorder,” OR “eating disorders,” AND “schizophrenia”, AND “antipsychotics.” PubMed yielded 48 articles. Medline returned more than 1,000 articles. Many of the articles examined used second-generation antipsychotics to treat anorexia, but not psychotic disorders. These articles were excluded, as were articles that separately examined eating disorders and schizophrenia.

Results:  The 20 articles in this literature review suggested that structured lifestyle intervention has a limited effect on health outcomes in people with psychotic disorders who are treated with antipsychotic medication (Holt, 2019; Coventry, 2021). Despite limited sample size, multiple studies found that binge eating disorder is overrepresented in patients with schizophrenia (de Beaurepaire, 2021).  Antipsychotics, especially clozapine and olanzapine, may cause binge eating behaviors independent of underlying eating disorder pathology (Kluge, 2007).

Conclusions: The paucity of research on comorbid eating disorders in patients with schizophrenia suggests that lifestyle interventions may be ineffective because they fail to target these eating disorders. Additional research could assess the best way to treat disordered eating in individuals with schizophrenia.

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research Areas


Rachel Hechinger, BA, Kathryn Eve Lewandowski, PhD

Principal Investigator

Kathryn Eve Lewandowski, PhD