Food craving and consumption evolution in patients starting treatment with clozapine.

Marina Garriga*, Andrea Mallorquí, Lourdes Serrano, J Ríos, Manel Salamero, E Parellada, Marta Gómez-Ramiro, Cristina Oliveira, Silvia Amoretti, Eduard Vieta, Miquel Bernardo, Clemente García-Rizo

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)


Background: Antipsychotic-induced weight gain has been especially related to clozapine and olanzapine. Underlying mechanisms in relation to food preferences with an increased food craving and consumption of specific nutrients have not been extensively studied in patients with serious mental illness (SMI). We aim to describe specific food preferences (craving) and subsequent food consumption in SMI patients starting clozapine, as well as their possible relation to weight and body mass index (BMI).
Methods: An observational prospective follow-up study (18 weeks) was conducted in a cohort of 34 SMI patients who started clozapine due to resistant-psychotic symptoms. Anthropometric measures, Food Craving Inventory (FCI), and a food consumption frequency questionnaire were evaluated at baseline, weeks 8 and 18 of treatment. Statistical analysis included generalized estimating equations models with adjustment for potential confounding factors.
Results: No longitudinal changes over time were found across the different food craving scores after 18 weeks of treatment. However, adjusted models according to BMI status showed that the normal weight (NW) group presented an increased score for the “complex carbohydrates/proteins” food cravings (− 0.67; 95% CI [− 1.15, − 0.19]; P = 0.010), while baseline scores for “fast-food fats” cravings were significantly higher in the overweight/obese (OWO) group in comparison with NW patients (NW, 2.05; 95% CI [1.60, 2.49]; OWO, 2.81, 95% CI [2.37, 3.25]; P = 0.016). When considering if food craving could predict weight gain, only increments in “fast-food fats” cravings were associated (β = − 5.35 ± 1.67; 95% CI [− 8.64, − 2.06]; P = 0.001).
Conclusions: No longitudinal differences were found for any of the food craving scores evaluated; however, in the NW group, food craving for “complex carbohydrates/proteins” changed. Thus, changes in “fast-food fats” cravings predicted weight increase in this sample. Interventions targeting food preferences may help to mitigate weight gain in patients starting treatment with clozapine.
Original languageEnglish
Pages (from-to)3317-3327
Number of pages11
Publication statusPublished - Jun 2019


  • Antipsychotic-induced weight gain
  • Clozapine
  • Food Craving Inventory (FCI)
  • Serious mental illness


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