• Weight loss [ Time Frame: Measured at Weeks 7 and 14 ] [ Designated as safety issue: No ]
  
• Long term maintenance of weight loss [ Time Frame: Measured at Months 12 and 24 ] [ Designated as safety issue: No ]
  

• Blood pressure and cholesterol [ Time Frame: Measured at pre-treatment, Week 14, and Months 12 and 24 ] [ Designated as safety issue: Yes ]
  
• Graded Exercise Tolerance Test [ Time Frame: Measured at pre-treatment and Week 14 ] [ Designated as safety issue: No ]
  

Schizophrenia is a life-long brain disorder affecting 1 percent of Americans each year. Schizophrenia can be extremely disabling, causing people to hear voices, experience paranoia or hallucinations, and believe that others are controlling their thoughts. Because of medications, lifestyle, or diet, people with schizophrenia are more at risk for being overweight than others. Excess weight and obesity continue to present ongoing challenges when managing the care of people with schizophrenia. Weight gain often leads to other chronic conditions, such as diabetes or heart disease, which can affect how regularly medications are taken. Behavioral treatment plans for weight reduction are a practical option for people with schizophrenia. Therefore, this study will evaluate the effectiveness of a weight loss treatment program for overweight and obese people with schizophrenia.

Participation in this open-label study will last between 4 and 28 months. Participants will be randomly assigned to one of the following three groups:

• Group 1 participants will receive behavioral weight loss treatment to learn ways to control urges to overeat and snack, limit food intake, develop good eating habits, and make changes in daily physical activity. Before starting treatment, participants may complete a motivational interview session aimed at strengthening their commitment to losing weight.
• Group 2 participants will receive social skills training. Topics discussed may include communication, assertiveness, conflict management, dating, medication management, and vocational skills.
• Group 3 participants will receive routine clinical care. They will meet with a research staff member once a month to record their weight.

Group 1 and 2 participants will attend 20 group sessions over a period of 14 weeks. Sessions will last 1 hour and will occur twice a week for the first 6 weeks and once a week for the remaining 8 weeks. All participants in this study will have an additional study visit, during which a psychiatric assessment will be conducted. After 16 weeks, Groups 2 and 3 will have the option of receiving the behavioral weight loss treatment.

Group 1 participants who lose at least 3 percent of their initial body weight will be randomly assigned to receive either booster treatments or routine clinical care for 2 years. Participants receiving booster treatments will attend one session every 2 weeks during which they will continue to learn behavior techniques for weight reduction and receive ongoing encouragement to maintain their weight loss efforts. Participants assigned to receive routine clinical care will attend study visits at 12 and 24 months. These visits will include various measurements and questions regarding weight, blood pressure, diet, self esteem, mood, and symptoms of schizophrenia. At the end of the study, all participants will undergo blood collection to test for signs of diabetes.