What strategies have you found most effective for supporting weight loss in patients with bipolar disorder while minimizing the risk of mood destabilization?  

If residual depressive symptoms are present, then the addition of bupropion is helpful. If the weight gain is deemed due to necessary psychiatric medication, then the addition of metformin often works. Of course, for the management of weight, diet and exercise need to be encouraged (in addition to t...

I concur with the prior answers; in addition, in my practice when weight gain is a problem I strive to advise about weight loss much more than just lip service. I try to enlist the patient in making healthy body weight a priority and go into detail about motivating the patient for healthy body weigh...

I sometimes will add Topamax.

It would be very difficult to disagree with the above opinions. We are the most obese nation on the planet, it seems. We also try to repair the most delicate and poorly understood conditions like bipolar disorder with a sledgehammer of our pills. It is very hard to not agree with a balanced diet, w...

A healthy keto diet is my first recommendation but compliance with that is generally poor. GLP-1 agonists if you can hurdle the onerous PA process. I agree with Topiramate. More effective at higher dosages of 200-300 mg/day and may provide additional mood stabilization.