Table 1.

Main characteristics of the included studies

Author and country	Setting	Population (inclusion criteria)	Comparator	N	Type of intervention	Primary outcome(s)	Who delivered the intervention	Intervention format (individual/group/community)	Training and supervision (yes/no) By whom?	Fidelity measured (yes/no) and how?	Intervention duration	Follow up time	Overall ROB
Weight gain
Attux et al. (2013) Brazil	Outpatients and inpatients	Schizophrenia DSM-IV 18–65 years Motivated or showing concerns about weight	Standard care	85	Lifestyle	Body weight BMI Waist circumference	Mental health professionals (nurses, occupational therapists, psychologists and dietitians)	Group (Patients and their relatives)	Yes, trained with a manual and a set of DVDs explaining the program Program coordinator supervises and follow up any absence in sessions	Not stated	12 weeks, 1 h sessions	12 weeks	Low
Baptista et al. (2007) Venezuela	Outpatients and inpatients	Schizophrenia (DSM-IV) <18 years Free of hormone replacement and any chronic diseases	Placebo	72	Pharmacological (Metformin 5–20 mg a day)	Body weight BMI Waist circumference	Research psychiatrists and social workers	Individual	Not stated	Not stated	12 weeks	12 weeks	Some concerns
de Silva et al. (2015) Sri Lanka	Outpatients	schizophrenia or schizoaffective disorder (ICD-10) <18 years treated with atypical antipsychotics, who had increased their pre-treatment body weight by more than 10%,	Placebo	66	Pharmacological (Metformin 500 mg a day)	Body weight BMI Waist circumference	Not stated	Individual	Yes, supervision – If there were problems with tolerability of 500 mg dosage, participants were treated with a lower dose of 250 mg, which was then titrated to the standard dose.	Not stated	24 weeks of treatment	24 weeks	Low
Methapatara and Srisurapanont (2011) Thailand	Outpatients	Schizophrenia (DSM-IV) 18–65 years BMI > 23 kg	Very brief intervention	64	Lifestyle	Body weight BMI Waist circumference	Therapist	Mixture of individual and group intervention	Yes, training on motivational interview	Not stated	6 sessions of 1 h each week	12 weeks	High
Romo-Nava et al. (2014) Mexico	Outpatients and inpatient	schizo-Phrenia or Bipolar disorder (DSM-IV) 18–45 years free of DSM-IV current substance abuse or a history of substance dependence in the last six months;	Placebo	44	Pharmacological (Melatonin 5 mg a day)	Body weight BMI Waist circumference	Psychiatrist	Individual	Yes, training of psychiatrists to deliver the intervention.	Not stated	Eight weeks of medication	8 weeks	Some concerns
Wu et al. (2008) China	Outpatients	18–45 years First psychotic episode of schizo-Phrenia (DSM-IV)	Placebo	128	Pharmacological and/or lifestyle intervention (Metformin 750 mg a day)	Body weight BMI Waist circumference	Physiologist	Individual for the pharmacological intervention, group for the lifestyle intervention	Not Stated	Not Stated	12 Weeks of medication or lifestyle interventions (psychoeducational, dietary, and exercise)	12 weeks	Low
Sleeping patterns
Kumar et al. (2007) India	Outpatients	paranoid schizophre-nia.DSM-IV <18 years insomnia, defined as sleep-onset latency that was 30 min or greater, that had been present for at least the past 2 weeks	Placebo	40	Pharmacological (Melatonin 3–12 mg a day)	Time spent to fall asleep	Medical doctors	Individual	Not stated	Not stated	2 weeks	2 weeks	High
Physical activity
Acil et al. (2008) Turkey	Outpatients	Schizophrenia DSM-IV	Usual care	30	Physical activity	World Health Organisation Quality of Life Scale-Turkish Version (WHOQOL-BREF-TR)	Psychiatrist	Group	Not stated	Not stated	10 week exercise program	10 weeks	High
Loh et al. (2015) Malaysia	Inpatients	schizophrenia between the age of 18 to 65 DSM-IV <18	Usual care	104	Physical activity (Structured walking)	Quality of life	Psychiatrist	Group	Yes, training was provided to therapists, nurses, psychiatrists, nutritionists, and pharmacists involved in the intervention.	Not stated	12 week exercise program	12 weeks	High