Antipsychotic medications commonly stimulate appetite and promote weight gain, contributing to elevated obesity prevalence among people with psychotic disorders. Whether these medication‑related changes in eating behaviour attenuate over time or persist in the early phase following a first episode of psychosis is not well characterised. This study reports longitudinal dietary data for young people presenting with a first‑episode psychosis, evaluating intake at presentation and at three and six months of follow‑up.
The analysis used data from the PHAstER randomized controlled trial. Participants included individuals diagnosed with first‑episode psychosis who had minimal prior exposure to antipsychotic medications. Of 77 participants in the PHAstER study, dietary data were obtained from 70 participants (91%) at baseline. Follow‑up dietary data at both 3 and 6 months were available for 46 participants (60%). The PubMed abstract does not provide additional demographic details, recruitment criteria, or randomisation arm breakdowns.
Dietary patterns and compliance with the Australian Dietary Guidelines were assessed at baseline, 3 months and 6 months. The investigators analysed changes in food consumption and guideline adherence using signed‑rank tests with corrections for multiple testing. The abstract does not specify the exact dietary assessment instrument(s), portion quantification method, or thresholds used to define guideline compliance; those details were not reported in the PubMed abstract.
Dietary intake patterns and compliance with the dietary guidelines remained consistent across all three timepoints, with no significant changes detected over the 6‑month period.
At baseline, recommended intake of several major food groups was met by only a minority of participants:
A large proportion of participants reported a high intake of discretionary foods (defined as foods high in saturated fat and/or sugars); 64% had a high discretionary food intake at baseline. The lack of significant change in these patterns persisted through 3 and 6 months.
At baseline, higher education levels were associated with healthier dietary patterns. This association was not observed at the 3‑ or 6‑month follow‑up assessments. The abstract does not report associations with other sociodemographic or clinical variables, nor does it provide effect sizes or adjustment factors.
The full article includes figures showing: consumption of discretionary foods at baseline and at 3 and 6 months, and the percentage of participants compliant with the Australian Dietary Guidelines at baseline and at follow‑up timepoints. The abstract indicates these visual summaries but does not present numeric detail beyond the percentages noted above.
Over the first six months following presentation for first‑episode psychosis, participants in this cohort consistently reported diets that did not adhere to national dietary guidelines and a high prevalence of discretionary food consumption. The authors interpret these findings as evidence of persistent dietary inequity in people with psychosis, especially among those with lower education levels.
Given the established links between unhealthy diet, weight gain and cardiometabolic risk—risks that may be amplified by antipsychotic treatment—the authors recommend integrating dietary advice and support into routine clinical care for people with first‑episode psychosis. They characterise such nutritional interventions as having high marginal gain in this population.
The authors declare no conflicts of interest. The PubMed abstract does not report several methodological details that clinicians and researchers may seek, including the specific dietary assessment tool(s), absolute intake quantities or energy intake, individual trial arm results from PHAstER, effect sizes and confidence intervals, or additional covariate analyses. These details would need to be consulted in the full text for a complete appraisal.
This summary is based on the PubMed/PMC abstract of: O’Mahony B et al., Early Intervention in Psychiatry. 2026;20(8):e70226. DOI: 10.1111/eip.70226. Full methodological and numerical detail should be reviewed in the open PMC article (PMCID: PMC13411650) where available.