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Individuals with a diagnosis of mental illness have an increased risk for obesity and its related co-morbidities. Several factors contribute to obesity risk in this population: psychotropic medications, psychiatric symptoms, cognitive impairment, and motivation issues. Lifestyle or behavioral modification interventions rely on several techniques that can be implemented during psychiatric care to help manage body weight and improve quality of life. In this paper, we discuss behavioral changes necessary for weight reduction and review the available evidence on the efficacy of lifestyle interventions for obesity in patients with severe mental illness.