The proven efficacy of second-generation antipsychotics (SGA) has led many clinicians to switch patients from a conventional antipsychotic to an SGA. However, SGAs may be associated with weight gain, dyslipidemia, high blood pressure, and ultimately with cardiovascular disease, diabetes, and metabolic syndrome. Clinicians should be aware of patients’ individual risk factors for developing these illnesses and should carefully screen for changes in weight, body mass index, waist size, or lipid levels that could be potentially harmful and increase the risk for a more serious illness.