Psychiatry is constantly faced with challenges related to the medical status of its patients and comorbid effects of pharmacologic treatment for psychiatric disorders. Other articles in this supplement review how obesity, diabetes, and dyslipidemia play a role in the treatment of schizophrenia, but these issues are by no means limited to schizophrenia. As the population of the United States becomes more obese and sedentary over time, risk factors for cardiovascular disease and diabetes are increasing in prevalence and affect the treatment of any psychiatric condition. As our understanding of how metabolic factors contribute to disease grows, it has become clear that a clustering of individual dysmetabolic factors, now known as metabolic syndrome, can contribute to significant morbidity and mortality and should be accounted for in the treatment of psychiatric conditions.