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Background: Patients with severe mental illness have higher cardiovascular mortality and shortened life span; this is at least partly attributed to medications although lifestyle plays a significant part. Aim: To identify the role of lifestyle factors in contributing to weight gain and metabolic disturbances. Method: We used a cross-sectional approach to measure physical health indices (Blood Pressure, Waist Circumference, Weight and BMI), laboratory indices (fasting sugar and lipid profile) and lifestyle measures using International Physical Activity Questionnaire-IV (IPAQ-IV) and a locally developed questionnaire to identify dietary patterns. Results: We had a total of 45 patients; nearly half of our sample had metabolic syndrome and high Framingham Risk Score. 51% of our sample had high fast-food frequency and 40% used sugared drinks on a daily basis. High fast-food consumption, sugared drink use and low physical activity were significantly associated with obesity, which in turn was significantly associated with risk of metabolic syndrome. Conclusions: It is important to monitor for metabolic parameters and also to identify the lifestyle factors in patients maintained on second generation antipsychotics that increases the risk for weight gain and metabolic syndrome.