The thing about clozapine is that by the time it is coming up as an option, especially in the US, there is generally nothing left to try. So the weight gain is the trade-off for feeling better. In my case it works so I deal with the weight the best I can. I will say that it is not a matter of working hard at losing as someone said above, clozapine just shifts metabolism so that it is a huge problem. I've worked hard and lost a lot of weight (40 lbs?) on Seroquel but Clozapine is different. Because it's rarely used people don't know that it is actually more likely to cause significant weight gain than Zyprexa, which is well-known for weight gain.

Personally I'm happy keeping my weight stable for now and keep remembering that at least I am not where I was a year ago (IP and extremely ill).