Intentional weight loss in overweight and obese patients with severe mental illness: 8-year experience of a behavioral treatment program.
OBJECTIVE
Obesity is 2 to 3 times more common among people with severe mental illness and has adverse effects on physical and psychological health. We report the experience from the first 8 years of a self-referring weight management clinic.


METHODS
From 2000 to 2008, 113 patients with severe mental illness (according to ICD-10 criteria) with a mean +/- SE age of 43.8 +/- 1.7 years (range, 22-71 years) referred themselves to this clinic. The patients were seen in weekly group sessions lasting 1 hour that involved weight measurement, discussion, and education. The response to the program was assessed by the paired Student t test and linear analysis corrected for repeated measures.


RESULTS
Mean +/- SE baseline weight was 90.1 +/- 1.6 kg (body mass index [BMI] = 32.2 +/- 0.5 kg/m(2)). Fifty subjects of the 142 total patient episodes (35%) dropped out within the first 3 months. Sixty-four subjects completed 1 year of the program, and 35 have attended for 2 years or longer. There were progressive statistically significant reductions in mean weight and BMI throughout the duration of monitoring, with no suggestion of a plateau. The mean +/- SE final weight loss was 7.2 +/- 0.6 kg. Weight loss was correlated only with the number of sessions attended (r = 0.42, P < .0001).


CONCLUSIONS
Lifestyle advice within a group setting may be effective in long-term management of obese and overweight patients with severe mental illness.
Holt
Richard I G
RI
Developmental Origins of Health and Disease Division, School of Medicine, University of Southampton, United Kingdom.
Pendlebury
John
J
Wildgust
Hiram J
HJ
Bushe
Chris J
CJ
D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents; D001521:Behavior Therapy / Q000379:methods* / Q000706:statistics & numerical data; D015992:Body Mass Index; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008134:Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D009767:Obesity, Morbid / Q000628:therapy; D050177:Overweight / Q000139:chemically induced / Q000628:therapy*; D010349:Patient Compliance; D015397:Program Evaluation; D011615:Psychotherapy, Group / Q000379:methods / Q000706:statistics & numerical data; D016896:Treatment Outcome; D006113:United Kingdom; D015431:Weight Loss
D019440:Anti-Obesity Agents