A behavioral weight-loss intervention for persons with serious mental illness in psychiatric rehabilitation centers.
OBJECTIVE
Overweight and obesity are epidemic in populations with serious mental illnesses. We developed and pilot-tested a behavioral weight-loss intervention appropriately tailored for persons with serious mental disorders.


METHODS
We conducted a single-arm pilot study in two psychiatric rehabilitation day programs in Maryland, and enrolled 63 overweight or obese adults. The 6-month intervention provided group and individual weight management and group physical activity classes. The primary outcome was weight change from baseline to 6 months.


RESULTS
A total of 64% of those potentially eligible enrolled at the centers. The mean age was 43.7 years; 56% were women; 49% were white; and over half had schizophrenia or a schizoaffective disorder. One-third had hypertension and one-fifth had diabetes. In total, 52 (82%) completed the study; others were discharged from psychiatric centers before completion of the study. Average attendance across all weight management sessions was 70% (87% on days participants attended the center) and 59% for physical activity classes (74% on days participants attended the center). From a baseline mean of 210.9 lbs (s.d. 43.9), average weight loss for 52 participants was 4.5 lb (s.d. 12.8) (P<0.014). On average, participants lost 1.9% of body weight. Mean waist circumference change was 3.1 cm (s.d. 5.6). Participants on average increased the distance on the 6-minute walk test by 8%.


CONCLUSIONS
This pilot study documents the feasibility and preliminary efficacy of a behavioral weight-loss intervention in adults with serious mental illness who were attendees at psychiatric rehabilitation centers. The results may have implications for developing weight-loss interventions in other institutional settings such as schools or nursing homes.
Division of General Internal Medicine, Department of Medicine, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA. gdaumit@jhmi.edu
G L
GL
Daumit
A T
AT
Dalcin
G J
GJ
Jerome
D R
DR
Young
J
J
Charleston
R M
RM
Crum
C
C
Anthony
J H
JH
Hayes
P B
PB
McCarron
E
E
Khaykin
L J
LJ
Appel
D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D004038:Diet, Reducing; D015444:Exercise; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D009765:Obesity / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D005082:Physical Exertion; D010865:Pilot Projects; D015431:Weight Loss