title: Clinically significant improved fitness and weight loss among overweight persons with serious mental illness.
abstract: OBJECTIVE
  The objective of this study was to evaluate the effectiveness of a fitness health mentor program (In SHAPE) in improving physical fitness and weight loss among overweight and obese adults with serious mental illness.
  
  
  METHODS
  A randomized controlled trial was conducted with 133 persons with serious mental illness and a body mass index (BMI) >25 who were assigned either to the In SHAPE program (one year of weekly sessions with a fitness trainer plus a fitness club membership) or to one year of fitness club membership and education. Assessments were conducted at baseline and three, six, nine, and 12 months later.
  
  
  RESULTS
  Participants had a mean baseline weight of 231.8±54.8 pounds and a mean BMI of 37.6±8.2. At 12-month follow-up, In SHAPE (N=67) compared with fitness club membership and education (N=66) was associated with three times greater fitness club attendance, twice as much participation in physical exercise, greater engagement in vigorous physical activity, and improvement in diet. Twice the proportion of participants (40% versus 20%) achieved clinically significant improvement in cardiorespiratory fitness (>50 m on the six-minute walk test). Weight loss and BMI did not differ between groups. Among In SHAPE participants, 49% achieved either clinically significant increased fitness or weight loss (5% or greater), and 24% achieved both clinically significant improved fitness and weight loss.
  
  
  CONCLUSIONS
  The In SHAPE program achieved clinically significant reduction in cardiovascular risk for almost one-half of participants at 12 months. Although the intervention showed promise in improving fitness, optimizing weight loss may require additional intensive, multicomponent dietary interventions.
authors.affiliation: Department of Psychiatry, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 200, Lebanon, NH 03766, USA. sbartels@dartmouth.edu
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Pratt
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Aschbrenner
authors.forename: Laura K
authors.initials: LK
authors.lastname: Barre
authors.forename: Kenneth
authors.initials: K
authors.lastname: Jue
authors.forename: Rosemarie S
authors.initials: RS
authors.lastname: Wolfe
authors.forename: Haiyi
authors.initials: H
authors.lastname: Xie
authors.forename: Gregory
authors.initials: G
authors.lastname: McHugo
authors.forename: Meghan
authors.initials: M
authors.lastname: Santos
authors.forename: Gail E
authors.initials: GE
authors.lastname: Williams
authors.forename: John A
authors.initials: JA
authors.lastname: Naslund
authors.forename: Kim T
authors.initials: KT
authors.lastname: Mueser
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control; D015897:Comorbidity; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000628:therapy; D050177:Overweight / Q000453:epidemiology / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods; D010809:Physical Fitness / Q000502:physiology*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*