title: Waist circumference and not body mass index as the outcome of a group weight intervention for patients with severe mental illness.
abstract: OBJECTIVE
  Most weight interventions among patients with severe mental illness (SMI) used body mass index (BMI) as outcome measure but excluded waist circumference (WC) although the latter is a stronger predictor of obesity complications. This study aimed to assess a weight-management program consisting of education, exercise and behavioural techniques for patients with SMI using weight parameters including WC as the outcome measures.
  
  
  METHODS
  A group intervention was carried out as part of psychiatric outpatient community service. It used structured modules on diet, exercise and related topics comprising of education and exercises sessions with a total of 12-week duration. The participants were outpatients with SMI recruited through referrals to the program by the treating doctor. The participants' body weight, BMI and WC were measured at the baseline, fortnightly and at the end of the program.
  
  
  RESULTS
  A total of 27 patients participated in the program which was carried out in 6 cycles. The pre- and post-intervention comparisons analysis of the weight parameters found a significant reduction in the WC (mean=3.878 cm+5.165, p=0.001) while no significant changes were recorded in body weight and BMI.
  
  
  CONCLUSIONS
  Small but significant loss in WC and possibly weight maintenance were achieved using this non-pharmacological intervention. Modest loss in WC may have an impact on reducing the risk of obesity-related health risks.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras, 56000 Kuala Lumpur, Malaysia. Electronic address: njruzyanei@gmail.com.
authors.forename: Nik Ruzyanei
authors.initials: NR
authors.lastname: Nik Jaafar
authors.forename: Marhani
authors.initials: M
authors.lastname: Midin
authors.forename: Raynuha
authors.initials: R
authors.lastname: Mahadevan
authors.forename: Aishvarya
authors.initials: A
authors.lastname: Sinniah
authors.forename: Abdul Hamid Abdul
authors.initials: AH
authors.lastname: Rahman
authors.forename: Wong
authors.initials: W
authors.lastname: Ming
authors.forename: Shamsul Azhar
authors.initials: SA
authors.lastname: Shah
authors.forename: Srijit
authors.initials: S
authors.lastname: Das
authors.forename: Hatta
authors.initials: H
authors.lastname: Sidi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011615:Psychotherapy, Group / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055105:Waist Circumference / Q000502:physiology*; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult