title: The effects of lifestyle interventions on (long-term) weight management, cardiometabolic risk and depressive symptoms in people with psychotic disorders: a meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to estimate the effects of lifestyle interventions on bodyweight and other cardiometabolic risk factors in people with psychotic disorders. Additionally, the long-term effects on body weight and the effects on depressive symptoms were examined.
  
  
  METHODS
  We searched four databases for randomized controlled trials (RCTs) that compared lifestyle interventions to control conditions in patients with psychotic disorders. Lifestyle interventions were aimed at weight loss or weight gain prevention, and the study outcomes included bodyweight or metabolic parameters.
  
  
  RESULTS
  The search resulted in 25 RCTs -only 4 were considered high quality- showing an overall effect of lifestyle interventions on bodyweight (effect size (ES)  =  -0.63, p<0.0001). Lifestyle interventions were effective in both weight loss (ES =  -0.52, p<0.0001) and weight-gain-prevention (ES =  -0.84, p = 0.0002). There were significant long-term effects, two to six months post-intervention, for both weight-gain-prevention interventions (ES =  -0.85, p = 0.0002) and weight loss studies (ES =  -0.46, p = 0.02). Up to ten studies reported on cardiometabolic risk factors and showed that lifestyle interventions led to significant improvements in waist circumference, triglycerides, fasting glucose and insulin. No significant effects were found for blood pressure and cholesterol levels. Four studies reported on depressive symptoms and showed a significant effect (ES =  -0.95, p = 0.05).
  
  
  CONCLUSIONS
  Lifestyle interventions are effective in treating and preventing obesity, and in reducing cardiometabolic risk factors. However, the quality of the studies leaves much to be desired.
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research center, Groningen, The Netherlands.
authors.forename: Jojanneke
authors.initials: J
authors.lastname: Bruins
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research center, Groningen, The Netherlands; Friesland Mental Health Services, Research Department, Leeuwarden, Friesland, The Netherlands.
authors.forename: Frederike
authors.initials: F
authors.lastname: Jörg
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research center, Groningen, The Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Bruggeman
authors.affiliation: University of Groningen, University Medical Center Groningen, University Center Psychiatry, Rob Giel Research center, Groningen, The Netherlands; GGZ Drenthe, Department of Psychotic Disorders, Assen, Drenthe, The Netherlands.
authors.forename: Cees
authors.initials: C
authors.lastname: Slooff
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, The Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: Corpeleijn
authors.affiliation: GGZ Drenthe, Department of Psychotic Disorders, Assen, Drenthe, The Netherlands; University of Groningen, Department of Clinical Psychology and Experimental Psychopathology, Groningen, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Pijnenborg
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D001835:Body Weight; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D015444:Exercise; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008019:Life Style; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000150:complications / Q000453:epidemiology*; D012307:Risk Factors; D015431:Weight Loss