title: Lifestyle Intervention for People With Severe Obesity and Serious Mental Illness.
abstract: BACKGROUND
  People with serious mental illness experience elevated severe obesity rates, yet limited evidence documents whether lifestyle intervention participation can benefit these individuals. This study examined the impact of the In SHAPE lifestyle intervention on weight loss among participants with serious mental illness and severe obesity (BMI ≥40) compared with participants who are overweight (BMI 25 to <30) and have class I (BMI 30 to <35) or class II (BMI 35 to <40) obesity.
  
  
  METHODS
  Data were combined from three trials of the 12-month In SHAPE intervention for individuals with serious mental illness collected between 2007 and 2013 and analyzed in 2014. In SHAPE includes individual weekly meetings with a fitness trainer, a gym membership, and nutrition education. The primary outcome was weight loss. Secondary outcomes were fitness, blood pressure, lipids, and program adherence.
  
  
  RESULTS
  Participants (N=192) were diagnosed with schizophrenia spectrum (53.1%) or mood (46.9%) disorders. At 12 months, the overall sample showed significant weight loss, but differences among BMI groups were not significant (severe obesity, 2.57% [7.98%]; class II, 2.26% [8.69%]; class I, 1.05% [6.86%]; overweight, 0.83% [7.62%]). One third of participants with severe obesity achieved ≥5% weight loss, which was comparable across groups. More participants with severe obesity achieved ≥10% weight loss (20%) than overweight (2.9%, p=0.001) and class I (5.9%, p<0.001), but not class II (17.8%, p=0.974), obesity groups.
  
  
  CONCLUSIONS
  People with severe obesity and serious mental illness benefit similarly to those in lower BMI groups from lifestyle intervention participation.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire. Electronic address: john.a.naslund@gmail.com.
authors.forename: John A
authors.initials: JA
authors.lastname: Naslund
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Aschbrenner
authors.affiliation: Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Scherer
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Sarah I
authors.initials: SI
authors.lastname: Pratt
authors.affiliation: Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Rosemarie S
authors.initials: RS
authors.lastname: Wolfe
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Lebanon, New Hampshire; Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire; Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Bartels
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000628:therapy*; D050177:Overweight / Q000453:epidemiology / Q000628:therapy; D010349:Patient Compliance; D010809:Physical Fitness; D015431:Weight Loss
chemical_list: D008055:Lipids