Intentional Weight Loss in Overweight and Obese Patients With Severe Mental Illness: 8-Year Experience of a Behavioral Treatment Program

Objective: Obesity is 2 to 3 times more common among people with severe mental illness and has adverse effects on physical and psychological health. We report the experience from the first 8 years of a self-referring weight management clinic.

Method: From 2000 to 2008, 113 patients with severe mental illness (according to ICD-10 criteria) with a mean’ ‰±’ ‰SE age of 43.8′ ‰±’ ‰1.7 years (range, 22-71 years) referred themselves to this clinic. The patients were seen in weekly group sessions lasting 1 hour that involved weight measurement, discussion, and education. The response to the program was assessed by the paired Student t test and linear analysis corrected for repeated measures.

Results: Mean’ ‰±’ ‰SE baseline weight was 90.1′ ‰±’ ‰1.6 kg (body mass index [BMI]’ ‰=’ ‰32.2′ ‰±’ ‰0.5 kg/m2). Fifty subjects of the 142 total patient episodes (35%) dropped out within the first 3 months. Sixty-four subjects completed 1 year of the program, and 35 have attended for 2 years or longer. There were
progressive statistically significant reductions in mean weight and BMI throughout the duration
of monitoring, with no suggestion of a plateau. The mean’ ‰±’ ‰SE final weight loss was 7.2′ ‰±’ ‰0.6 kg. Weight loss was correlated only with the number of sessions attended (r’ ‰=’ ‰0.42, P’ ‰<‘ ‰.0001).

Conclusions: Lifestyle advice within a group
setting may be effective in long-term management of obese and overweight patients with severe mental illness.

J Clin Psychiatry 2010;71(6):800-805

Submitted: August 20, 2009; accepted December 2, 2009.

Online ahead of print: February 23, 2010
(doi:10.4088/JCP.09m05627gre).

Corresponding author: John Pendlebury, RN, MSc, Cromwell House, Cromwell Road, Eccles, Manchester M30 0GT, United Kingdom
([email protected]).