Intentional Weight Loss in Overweight and Obese Patients With Severe Mental Illness

Article AbstractObjective: 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 †‰=†‰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):800-805Submitted: 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 (john@pendlebury.freeserve.co.uk).