Intentional weight loss in overweight and obese patients with severe mental illness: 8-year experience of a behavioral treatment program.

摘要

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/m(2)). 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.