Objective Effective and scalable lifestyle interventions are needed to address high rates of obesity in people with serious mental illness (SMI). This pilot study evaluated the feasibility of a behavioral weight loss intervention enhanced with peer support and mobile health (mHealth) technology for obese individuals with SMI. Methods The Diabetes Prevention Program Group Lifestyle Balance intervention enhanced with peer support and mHealth technology was implemented in a public mental health setting. Thirteen obese individuals with SMI participated in a pre-post pilot study of the 24-week intervention. Feasibility was assessed by program attendance, and participant satisfaction and suggestions for improving the model. Descriptive changes in weight and fitness were also explored. Results Overall attendance amounted to approximately half (56%) of weekly sessions. At 6-month follow-up, 45% of participants had lost weight, and 45% showed improved fitness by increasing their walking distance. Participants suggested a number of modifications to increase the relevance of the intervention for people with SMI, including less didactic instruction and more active learning, a simplified dietary component, more in depth technology training, and greater attention to mental health. Conclusions The principles of standard behavioral weight loss treatment provide a useful starting point for promoting weight loss in people with SMI. However, adaptions to standard weight loss curricula are needed to enhance engagement, participation, and outcomes to respond to the unique challenges of individuals with SMI.

This pilot study examined the preliminary effectiveness of a peer-group lifestyle intervention enhanced with mHealth technology and social media for obese individuals with serious mental illness. Thirty-two participants with BMI ≥30 received the 24-week intervention designed to facilitate peer support for lifestyle change through experiential learning and use of wearable activity tracking devices, smartphone applications, and Facebook to reinforce physical activity, healthy eating, and group participation between sessions. The primary outcome was weight loss. Secondary measures included fitness and participants’ perceptions of peer group support. Most participants (72%) lost weight, including 28% achieving clinically significant weight loss, and 17% of participants showed clinically significant improvements in cardiovascular fitness. Weight loss was associated with perceived peer group support. This evaluation demonstrated the preliminary effectiveness of a potentially scalable peer-group lifestyle intervention delivered in community mental health settings for obese individuals with serious mental illness.

These direct admission guidelines can be adapted by hospitals and health systems to inform hospital admission policies and protocols. Multistakeholder engagement in evaluation of hospital admission processes may improve transitions of care and health system integration.