Clinically Significant Improved Fitness and Weight Loss Among Overweight Persons With Serious Mental Illness

Abstract

Objective The objective of this study was to evaluate the effectiveness of a fitness health mentor program (In SHAPE) in improving physical fitness and weight loss among overweight and obese adults with serious mental illness. Methods A randomized controlled trial was conducted with 133 persons with serious mental illness and a body mass index (BMI) >25 who were assigned either to the In SHAPE program (one year of weekly sessions with a fitness trainer plus a fitness club membership) or to one year of fitness club membership and education. Assessments were conducted at baseline and three, six, nine, and 12 months later. Results Participants had a mean baseline weight of 231.8±54.8 pounds and a mean BMI of 37.6±8.2. At 12-month follow-up, In SHAPE (N=67) compared with fitness club membership and education (N=66) was associated with three times greater fitness club attendance, twice as much participation in physical exercise, greater engagement in vigorous physical activity, and improvement in diet. Twice the proportion of participants (40% versus 20%) achieved clinically significant improvement in cardiorespiratory fitness (>50 m on the six-minute walk test). Weight loss and BMI did not differ between groups. Among In SHAPE participants, 49% achieved either clinically significant increased fitness or weight loss (5% or greater), and 24% achieved both clinically significant improved fitness and weight loss. Conclusions The In SHAPE program achieved clinically significant reduction in cardiovascular risk for almost one-half of participants at 12 months. Although the intervention showed promise in improving fitness, optimizing weight loss may require additional intensive, multicomponent dietary interventions.

Adherence to a Videogame-Based Physical Activity Program for Older Adults with Schizophrenia

“…9,14,32 The adherence findings from two recent physical activity randomized controlled trials in younger adults with schizophrenia provide some context for our findings. 14,32 The interventions (group exercise classes or a health club membership plus a health mentor) in both programs were offered for a year.…”

“…9,14,32 The adherence findings from two recent physical activity randomized controlled trials in younger adults with schizophrenia provide some context for our findings. 14,32 The interventions (group exercise classes or a health club membership plus a health mentor) in both programs were offered for a year. In the program that offered group exercise classes, 32 adherence to the program was higher during the first 6 months (median number of total attended sessions was 30 out of a median of 61 sessions offered) than during the last 6 months (median of 24 sessions attended out of a median of 141 sessions offered).…”

Assessing Sustainability of InSHAPE Participants’ Fitness Activities in a Community Mental Health Setting

“…Bartels et al (2013) estimated that the health care savings achieved by preventing chronic disease would offset the annual per-person cost of the InSHAPE program. The trainerparticipant relationship can be a model for other professionals working with individuals with SMI.…”

“…Although several evaluation studies have assessed InSHAPE program outcomes and reported increased exercise capacity, weight loss, and improved mental health status (Bartels et al, 2013;Shiner, Whitley, Van Citters, Pratt, & Bartels, 2008;Van Citters et al, 2010), no post-program follow-up studies have been reported. The authors do not know if participants who successfully completed the year-long program were able to sustain gains in physical activity and fi tness levels.…”

Increasing US health plan coverage for exercise programming in community mental health settings for people with serious mental illness: a position statement from the Society of Behavior Medicine and the American College of Sports Medicine

“…Studies conducted in community mental health settings show that supported exercise programming can significantly reduce health risks in people with serious mental illness [11][12][13][14] by helping people achieve a healthy weight and better manage chronic disease risk factors [10,[15][16][17]. Regular exercise also increases cardiovascular fitness and helps prevent costly, disease-related disability [11,12,14].…”