Lifestyle interventions for weight loss among overweight and obese adults with serious mental illness: A systematic review and meta-analysis

Abstract

Objective To conduct a systematic review and meta-analysis to estimate effects of lifestyle intervention participation on weight reduction among overweight and obese adults with serious mental illness. Method We systematically searched electronic databases for randomized controlled trials comparing lifestyle interventions with other interventions or usual care controls in overweight and obese adults with serious mental illness, including schizophrenia spectrum or mood disorders. Included studies reported change in weight [kg] or body mass index (BMI) [kg/m2] from baseline to follow-up. Standardized mean differences (SMD) were calculated for change in weight from baseline between intervention and control groups. Results Seventeen studies met inclusion criteria (1968 participants; 50% male; 66% schizophrenia spectrum disorders). Studies were grouped by intervention duration (≤ 6-months or ≥ 12-months). Lifestyle interventions of ≤ 6-months duration showed greater weight reduction compared with controls as indicated by effect size for weight change from baseline (SMD = − 0.20; 95% CI = − 0.34, − 0.05; 10 studies), but high statistical heterogeneity (I2 = 90%). Lifestyle interventions of ≥ 12-months duration also showed greater weight reduction compared with controls (SMD = − 0.24; 95% CI = − 0.36, − 0.12; 6 studies) with low statistical heterogeneity (I2 = 0%). Conclusion Lifestyle interventions appear effective for treating overweight and obesity among people with serious mental illness. Interventions of ≥ 12-months duration compared to ≤ 6-months duration appear to achieve more consistent outcomes, though effect sizes are similar for both shorter and longer duration interventions.

Structured lifestyle education to support weight loss for people with schizophrenia, schizoaffective disorder and first episode psychosis: the STEPWISE RCT

“…24 Scheduled sessions went ahead but, when support contacts were attempted, they were not always successful (14). During the trial period, we reached a small fraction of those who were potentially eligible in the study areas (15).…”

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A systematic review of interventions aimed at improving the cardiovascular health of people diagnosed with personality disorders

“…In contrast to the paucity of trials in patients with PD, we have identified 10 systematic reviews investigating interventions to improve the cardiovascular health or cardiovascular risk profile of people with SMI [38][39][40][41][42][43][44][45][46][47]. Moreover, most of these reviews did not include people with PD.…”

Improving access to specialized care for first-episode psychosis: an ecological model

“…This approach could include focusing on increasing levels of physical activity and to achieving and maintaining a healthy weight. Although these interventions are not yet widespread, some have been developed for use with people with psychosis 94. Health care–level interventions are also limited, with many aiming at increasing access to care or to health-screening services.…”