Tackling obesity and its complications in secure settings

Abstract

Purpose -The purpose of this paper is to explore the incidence of obesity and its complications in secure psychiatric settings; and to assess changes in body mass index (BMI). Design/methodology/approach -Electronic patient records were used to determine levels of obesity and weight change over a three-year period. BMI levels were related to status, medication and patient characteristics.Findings -The incidence of obesity (34 per cent) in the sample (n ¼ 351) was higher than in the general population. One-third of patients were on medication for hyperlipidaemia and 10 per cent were diagnosed with type II diabetes. Patients on regular antipsychotic drugs and sodium valproate and who were less active had higher BMIs. Gender differences over a three-year period showed a tendency for women's weight to continue to increase which may be linked to lower levels of engagement in activities of moderate or vigorous intensity. Originality/value -Previous surveys using secure psychiatric populations have been point in time reviews. The current study tracks changes over a three-year time period and related this to a range of interventions.

The prevalence of overweight and obesity levels among forensic inpatients with learning disability

“…Previous research has reported equivocal findings on this variable, with Haw and Rowell () also reporting no correlation between LoS and BMI, while Long et al. () found a positive correlation in their study on women in an inpatient setting. However, it is likely that length of stay is confounded by the high prevalence of overweight and obesity on admission, or the drawback that previous hospital admissions/prior living environment was not taken into consideration during analysis of the data.…”

“…Individuals with a learning disability appear to be at increased risk of being overweight or obese (Atkinson et al, 2013;Grondhuis & Aman, 2014;Hsieh, Rimmer, & Heller, 2014;Long, Rowell, Gayton, Hodgson, & Dolley, 2014;Osborn et al, 2007), and there are a number of possible reasons for this. Burtner, Wakham, McNeal, and Garvey (1995) suggested that many people with learning disabilities are unable to access public health messages because of difficulties in understanding product labelling and health campaigns, as well as reduced capacity to understand the implications of certain health behaviours.…”

“…Atkinson et al (2013) reported that <10% of adults with learning disabilities residing in supported accommodation consumed a balanced diet. Living in a restrictive environment also negatively affects physical activity levels (Long et al, 2014;Wardle, 2005). Yilmaz, Sari, Serin, Kisa, and Aydin (2014) reported that to maintain a healthy lifestyle, a person must be able to take responsibility over their health, be motivated and have the knowledge to do so, and that this may be difficult for people with learning disabilities.…”

“…Obesity levels among adults with severe mental illness (SMI) are higher than in the general population, in both community and inpatient services (Haw & Bailey, 2012;Long et al, 2014;Osborn et al, 2007), and more prevalent with increasing age (Haw & Rowell, 2011). This appears to be due to factors such as diet choices, lack of exercise, problems with poor motivation, low self-esteem and lack of energy (Cormac, Ferriter, & Buchan, 2013;Haw & Bailey, 2012;Long et al, 2014). Associations have been found between the prescription of antipsychotic or mood stabilising medication and BMI within adolescent and adult forensic mental health patients (Haw & Bailey, 2012;Haw & Rowell, 2011;Long et al, 2014).…”

“…() reported that <10% of adults with learning disabilities residing in supported accommodation consumed a balanced diet. Living in a restrictive environment also negatively affects physical activity levels (Long et al., ; Wardle, ).…”