Change Your Behavior, Lose the Weight

Weight loss despite mental disorders is possible

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Losing weight can be tough for those who are obese. It can be an even tougher battle with a serious mental health disorder. But it is possible.

A recent study compared weight loss successes in two groups of individuals with serious mental health disorders.

The group that participated in a behavioral weight loss program lost an average 7 pounds more than those who did not participate in the program.

The key components of the program focused on fewer calories eaten, healthier diets and regular exercise.

"Eat healthy and exercise to lose weight."

The study, led by Gail L. Daumit, MD, MHS, of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins University, looked at the effectiveness of a weight loss program for adults with serious mental illness.

The researchers included 291 participants in the study, which lasted for 18 months. The participants were randomly divided into two groups, one with a weight loss program and one without.

All the participants had been recruited from 10 community psychiatric rehabilitation programs or the outpatient mental health clinics associated with those programs.

Among the participants, 58 percent has schizophrenia or a schizoaffective disorder, 22 percent had bipolar disorder and 12 percent had major depression. Those with alcohol or substance abuse problems and those with a heart attack or stroke within the past six months were not included in the study.

At the start of the study, the average weight of the participants was 225.9 pounds. The average body mass index (BMI) of the participants at the study's start was 36.3.

BMI is a ratio of a person's height to weight and is used to classify whether a person's weight is healthy. A BMI of 30 or higher is considered obese.

During the study, the group in the behavioral weight loss program learned "cognitive and behavioral self-management" skills along with lifestyle changes that have been successful in achieving weight loss in the general population.

The intervention included group meetings, individual sessions and group exercise sessions. The program aimed to reduce participants' total daily calories by cutting out sugar-sweetened beverages and junk food.

Participants were also encouraged to eat five servings of fruits and vegetables each daily, to eat smaller portions, to choose healthy snacks and to do aerobic exercise regularly.

Those in the control group were provided with standard information about nutrition and physical activity and could attend four health information classes a year with information unrelated to weight loss.

The researchers checked in with changes in the participants weight at six, 12 and 18 months. At 18 months, the individuals in the weight loss program group lost an average 7 pounds more than those in the control group.

Overall, just over a third of the participants in the weight loss group (38 percent) lost 5 percent or more of their original weight. In the control group, only 23 percent lost 5 percent or more of their starting weight.

The researchers did not discover any negative side effects that were different between the two groups. They concluded that the behavioral weight loss program did help the patients in the intervention group lose weight.

"Given the epidemic of obesity and weight-related disease among persons with serious mental illness, our findings support implementation of targeted behavioral weight loss interventions in this high-risk population," the researchers wrote.

The study was published March 21 in the New England Journal of Medicine. The research was funded by the National Institute for Mental Health.

Reviewed by: 
Review Date: 
March 21, 2013
Last Updated:
March 21, 2013