Featured Research

from universities, journals, and other organizations

Serious mental illness no barrier to weight loss success

Date:
March 21, 2013
Source:
Johns Hopkins Medicine
Summary:
Through a program that teaches simple nutrition messages and involves both counseling and regular exercise classes, people with serious mental illness can make healthy behavioral changes and achieve significant weight loss.

Through a program that teaches simple nutrition messages and involves both counseling and regular exercise classes, people with serious mental illness can make healthy behavioral changes and achieve significant weight loss, according to new Johns Hopkins research.

Related Articles


These weight loss amounts were similar to those in other successful programs studied with subjects in the general population -- studies that specifically excluded people with serious mental illnesses, the researchers say.

Results of the new research, believed to be the first large study of its kind to involve people with schizophrenia, bipolar disorder or major depression, suggest that a population many consider to be unable to engage in a behavior management program can make substantial lifestyle changes to improve their health. People with serious mental illness often are overweight or obese and have mortality rates two to three times higher than that of the general population, primarily from obesity-related conditions. Many are sedentary and take several psychotropic medications, which include weight gain as a side effect.

Results of the research are being published online March 21 in the New England Journal of Medicine and presented that day at the American Heart Association's Epidemiology and Prevention/Nutrition, Physical Activity and Metabolism 2013 Scientific Sessions (EPI/NPAM).

"We sought to dispel the perception that lifestyle programs don't work in this population," says study leader Gail L. Daumit, M.D., M.H.S., an associate professor of general internal medicine at the Johns Hopkins University School of Medicine. "There's this really important need to find ways to help this population be healthier and lose weight. We brought a weight-loss program to them, tailored to the needs of people with serious mental illness. And we were successful."

Known as ACHIEVE (Randomized Trial of Achieving Healthy Lifestyles in Psychiatric Rehabilitation), the study enrolled 291 overweight or obese patients with serious mental illness. Some 144 were randomly placed in an intervention group, while 147 made up the control group. The intervention took place at 10 Baltimore area outpatient psychiatric rehabilitation day facilities that already offered vocational and skills training, case management and other services for people with mental illness not well enough to work full time.

The researchers added a schedule of regular group and individual weight-management sessions, thrice-weekly exercise classes and a weekly weigh-in for the first six months of the trial. The sessions and weigh-ins continued, though less frequently, for the following year, though the exercise class schedule remained the same.

At the 18-month point, on average, the intervention group lost seven more pounds than the control group. Nearly 38 percent of the intervention group lost 5 percent or more of their initial weight, as compared with 23 percent of the control group. More than 18 percent of those in the intervention arm of the study lost more than 10 percent of their body weight after 18 months, compared with 7 percent in the control group.

Participants lost more weight as the intervention went on. This suggests it took a while to make behavioral change, but once these modifications took hold, the changes yielded positive results, Daumit says.

Of the people in the study, 50 percent had schizophrenia, 22 percent had bipolar disorder and 12 percent major depression. Many with serious mental illness, particularly schizophrenia, have impairments in memory and executive function, as well as residual psychiatric symptoms that impede learning and adoption of new behaviors.

What the study suggested, Daumit says, is that tailored programs can overcome these impediments.

The average number of psychotropic medications study participants took was three; the medications, often required for long-term symptom control, are known to cause weight gain in part by stimulating appetites and increased eating.

Instead of asking participants to keep detailed food logs and counting every calorie they consume -- a practice common to other weight-loss programs -- Daumit's program instead focused on relatively simple messages and goals, she says. They were encouraged to avoid junk food and sugary beverages, monitor portion sizes and include more fruits and vegetables in their diet. They had regular exercise at the rehabilitation facilities as part of the study, and were encouraged to exercise 30 minutes on other days, too. Daumit says she thinks the weight-loss program could be adopted by other psychiatric rehabilitation facilities.

"This population is often stigmatized, " she says. "This study's findings should help people think differently about people with serious mental illness. Our results provide clear evidence that this population can make healthy lifestyle changes and achieve weight loss."

The research was funded by a grant from the National Institutes of Health's National Institute of Mental Health (R01 MH080964).

Other Johns Hopkins researchers involved in the study include Nae-Yuh Wang, Ph.D.; Arlene Dalcin, R.D.; Gerald J. Jerome, Ph.D.; Kevin D. Frick, Ph.D.; Airong Yu, M.S.; Joseph V. Gennusa III, Ph.D., R.D., L.D.N.; Meghan Oefinger; Rosa M. Crum, M.D., M.H.S.; Jeanne Charelston, R.N.; Eliseo Guallar, M.D., Dr.PH., M.P.H.; Richard W. Goldberg, Ph.D.; Leslie M. Campbell; and Lawrence J. Appel, M.D., M.P.H.


Story Source:

The above story is based on materials provided by Johns Hopkins Medicine. Note: Materials may be edited for content and length.


Journal Reference:

  1. Gail L. Daumit, Faith B. Dickerson, Nae-Yuh Wang, Arlene Dalcin, Gerald J. Jerome, Cheryl A.M. Anderson, Deborah R. Young, Kevin D. Frick, Airong Yu, Joseph V. Gennusa, Meghan Oefinger, Rosa M. Crum, Jeanne Charleston, Sarah S. Casagrande, Eliseo Guallar, Richard W. Goldberg, Leslie M. Campbell, Lawrence J. Appel. A Behavioral Weight-Loss Intervention in Persons with Serious Mental Illness. New England Journal of Medicine, 2013; 130321133006009 DOI: 10.1056/NEJMoa1214530

Cite This Page:

Johns Hopkins Medicine. "Serious mental illness no barrier to weight loss success." ScienceDaily. ScienceDaily, 21 March 2013. <www.sciencedaily.com/releases/2013/03/130321204812.htm>.
Johns Hopkins Medicine. (2013, March 21). Serious mental illness no barrier to weight loss success. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2013/03/130321204812.htm
Johns Hopkins Medicine. "Serious mental illness no barrier to weight loss success." ScienceDaily. www.sciencedaily.com/releases/2013/03/130321204812.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Mind & Brain News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Reuters - Innovations Video Online (Dec. 22, 2014) Cambridge scientists have unravelled the genetic code of a rare tapeworm that lived inside a patient's brain for at least four year. Researchers hope it will present new opportunities to diagnose and treat this invasive parasite. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Researchers Test Colombian Village With High Alzheimer's Rates

Researchers Test Colombian Village With High Alzheimer's Rates

AFP (Dec. 19, 2014) In Yarumal, a village in N. Colombia, Alzheimer's has ravaged a disproportionately large number of families. A genetic "curse" that may pave the way for research on how to treat the disease that claims a new victim every four seconds. Duration: 02:42 Video provided by AFP
Powered by NewsLook.com
Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Double-Amputee Becomes First To Move Two Prosthetic Arms With His Mind

Buzz60 (Dec. 19, 2014) A double-amputee makes history by becoming the first person to wear and operate two prosthetic arms using only his mind. Jen Markham has the story. Video provided by Buzz60
Powered by NewsLook.com
Prenatal Exposure To Pollution Might Increase Autism Risk

Prenatal Exposure To Pollution Might Increase Autism Risk

Newsy (Dec. 18, 2014) Harvard researchers found children whose mothers were exposed to high pollution levels in the third trimester were twice as likely to develop autism. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins