A behavioral weight-loss intervention in persons with serious mental illness

Gail L Daumit, Faith B. Dickerson, Nae Yuh Wang, Arlene Dalcin, Gerald J. Jerome, Cheryl A M Anderson, Deborah R. Young, Kevin Frick, Airong Yu, Joseph V. Gennusa, Meghan Oefinger, Rosa M Crum, Jeanne B Charleston, Sarah S. Casagrande, Eliseo Guallar, Richard W. Goldberg, Leslie M. Campbell, Lawrence Appel

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P = 0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P = 0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. 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. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694).

Original languageEnglish (US)
Pages (from-to)1594-1602
Number of pages9
JournalNew England Journal of Medicine
Volume368
Issue number17
DOIs
StatePublished - Apr 25 2013

Fingerprint

Weight Loss
Weights and Measures
Control Groups
Obesity
Community Psychiatry
National Institute of Mental Health (U.S.)
Vulnerable Populations
Random Allocation
Bipolar Disorder
Psychotic Disorders
Psychiatry
Life Style
Schizophrenia
Body Mass Index
Outpatients
Exercise
Depression
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A behavioral weight-loss intervention in persons with serious mental illness. / Daumit, Gail L; Dickerson, Faith B.; Wang, Nae Yuh; Dalcin, Arlene; Jerome, Gerald J.; Anderson, Cheryl A M; Young, Deborah R.; Frick, Kevin; Yu, Airong; Gennusa, Joseph V.; Oefinger, Meghan; Crum, Rosa M; Charleston, Jeanne B; Casagrande, Sarah S.; Guallar, Eliseo; Goldberg, Richard W.; Campbell, Leslie M.; Appel, Lawrence.

In: New England Journal of Medicine, Vol. 368, No. 17, 25.04.2013, p. 1594-1602.

Research output: Contribution to journalArticle

Daumit, GL, Dickerson, FB, Wang, NY, Dalcin, A, Jerome, GJ, Anderson, CAM, Young, DR, Frick, K, Yu, A, Gennusa, JV, Oefinger, M, Crum, RM, Charleston, JB, Casagrande, SS, Guallar, E, Goldberg, RW, Campbell, LM & Appel, L 2013, 'A behavioral weight-loss intervention in persons with serious mental illness', New England Journal of Medicine, vol. 368, no. 17, pp. 1594-1602. https://doi.org/10.1056/NEJMoa1214530
Daumit, Gail L ; Dickerson, Faith B. ; Wang, Nae Yuh ; Dalcin, Arlene ; Jerome, Gerald J. ; Anderson, Cheryl A M ; Young, Deborah R. ; Frick, Kevin ; Yu, Airong ; Gennusa, Joseph V. ; Oefinger, Meghan ; Crum, Rosa M ; Charleston, Jeanne B ; Casagrande, Sarah S. ; Guallar, Eliseo ; Goldberg, Richard W. ; Campbell, Leslie M. ; Appel, Lawrence. / A behavioral weight-loss intervention in persons with serious mental illness. In: New England Journal of Medicine. 2013 ; Vol. 368, No. 17. pp. 1594-1602.
@article{d26e0671a547468c8ca5c9cd46b6fc45,
title = "A behavioral weight-loss intervention in persons with serious mental illness",
abstract = "BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1{\%} had schizophrenia or a schizoaffective disorder, 22.0{\%} had bipolar disorder, and 12.0{\%} had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P = 0.002); 37.8{\%} of the participants in the intervention group lost 5{\%} or more of their initial weight, as compared with 22.7{\%} of those in the control group (P = 0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. 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. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694).",
author = "Daumit, {Gail L} and Dickerson, {Faith B.} and Wang, {Nae Yuh} and Arlene Dalcin and Jerome, {Gerald J.} and Anderson, {Cheryl A M} and Young, {Deborah R.} and Kevin Frick and Airong Yu and Gennusa, {Joseph V.} and Meghan Oefinger and Crum, {Rosa M} and Charleston, {Jeanne B} and Casagrande, {Sarah S.} and Eliseo Guallar and Goldberg, {Richard W.} and Campbell, {Leslie M.} and Lawrence Appel",
year = "2013",
month = "4",
day = "25",
doi = "10.1056/NEJMoa1214530",
language = "English (US)",
volume = "368",
pages = "1594--1602",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "17",

}

TY - JOUR

T1 - A behavioral weight-loss intervention in persons with serious mental illness

AU - Daumit, Gail L

AU - Dickerson, Faith B.

AU - Wang, Nae Yuh

AU - Dalcin, Arlene

AU - Jerome, Gerald J.

AU - Anderson, Cheryl A M

AU - Young, Deborah R.

AU - Frick, Kevin

AU - Yu, Airong

AU - Gennusa, Joseph V.

AU - Oefinger, Meghan

AU - Crum, Rosa M

AU - Charleston, Jeanne B

AU - Casagrande, Sarah S.

AU - Guallar, Eliseo

AU - Goldberg, Richard W.

AU - Campbell, Leslie M.

AU - Appel, Lawrence

PY - 2013/4/25

Y1 - 2013/4/25

N2 - BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P = 0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P = 0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. 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. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694).

AB - BACKGROUND: Overweight and obesity are epidemic among persons with serious mental illness, yet weight-loss trials systematically exclude this vulnerable population. Lifestyle interventions require adaptation in this group because psychiatric symptoms and cognitive impairment are highly prevalent. Our objective was to determine the effectiveness of an 18-month tailored behavioral weight-loss intervention in adults with serious mental illness. METHODS: We recruited overweight or obese adults from 10 community psychiatric rehabilitation outpatient programs and randomly assigned them to an intervention or a control group. Participants in the intervention group received tailored group and individual weight-management sessions and group exercise sessions. Weight change was assessed at 6, 12, and 18 months. RESULTS: Of 291 participants who underwent randomization, 58.1% had schizophrenia or a schizoaffective disorder, 22.0% had bipolar disorder, and 12.0% had major depression. At baseline, the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 36.3, and the mean weight was 102.7 kg (225.9 lb). Data on weight at 18 months were obtained from 279 participants. Weight loss in the intervention group increased progressively over the 18-month study period and differed significantly from the control group at each follow-up visit. At 18 months, the mean between-group difference in weight (change in intervention group minus change in control group) was -3.2 kg (-7.0 lb, P = 0.002); 37.8% of the participants in the intervention group lost 5% or more of their initial weight, as compared with 22.7% of those in the control group (P = 0.009). There were no significant between-group differences in adverse events. CONCLUSIONS: A behavioral weight-loss intervention significantly reduced weight over a period of 18 months in overweight and obese adults with serious mental illness. 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. (Funded by the National Institute of Mental Health; ACHIEVE ClinicalTrials.gov number, NCT00902694).

UR - http://www.scopus.com/inward/record.url?scp=84876531583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876531583&partnerID=8YFLogxK

U2 - 10.1056/NEJMoa1214530

DO - 10.1056/NEJMoa1214530

M3 - Article

C2 - 23517118

AN - SCOPUS:84876531583

VL - 368

SP - 1594

EP - 1602

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 17

ER -