Effectiveness of Interventions for Weight Loss for People With Serious Mental Illness: A Systematic Review and Meta-Analysis

Brown, Catana; Geiszler, Lydia C.; Lewis, Kelsie J.; Arbesman, Marian

doi:10.5014/ajot.2018.033415

Cited by 15 publications

(12 citation statements)

References 33 publications

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“…Speyer et al and Vancampfort et al found that studies with an individual approach yield higher effects on weight outcomes [ 12 , 13 ]. In contrast, other reviews state that group interventions would be more effective and highlight the importance of peer support for motivation [ 73 , 76 , 77 ]. Our own analysis showed a tendency of larger benefits of group settings on QoL.…”

Section: Discussionmentioning

confidence: 99%

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

et al. 2022

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Background Lifestyle interventions for severe mental illness (SMI) are known to have small to modest effect on physical health outcomes. Little attention has been given to patient-reported outcomes (PROs). Aim To systematically review the use of PROs and their measures, and quantify the effects of lifestyle interventions in patients with SMI on these PROs. Methods Five electronic databases were searched (PubMed/Medline, Embase, PsycINFO, CINAHL, and Web of Science) from inception until 12 November 2020 (PROSPERO: CRD42020212135). Randomised controlled trials (RCTs) evaluating the efficacy of lifestyle interventions focusing on healthy diet, physical activity, or both for patients with SMI were included. Outcomes of interest were PROs. Results A total of 11.267 unique records were identified from the database search, 66 full-text articles were assessed, and 36 RCTs were included, of which 21 were suitable for meta-analyses. In total, 5.907 participants were included across studies. Lifestyle interventions had no significant effect on quality of life (g = 0.13; 95% CI = − 0.02 to 0.27), with high heterogeneity (I2 = 68.7%). We found a small effect on depression severity (g = 0.30, 95% CI = 0.00 to 0.58, I2 = 65.2%) and a moderate effect on anxiety severity (g = 0.56, 95% CI = 0.16 to 0.95, I2 = 0%). Discussion This meta-analysis quantifies the effects of lifestyle interventions on PROs. Lifestyle interventions have no significant effect on quality of life, yet they could improve mental health outcomes such as depression and anxiety symptoms. Further use of patient-reported outcome measures in lifestyle research is recommended to fully capture the impact of lifestyle interventions.

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Section: Discussionmentioning

confidence: 99%

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

et al. 2022

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“…Implementation of screening programmes assessing overweight and obesity might be useful to identify people at higher risk, and referral to lifestyle interventions and collaborative care as suggested by the WHO guidelines for management of physical conditions in adults with SMI ( 8 ). Despite the multiple barriers faced by this population such as stigma, illness symptoms and low motivation, the few pharmacological and lifestyle interventions available to prevent and treat obesity in this population have proven to be effective to maintain and reduce body weight ( 39 – 42 ). In addition, they have shown benefits in other parameters such as fasting blood glucose, hypertension and dyslipidemia ( 43 ).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis

et al. 2021

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Aims1) To determine the pooled prevalence of overweight and obesity in people with severe mental illness (SMI), overall and by type of SMI, geographical region, and year of data collection; and 2) to assess the likelihood of overweight and obesity, in people with SMI compared with the general population.MethodsPubMed, Medline, EMBASE, and PsycINFO databases were searched to identify observational studies assessing the prevalence of obesity in adults with SMI. Screening, data extraction and risk of bias assessments were performed independently by two co-authors. Random effect estimates for the pooled prevalence of overweight and obesity and the pooled odds of obesity in people with SMI compared with the general population were calculated. Subgroup analyses were conducted for types of SMI, setting, antipsychotic medication, region of the world, country income classification, date of data collection and sex. We assessed publication bias and performed a series of sensitivity analyses, excluding studies with high risk of bias, with low sample size and those not reporting obesity according to WHO classification.Result120 studies from 43 countries were included, the majority were from high income countries. The pooled prevalence of obesity in people with SMI was 25.9% (95% C.I. = 23.3-29.1) and the combined pooled prevalence of overweight and obesity was 60.1% (95% C.I. = 55.8-63.1). Sub-Saharan Africa (13.0%, 95%C.I. = 6.7-25.1) and South Asia (17.7%, 95%C.I. = 10.5-28.5) had the lowest prevalence of obesity whilst North Africa and the Middle East (35.8%, 95%C.I. = 23.8-44.8) reported the highest prevalence. People with SMI were 3.04 more likely (95% C.I. = 2.42-3.82) to have obesity than the general population, but there was no difference in the prevalence of overweight. Women with schizophrenia were 1.44 (95% C.I. = 1.25-1.67) times more likely than men with schizophrenia to live with obesity; however, no gender differences were found among those with bipolar disorder.ConclusionPeople with SMI have a markedly high prevalence and higher odds of obesity than the general population. This may contribute to the very high prevalence of physical health conditions and mortality in this group. People with SMI around the world would likely benefit from interventions to reduce and prevent obesity.

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“…To date, weight loss interventions, including specific programmes designed for patients with psychosis, have shown limited clinical benefits for patients with psychosis Brown et al, 2018;Naslund et al, 2016;Speyer et al, 2019). Greater effectiveness is apparent for interventions self-worth and changed appearance amplified a sense of vulnerability.…”

Section: Backgrou N Dmentioning

confidence: 99%

The psychological journey of weight gain in psychosis

et al. 2022

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Effectiveness of Interventions for Weight Loss for People With Serious Mental Illness: A Systematic Review and Meta-Analysis

Abstract: Community-based interventions for people with SMI are effective for weight loss. Occupational therapists can be involved in the provision of weight loss interventions and in the development and study of intervention components that are most effective.

Cited by 15 publications

References 33 publications

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Patient-reported outcomes of lifestyle interventions in patients with severe mental illness: a systematic review and meta-analysis

Prevalence of Overweight and Obesity in People With Severe Mental Illness: Systematic Review and Meta-Analysis

The psychological journey of weight gain in psychosis

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