Perceptions of strategies for successful weight loss in persons with serious mental illness participating in a behavioral weight loss intervention: A qualitative study.

Abstract

Objective The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention. Methods Semi-structured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach. Results Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE – such as reducing portion sizes and avoiding sugar-sweetened beverages – as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions. Conclusions and Implications for Practice There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on non-clinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness.

Health behavior models for informing digital technology interventions for individuals with mental illness.

“…Lastly, verbal or social persuasion refers to encouraging an individual and letting them know that they have the ability to perform the behavior, which can increase confidence and promote greater sustained effort to change. Social Cognitive Theory has informed numerous interventions for people with mental illness, including skills training (Patterson et al, 2006) and diabetes management and education (McKibbin et al, 2006) programs for middle-aged and older adults with schizophrenia, and lifestyle interventions for obese adults with serious mental illness (Aschbrenner, Naslund, & Bartels, 2016; Aschbrenner, Naslund, Shevenell, Mueser, & Bartels, 2016; Vazin et al, 2016). …”

Development and Evaluation of Innovative Peer-Led Physical Activity Programs for Mental Health Service Users

“…Conversely, service providers believe clients experience positive support in adopting healthier lifestyle behaviors when clients take personal initiative, have peer support, and have easy access to community resources ( McKibbin et al, 2014 ; Browne et al, 2016 ; Naslund et al, 2016 ). Similarly, MHSUs have identified factors of empowerment, self-value and personal growth, social context and support, motivation and planning, and access as being important to engagement in healthy behaviors ( Graham et al, 2014 ; Vazin et al, 2016 ). These barriers and conversely lack of facilitators may account for lower rates of positive outcomes in service provider-delivered healthy lifestyle interventions ( Barre et al, 2011 ; Graham et al, 2013 ; Soundy et al, 2007 ).…”

Portion‐control intervention for people with serious mental illness: A feasibility study

“…7,25,26 Moreover, complimenting the PCI with physical activity likely would result in better outcomes. 11,27 The results of this study come with several limitations. First, due…”

“…[6][7][8] Prior studies have reported the effects of portion control to manage weight through education (eg, knowledge of nutrition), training in healthy eating practices (eg, increasing intake of fruits, vegetables, and water), support for behavioral changes, and action-oriented approaches (eg, grocery store visits, cooking demonstrations). 9,10 Moreover, a more recent study 11 demonstrates that reducing portion size is a useful weight loss strategy for people with SMI.…”