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Behavioral weight-loss programs can work for adults with mental illness, diabetes
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Adults with serious mental illness and obesity may be able to achieve significant weight-loss reduction with behavioral intervention regardless of the presence of diabetes, according to findings published in Diabetic Medicine.
“People with serious mental illness (SMI) have an extremely high prevalence of obesity that is nearly double that of the general population,” Eva Tseng, MD, MPH, assistant professor of medicine at Johns Hopkins University School of Medicine, and colleagues wrote. “Furthermore, although the prevalence of diagnosed type 2 diabetes in this vulnerable population is [approximately] 12%, up to 70% of cases of diabetes in this population are undiagnosed.”
Tseng and colleagues used data from 291 participants in the ACHIEVE trial, which recruited adults with serious mental illness and overweight or obesity from 10 community outpatient psychiatric rehabilitation programs in Maryland between January 2009 and February 2011. Among the cohort Teng and colleagues focused on, 82 had diabetes (mean age, 48.4 years; 52.1% women), and 209 did not (mean age, 44.1 years; 45.1% women).
Participants were randomly assigned to a behavioral weight-loss intervention, which included group and individual weight-management sessions and group exercise, or to a control group, which received nutrition and physical activity information and a quarterly health class. Participants had were weighed at baseline and at 6, 12 and 18 months after intervention began.
The researchers found that participants with diabetes in the intervention group lost an average of 6.6% of their baseline body weight. Those without diabetes in the intervention group lost 2.9% from baseline. In the control group, the researchers found a 0.6% loss in weight for participants with diabetes and a 0.7% loss in weight for participants without the condition. Despite these findings, the researchers noted that the difference in the intervention effects were not statistically significant. There was also no significant difference in intervention effects on secondary outcomes of fasting glucose levels and waist circumference.
“This finding is important because of the substantial burden of diabetes in patients with SMI and the dearth of information on the effectiveness of weight-loss interventions in SMI patients with diabetes,” the researchers wrote. “With effective behavioral weight-loss interventions like the one developed and tested in the ACHIEVE trial, we may be able to substantially improve the health of this vulnerable and understudied population.” – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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