The patients were randomized evenly to a control group or a group given the 18-month intervention.
The intervention had four components: alternating group and individual weight management sessions offered at least monthly, on-site group physical activity three times weekly, and weigh-ins.
It featured simplified behavioral recommendations (such as avoiding sugary drinks, consuming five fruits and vegetables daily), physical activity goals (on-site exercise three times a week plus exercise on other days for 30 minutes on one’s own), and tracking of eating and physical activity. All program sites were given recommendations for making their menus healthier.
"We did a lot of adapting of the material to the cognitive level of the population so that people who were cognitively impaired or having a lot of mental health symptoms were able to learn in the best way," Dr. Daumit said.
On average, the study patients were 45 years old and had a body mass index of 36 kg/m2. The leading mental illnesses were schizophrenia or schizoaffective disorder (seen in 58%) and bipolar disorder (22%).
The patients were taking, on average, three psychotropic medications. Fully 79% were unable to work, and 55% lived in a residential program or with a care provider.
Trial results showed that intervention patients had significantly greater weight loss when compared with their control counterparts (3.4 vs. 0.2 kg, P = .002). The intervention group was more likely to weigh the same as or less than their weight at baseline (64% vs. 49%, P less than .05) and to lose at least 5% of their body weight (38% vs. 23%, P less than .01), she said.
The study was funded by the National Institute of Mental Health. Dr. Daumit disclosed no conflicts of interest related to the research.