158382 Can we predict who will be successful in a weight loss intervention tailored for individuals with severe mental illness? The ACHIEVE Study

Tuesday, November 6, 2007

Jennifer H. Hayes, MEd MPH , Maryland Cancer Registry, State of Maryland Department of Health and Mental Hygiene, Baltimore, MD
Arlene Dalcin, RD , Johns Hopkins University, Baltimore, MD
Gerald Jerome, PhD , Towson University, Towson, MD
Rosa Crum, MD MHS , Johns Hopkins University, Baltimore, MD
Jeanne Charleston, RN , Johns Hopkins University, Baltimore, MD
Phyllis Mccarron, RD , Johns Hopkins University, Baltimore, MD
Larry Appel, MD MPH , Johns Hopkins University, Baltimore, MD
Gail Daumit, MD MHS , Department of General Internal Medicine, Johns Hopkins University, Baltimore, MD
     
Background: Obesity is epidemic in persons with severe mental illness (SMI), and interventions adapted to persons with SMI are needed. The ACHIEVE Study piloted a weight loss intervention tailored to persons with SMI. We examined whether baseline participant characteristics were associated with program attendance and weight loss, and hypothesized that less severe psychiatric symptoms and better health status would be associated with high attendance and weight loss.

Methods: We performed a pre/post 6 month intervention consisting of nutrition and exercise classes at two psychiatric rehabilitation centers. T-tests and linear regression were performed.

Results: Fifty one (81% of enrolled) participants completed the study. Mean age was 45 years, 53% were women, 53% African American, 57% had schizophrenia, 20% bipolar disorder, 20% depression, 27% mental retardation, 35% substance use, 73% used atypical antipsychotics. Mean BMI was 34.5 kg/m2. The mean SCL-90 General Severity Index was 1.0; CES-D depression score was 21; SF-36 General Health was 61.5. Participants completing the study attended 72% of sessions and lost an average of 4.1 pounds (p=0.02); 63% lost weight. Most baseline characteristics including psychiatric symptoms and health status were not significantly related to attendance or weight loss; participants with substance use had lower attendance (65% vs 76%, p=0.05).

Conclusion: Intervention attendance was high and most lost weight. While psychiatric symptoms were severe and health status was low, these characteristics were not related to intervention success. This pilot study illustrates that an effective weight loss intervention can be performed across a wide spectrum of persons with SMI.

Learning Objectives:
1. Present a successful exercise and nutrition intervention study in a population of adults with mental illness as indicated by significant weight loss. 2. Present baseline characteristics as possible predictors of success in an exercise and nutrition intervention study in a population of adults with mental illness.

Keywords: Obesity, Mental Illness

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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