Fitness for Mentally Ill Who Have Obesity
Seriously mentally ill people having obesity benefit by taking part in a program where they receive help with fitness and weight loss.
People who have been diagnosed with serious mental illness are one of the most disadvantaged groups in the United States in terms of how long they are likely to live. About 80% of people with serious mental illnesses1 are overweight or have obesity.
Research by Dartmouth College Prevention Research Centerexternal icon (PRC) has shown that a program known as InSHAPEexternal icon is effective in helping people with serious mental illness who are overweight or have obesity to lose weight and to be more physically fit. A series of studies found that those who can benefit from wellness programs include the mentally ill who are overweight to seriously obese with Body Mass Index (BMI) greater than 25 and less than 40 and severely obese with BMI greater or equal to 40. This group was also diagnosed with schizophrenia, bipolar disorder, or major depression.
InSHAPE was tested in two studies, one in rural New Hampshire, and the other in urban Boston. In these studies, about half of participants showed a reduced risk for heart disease with either:
- When they reduced their weight by at least 5% or
- An increase in fitness as measured by the distance a person can walk in 6 minutes.
Additionally, more than 1/3 of people with severe obesity achieved 5% or greater weight loss through InSHAPE. An important finding was that those with severe obesity and serious mental illness benefited similarly to those in the lower BMI groups from the wellness program.
The Dartmouth College Prevention Research Center is one of 26 academic research centers in 24 states. They study how people and their communities can reverse the risks for chronic illnesses.
How It Works
For those with serious mental illness and severe obesity who want to lose weight and improve their fitness, InSHAPE pairs them with a personal health mentor. The mentor is trained in fitness, nutrition, and motivational strategies. The mentors are also trained in working with people with mental illness. Meeting weekly at the gym or local fitness facility, the mentor and the participant work through the participant’s individual nutrition and fitness. The mentor also trains them on how to eat and shop for healthy food on a reduced budget. Participants in the study with serious mental illness include those with schizophrenia, those with symptoms of schizophrenia and of a mood disorder, major depression, and bipolar diagnoses.
Currently, the Dartmouth PRC is conducting a national study of InSHAPE in 48 mental health organizations across the country. This study will determine how effective health promotion programs like InSHAPE can be when used in mental health organizations. The Dartmouth PRC is also beginning a study of a group-based program called PeerFIT. This program is designed for young adults with serious mental illness who are overweight and obese.
The Bottom Line
For people with serious mental illness and obesity, work by Dartmouth researchers shows that lifestyle changes can lead to weight loss. These changes can also reduce the risk of early heart disease deaths in what is one of the largest disadvantaged populations in the nation.
- Daumit GL, Dickerson FB, Wang N-Y, Dalcin A, Jerome GJ, Anderson CAM, Young DR, Frick KD, Yu A, Gennusa III JV, Oefinger M, Crum RM, Charleston J, Casagrande SS, Guallar E, Goldberg RW, Campbell LM, Appel LJ. A behavioral weight-loss intervention in persons with serious mental illness. New England Journal of Medicine. 2013;368(17):1594-602.