Fitness Program Leads to Better Cardiovascular Health in Those With Serious Mental Illness

Overweight and obese adults with a severe mental illness showed a clinically significant reduction in cardiovascular risk after participation in a physical fitness program called In SHAPE, which involves a free fitness club membership and the active assistance of a health mentor. The program was also associated with weight loss and overall improvement in fitness. In a report to be published ahead of print next month in Psychiatric Services in Advance, Stephen Bartels, M.D., M.S., of the Department of Psychiatry and Department of Community and Family Medicine at Geisel School of Medicine at Dartmouth, and colleagues followed 133 subjects with serious mental illness and a body mass index over 25 for 12 months. They were randomly assigned to either the In SHAPE program or were provided with a one-year fitness club membership and educational materials about the benefits of exercise and a healthy diet. Subjects had been diagnosed with either major depression, bipolar disorder, schizoaffective disorder, or schizophrenia and had persistent impairment in major areas of functioning. The health mentors were taught about the symptoms of the mental illnesses, received instruction in motivational interviewing to help In SHAPE participants change their lifestyles and set goals and objectives, and were trained in nutrition education.

While many believe that individuals with severe mental illnesses are unlikely to be able to take steps to lose weight and improve physical fitness, Bartels and colleagues found that twice as many of the In SHAPE participants showed significant cardiorespiratory improvement after 12 months than did the control subjects, as well as clinically significant weight loss. They said their findings show that "a health mentor intervention may help overcome the motivational challenges and low self-efficacy often experienced by persons with serious mental illness."

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