Monday, September 15, 2014

Lifestyle Intervention Improves Weight Loss, Glucose Levels in People Taking Antipsychotics


People with serious mental illnesses such as schizophrenia or bipolar disorder are at greater risk for obesity and diabetes, both from the illness itself and contributing factors such as antipsychotic medications that affect glucose metabolism.

A study published online today in AJP in Advance shows that a comprehensive lifestyle intervention could be an effective approach to reducing the metabolic problems of people taking antipsychotics for their mental illness. As published in the report “The STRIDE Weight Loss and Lifestyle Intervention for Individuals Taking Antipsychotic Medications: A Randomized Trial,” Carla Green, Ph.D., M.P.H., and colleagues at the Kaiser Permanente Center for Health Research in Portland, Ore., tested the effectiveness of a multifaceted program of diet, physical activity, health education, and behavioral modification. They enrolled 200 adults taking antipsychotic medication and with a body mass index of at least 27; half of the participants were randomly chosen to participate in the STRIDE program for 12 months—a six-month initiation phase followed by a six-month maintenance phase.

After 12 months, the STRIDE participants had lost an average of 6 pounds more than the control group, while also reducing their fasting blood glucose levels from about 106 to 100 mg/dL (at the top of the normal range). During this time, the STRIDE group also reported significantly fewer medical hospitalizations than controls (6.7% were hospitalized versus 18.8% of controls).

Other interventions have demonstrated moderate weight loss in people with mental illness, but STRIDE is the first also to show improvements in glucose levels and number of hospitalizations. “This shows that if people with serious mental illness participate in intensive programs and are given the right tools and support they can lose the same amount of weight as people without serious mental illness,” the researchers said.

To learn about another approach to reduce weight and improve the health of people with serious mental illness, see the Psychiatric News article “Health Mentors Prove Valuable for Those With Serious Mental Illness.”

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