Weight management interventions in adults with a serious mental illness: A meta-analytic review

Persons with a serious mental illness have more physical health problems and shorter life expectancy compared to the general population, in part due to modifiable at-risk health behaviors like obesity. This study provides a systematic review and meta-analysis of the available evidence on the efficacy of weight management interventions when compared to treatment as usual. Fourteen studies were included in the meta-analysis, analyzing data from a total of 1779 participants. Across all studies, an effect in favor of the intervention groups, with a reduction in mean absolute weight of -2.01 kg, compared to control groups (95% CI: -2.93 kg to -1.10 kg, p< 0.001) over a period ranging from 3 months to 12 months. Subgroup meta-analyses indicate programs that incorporate individual sessions and are implemented at the onset of illness may have the greatest impact on weight management for this population. Despite the statistically significant findings of mean weight change in the intervention groups compared to controls, the reported weight loss only equates to a 2% change from the initial body weight. This falls short of the clinically significant target of 5% weight loss in order to reduce related health complications. The current research was not consistent in capturing data on other metrics that could supplement mean weight loss in assessing positive health outcomes. Due the current health epidemic faced by this population, it is imperative for future research to include adequate follow-up periods, provide protocols, and employ better control methods.