Perceptions of Strategies for Successful Weight Loss in Persons with Serious Mental Illness Participating in a Behavioral Weight Loss Intervention: A Qualitative Study

Overview

Journal Psychiatr Rehabil J

Publisher American Psychological Association

Specialty Psychiatry

Date 2016 Apr 8

PMID 27054900

Citations 12

Authors

Roza Vazin

Emma E McGinty

Faith Dickerson

Arlene Dalcin

Stacy Goldsholl

Meghan Oefinger Enriquez

Gerald J Jerome

Joseph V Gennusa

Gail L Daumit

Affiliations

Soon will be listed here.

Abstract

Objective: The purpose of this study was to describe perceptions of weight loss strategies, benefits, and barriers among persons with serious mental illness who lost weight in the ACHIEVE behavioral weight loss intervention.

Methods: Semistructured interviews with 20 ACHIEVE participants were conducted and analyzed using an inductive coding approach.

Results: Participants perceived tailored exercise sessions, social support, and dietary strategies taught in ACHIEVE-such as reducing portion sizes and avoiding sugar-sweetened beverages-as useful weight loss strategies. Health benefits, improved physical appearance, self-efficacy, and enhanced ability to perform activities of daily living were commonly cited benefits of intervention participation and weight loss. Some participants reported challenges with giving up snack food and reducing portion sizes, and barriers to exercise related to medical conditions.

Conclusions And Implications For Practice: There is emerging evidence that behavioral weight loss interventions can lead to clinically meaningful reductions in body weight among persons with serious mental illness. The perspective of persons with serious mental illness regarding strategies for, benefits of, and barriers to weight loss during participation in behavioral weight loss programs provide insight into which elements of multicomponent interventions such as ACHIEVE are most effective. The results of this study suggest that tailored exercise programs, social support, and emphasis on nonclinical benefits of intervention participation, such as improvements in self-efficacy and the ability to participate more actively in family and community activities, are promising facilitators of engagement and success in behavioral weight loss interventions for the population with serious mental illness. (PsycINFO Database Record

Citing Articles

A Group-Based, Six-Lesson Healthy Eating Curriculum for Individuals With Serious Mental Illnesses: Development and Implementation.

Fu E, Farland G, Cohen D, Gerstler C, Margolies P, Pope L Community Ment Health J. 2024; 60(7):1352-1363.

PMID: 38865032 DOI: 10.1007/s10597-024-01291-6.

Implications of Dietary Intake and Eating Behaviors for People with Serious Mental Illness: A Qualitative Study.

Mueller-Stierlin A, Cornet S, Peisser A, Jaeckle S, Lehle J, Moerkl S Nutrients. 2022; 14(13).

PMID: 35807799 PMC: 9268504. DOI: 10.3390/nu14132616.

Mental health consumers' perspectives of physical health interventions: An integrative review.

Tabvuma T, Stanton R, Browne G, Happell B Int J Ment Health Nurs. 2022; 31(5):1046-1089.

PMID: 35388954 PMC: 9542531. DOI: 10.1111/inm.13000.

Learning, doing and sticking with it: A qualitative study on achieving clinically significant reduction in cardiovascular disease risk in a healthy lifestyle intervention for people with serious mental illness.

Hawes M, Danforth M, Perez-Flores N, Bochicchio L, Tuda D, Stefancic A Health Soc Care Community. 2022; 30(5):e2989-e2999.

PMID: 35113479 PMC: 9346096. DOI: 10.1111/hsc.13744.

Identifying effective characteristics of behavioral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis.

Lee C, Piernas C, Stewart C, Michalopoulou M, Hajzadeh A, Edwards R Obes Rev. 2021; 23(1):e13355.

PMID: 34672069 PMC: 8952200. DOI: 10.1111/obr.13355.

References

Lesley M, Livingood K, Livingwood K . Assessing sustainability of InSHAPE participants' fitness activities in a community mental health setting. J Psychosoc Nurs Ment Health Serv. 2015; 53(2):46-53. DOI: 10.3928/02793695-20150126-05. View

Glover C, Ferron J, Whitley R . Barriers to exercise among people with severe mental illnesses. Psychiatr Rehabil J. 2013; 36(1):45-7. DOI: 10.1037/h0094747. View

Sabinsky M, Toft U, Raben A, Holm L . Overweight men's motivations and perceived barriers towards weight loss. Eur J Clin Nutr. 2006; 61(4):526-31. DOI: 10.1038/sj.ejcn.1602537. View

Jerome G, Young D, Dalcin A, Charleston J, Anthony C, Hayes J . Physical activity levels of persons with mental illness attending psychiatric rehabilitation programs. Schizophr Res. 2009; 108(1-3):252-7. PMC: 2679956. DOI: 10.1016/j.schres.2008.12.006. View

STAMLER R, Stamler J, Gosch F, Civinelli J, Fishman J, McKeever P . Primary prevention of hypertension by nutritional-hygienic means. Final report of a randomized, controlled trial. JAMA. 1989; 262(13):1801-7. View

Franz M, VanWormer J, Crain A, Boucher J, Histon T, Caplan W . Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007; 107(10):1755-67. DOI: 10.1016/j.jada.2007.07.017. View

Aschbrenner K, Carpenter-Song E, Mueser K, Kinney A, Pratt S, Bartels S . A qualitative study of social facilitators and barriers to health behavior change among persons with serious mental illness. Community Ment Health J. 2012; 49(2):207-12. DOI: 10.1007/s10597-012-9552-8. View

Daumit G, Clark J, Steinwachs D, Graham C, Lehman A, Ford D . Prevalence and correlates of obesity in a community sample of individuals with severe and persistent mental illness. J Nerv Ment Dis. 2003; 191(12):799-805. DOI: 10.1097/01.nmd.0000100923.20188.2d. View

Shiner B, Whitley R, Van Citters A, Pratt S, Bartels S . Learning what matters for patients: qualitative evaluation of a health promotion program for those with serious mental illness. Health Promot Int. 2008; 23(3):275-82. PMC: 2724880. DOI: 10.1093/heapro/dan018. View

10.

Allison D, Newcomer J, Dunn A, Blumenthal J, Fabricatore A, Daumit G . Obesity among those with mental disorders: a National Institute of Mental Health meeting report. Am J Prev Med. 2009; 36(4):341-50. DOI: 10.1016/j.amepre.2008.11.020. View

11.

Dixon L, Dickerson F, Bellack A, Bennett M, Dickinson D, Goldberg R . The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements. Schizophr Bull. 2009; 36(1):48-70. PMC: 2800143. DOI: 10.1093/schbul/sbp115. View

12.

Daumit G, Goldberg R, Anthony C, Dickerson F, Brown C, Kreyenbuhl J . Physical activity patterns in adults with severe mental illness. J Nerv Ment Dis. 2005; 193(10):641-6. DOI: 10.1097/01.nmd.0000180737.85895.60. View

13.

McDevitt J, Snyder M, Miller A, Wilbur J . Perceptions of barriers and benefits to physical activity among outpatients in psychiatric rehabilitation. J Nurs Scholarsh. 2006; 38(1):50-5. DOI: 10.1111/j.1547-5069.2006.00077.x. View

14.

Bartels S, Pratt S, Aschbrenner K, Barre L, Jue K, Wolfe R . Clinically significant improved fitness and weight loss among overweight persons with serious mental illness. Psychiatr Serv. 2013; 64(8):729-36. PMC: 5662189. DOI: 10.1176/appi.ps.003622012. View

15.

Carney C, Jones L, Woolson R . Medical comorbidity in women and men with schizophrenia: a population-based controlled study. J Gen Intern Med. 2006; 21(11):1133-7. PMC: 1831667. DOI: 10.1111/j.1525-1497.2006.00563.x. View

16.

McElroy S, Frye M, Suppes T, Dhavale D, Keck Jr P, Leverich G . Correlates of overweight and obesity in 644 patients with bipolar disorder. J Clin Psychiatry. 2002; 63(3):207-13. DOI: 10.4088/jcp.v63n0306. View

17.

Dipasquale S, Pariante C, Dazzan P, Aguglia E, McGuire P, Mondelli V . The dietary pattern of patients with schizophrenia: a systematic review. J Psychiatr Res. 2012; 47(2):197-207. DOI: 10.1016/j.jpsychires.2012.10.005. View

18.

Green C, Yarborough B, Leo M, Yarborough M, Stumbo S, Janoff S . The STRIDE weight loss and lifestyle intervention for individuals taking antipsychotic medications: a randomized trial. Am J Psychiatry. 2014; 172(1):71-81. PMC: 4282602. DOI: 10.1176/appi.ajp.2014.14020173. View

19.

Schneider K, Sullivan J, Pagoto S . Translation of the diabetes prevention program into a community mental health organization for individuals with severe mental illness: a case study. Transl Behav Med. 2013; 1(3):453-60. PMC: 3717631. DOI: 10.1007/s13142-011-0053-z. View

20.

Graham C, Griffiths B, Tillotson S, Rollings C . Healthy living? By whose standards? Engaging mental health service recipients to understand their perspectives of, and barriers to, healthy living. Psychiatr Rehabil J. 2013; 36(3):215-8. DOI: 10.1037/prj0000009. View