Obesity, Poor Diet Widespread in Severe Mental Illness

TOPLINE:

A survey of adults with severe mental illness reported obesity in 42% of participants, along with poor diet quality and ineffective weight management despite efforts, highlighting gaps in current weight management approaches.

METHODOLOGY:

• Researchers conducted a cross-sectional survey using online, postal, or researcher-assisted methods and included 529 adults (mean age, 49.3 years; 58% men) with severe mental illness.
• Participants were required to have a documented diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder.
• Data on physical activity and sedentary behaviour, diet, medication use, body mass index, mental health, and sociodemographic measures were collected in two phases: Pre–COVID-19 pandemic (before March 2020) and post-onset (June 2021 to March 2022).

TAKEAWAY:

• Overall, 42% of participants had obesity, 30% reported a weight gain of 6 kg or more at least once in their adult life, 6% consumed no fruits or vegetables, and 6% had the highest consumption of carbonated drinks.
• Participants on antipsychotic medications had higher risks for weight gain (gaining more than 6 kg and not losing it again; adjusted odds ratio [aOR], 1.31; 95% CI, 0.78-2.20) and weight fluctuation (weight gain more than once; aOR, 1.62; 95% CI, 0.80-3.25) than those not on antipsychotic medications.
• Participants who currently managed their weight had a significantly higher risk for weight fluctuation than those who did not (aOR, 1.73; 95% CI, 1.00-2.96).
• Similarly, they had higher odds of weight gain than those who did not (47% vs 43%; aOR, 1.32), although the CI was inconclusive.

IN PRACTICE:

“The high levels of overweight and obesity in this sample along with the high proportion who report actively managing their weight, suggests that current weight management options are inadequate in addressing the specific needs of people with SMI [severe mental illness], namely medication management,” the authors wrote.

SOURCE:

This study was led by Gemma D. Traviss-Turner, Leeds Institute of Health Sciences, University of Leeds, Leeds, England. It was published online on April 23 in Nutrients.

LIMITATIONS:

Due to the cross-sectional nature of the study, researchers could not establish causality or temporal relationships between food consumption, medication use, weight management, and weight change. The assessment of diet quality was not comprehensive. Additionally, the reliance on self-reported data may have affected the accuracy of medication use and food consumption reporting. Data on height and weight were missing for some participants. Furthermore, the sample excluded inpatients, potentially missing more severe cases and those on higher doses of antipsychotic medications.

DISCLOSURES:

This study was supported by a National Institute for Health and Care Research (NIHR) Programme Grant for Applied Research programme and the NIHR Yorkshire and Humber Applied Research Collaboration. The authors reported having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.