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Obesity, Physical Activity, and Mental Illness. Patricia Dubbert, PhD Professor, Psychiatry, PRI; UAMS COM Associate Director for Research Training, VA SC MIRECC Psychologist Investigator, VA VISN 16 GRECC. Obesity, Physical Activity, and Serious Mental Illness: Significance .
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Obesity, Physical Activity, and Mental Illness Patricia Dubbert, PhD Professor, Psychiatry, PRI; UAMS COM Associate Director for Research Training, VA SC MIRECC Psychologist Investigator, VA VISN 16 GRECC
Obesity, Physical Activity, and Serious Mental Illness: Significance • Persons with mental disorders lose 25-30 years of potential life due to CV mortality • Causes are complex: • Genetic vulnerabilities • Poverty and reduced access to healthcare • Adverse metabolic side effects associated with antipsychotic and other medications • Prevalence of lifestyle risk behaviors & obesity • 1.5 times risk of obesity • Low levels of physical activity
Lifestyle Interventions Improve Weight Management In Persons with SMI RCTs show methods used in other populations can help SMI patients lose weight, reduce weight gain associated with medications, increase physical activity • May need adaptations for cognitive deficits • Simplify • Repeat content • Reduce amount of content per session • Supportive environment • Healthy foods available • Group exercise opportunities • Staff /therapist support/leadership
Examples of Physical Activity Interventions in Obesity and SMI Daumit (2013) RCT included group exercise sessions • Patients with schizophrenia, schizoaffective, bipolar, major depressive disorders exercised with staff/ videos • Average attendance ~ 50% first 6 mo; lower in mo 7-18 Piette (2011) RCT of telephone therapy • Obese diabetic patients with depression given pedometers; increased steps/day, reduced depression Central Arkansas VA Healthcare System Get Moving and Get Well • Clinical walking program for SMI patients attending psychosocial rehabilitation center • Facilitator manual available free @ SC MIRECC website