InSHAPE Lifestyle Program

Overview

The InSHAPE Lifestyle Program helps people with serious mental illness and severe obesity lose weight. People with diagnosed serious mental illness are one of the most disadvantaged groups in the United States in terms of life expectancy.^1,2 InSHAPE works by pairing participants with a personal health mentor who is trained in fitness and nutrition, as well as in how to motivate people with mental-health challenges. The Dartmouth College Prevention Research Center (DCPRC) conducted research and created this program with funding from a variety of sources to determine whether this group could benefit from lifestyle changes.

Research Question

How effective is the InSHAPE Lifestyle Program for people with serious mental illness and severe obesity who want to lose weight and be more physically active?

Study

This research assessed how effective the InSHAPE program is for people with severe obesity (Body Mass Index > 40 kg/m²) when compared with less obese individuals with lower body mass index (BMI). All of the participants had been diagnosed with serious mental illness, including schizophrenia, schizoaffective disorder, major depressive disorder, and bipolar disorder. The 12-month lifestyle program was assessed in 3 studies that were conducted from 2007 to 2013 in community mental health centers in Concord, New Hampshire, Boston, Massachusetts, and rural and urban settings in New Hampshire. The program included gym memberships at a community mental health center, weekly meetings with certified fitness trainers, and instruction on healthy eating and nutrition.

The research found that seriously mentally ill people with severe obesity and those with less severe obesity both benefited from participation in the lifestyle program assisting with fitness and weight loss.

• Over one third of the participants with severe obesity achieved 5% or greater weight loss.
• One in five participants across all the obesity groups achieved 10% or greater weight loss.
• One quarter of participants with severe obesity achieved improved fitness.

Modest weight loss and improved fitness reduces cardiovascular risk. Given the health concerns for this population, these are important findings because high blood pressure and diabetes affect people with severe obesity and serious mental illness in greater numbers than others.^4,5,6,7

The Bottom Line

For patients with mental illness and severe obesity, this study showed that lifestyle changes can lead to weight loss and reduce heart health concerns.

Learn more at the “Lifestyle Intervention for People with Severe Obesity and Serious Mental Illness” journal article.

This study was supported by grants for CDC (CDCU48DP001935 0) and the National Institute of Mental Health (R01Mh078052 and R01 MH089811 01). The Dartmouth Prevention Research Center is funded by the CDC. Additional support was received from the CDC Health Promotion and Disease Prevention Research Center at Dartmouth (Cooperative Agreement Number U48DP005018).

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References

¹ Druss G, Zhao L, Von Esenwein S, Morrato EH, Marcus SC. Understanding excess mortality in persons with mental illness: 17-year follow up of a nationally representative U.S. survey. Med Care. 2011;49(6):599–604.

² Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis. 2006;3(2):A42.

³ Blackburn G. Effect of degree of weight loss on health benefits. Obes Res. 1995;3(suppl 2):211s–216s.

⁴ Dickerson FB, Brown CH, Kreyenbuhl JA, et al. Obesity among individuals with serious mental illness
Acta Psychiatr Scand. 2006;113(4):306–313.

⁵ Allison DB, Newcomer JW, Dunn AL, et al. Obesity among those with mental disorders: a National Institute of Mental Health meeting report. Am J Prev Med. 2009;36(4):341–350.

⁶ Brown CD, Higgins M, Donato KA, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–619.

⁷ Park YW, Zhu S, Palaniappan L, Heshka S, Carnethon MR, Heymsfield SB.
The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988–1994. Arch Intern Med. 2003;163(4):427–436.

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