Preliminary Findings of a Community Tier 2 Weight Management Service for Clients with Severe Mental Illnesses: Client Insights
Preliminary Findings of a Community Tier 2 Weight Management Service for Clients with Severe Mental Illnesses: Client Insights
Dr AB Sirin-Ayva, Emily Costelloe, Dr Sophie Edwards, Prof Paul Gately
Introduction
Severe mental illness and obesity are each serious public health problems. Some of the effective medications for severe mental illnesses are associated with weight gain (McElroy, 2009). When using drugs with weight inducing effects, behavioural weight management services are recommended to manage weight. Previous studies show that group-based approaches are effective on reducing weight and the weight loss is correlated with number of sessions attended (Pendlebury, Haddad, & Dursun, 2005: Daumit, et al, 2013: Lee, et al. 2022).
Morelife is a nationwide weight management provider in the UK. Service users are either referred by healthcare professionals or using self-referral path and inclusion criteria include BMI ≥ 30kg/m² without co-morbidities (adjusted to 27.5kg/m² for Black African, African-Caribbean and Asian ethnic groups), BMI ≥ 25kg/m² with one or more co-morbidities (adjusted to 23kg/m² for Black African, African-Caribbean and Asian ethnic groups). The Morelife programme offers year-long support with weekly and monthly sessions to cover nutrition, dietetic, psychological and physical activity contents.
Methods
Morelife works collaboratively with a local mental health service to provide bespoke services to clients with severe mental illnesses in the area. Upon consultation with the local mental health professionals, who are heavily involved with the target population regarding their mental health support, adjustments to the main curriculum and programme are agreed to address needs of this population. The targeted client population is individuals with a diagnosis of personality disorder and schizophrenia.
The programme consists of eight weekly sessions delivered by the same practitioner. The sessions took place in the community area which all the clients are familiar with. Their weight and wellbeing were monitored before and after the programme. Qualitative data was collected through one focus group and online feedback forms after completion of the main programme.
Outcomes
Five clients attended the focus group, and 2 clients used online feedback forms to answer the same questions. Below are the main themes identified from the focus group and client feedback forms.
Barriers to Managing Weight Before the Morelife Programme
- Limited awareness around nutrition and healthy shopping
- Not monitoring calorie/nutrition intake
- Mental health medication/increasing appetite
Group Support
- Not feeling alone/seeing other people going through the same issues
- The group giving hope
- Group motivates people to make changes
Suggestions for Future Programmes
- Outdoor activities with physical activity
- Cooking sessions
- Inspirational content/seeing people with lived experience
Changes in their Lifestyle
- More awareness and monitored eating
- Dealing with emotional eating
- Making informed choices
- Eating more vegetables and drinking more water
- Being more active by walking more
- Feeling more empowered and in control
- Dealing with stigma around obesity/weight
Healthy Lifestyle Changes Clients Intended to Continue
- Food diaries
- Portion control
- Hydration
- Having lots of healthy food
- Made friends, going to see them
- Learnt so much in 8 weeks; it was thorough and informative
Conclusion
These outcomes show that the MLP digital programme helps clients with hypertension and diabetes lose weight in 12 weeks. Future research is needed to evaluate the long-term effectiveness of this platform for weight loss maintenance and to identify characteristics of those most likely to have success using a digital platform for weight management.
References:
Pendlebury, J., Haddad, P., & Dursun, S. (2005) Evaluation of a behavioural weight management programme for patients with severe mental illness: 3-year results. Human Psychopharmacology: Clinical & Experimental. 20 (6), 447-778
Damuit, G. L. et all. (2013). A Behavioural Weight- Loss Intervention in Persons with Serious Mental Illness. The New England Journal of Medicine. 368:1594-1602 DOI: 10.1056/NEJMoa1214530
Lee, C., Piernas, C., Stewart, C., Michalopoulou, M., Hajzadeh, R. E., Aveyard, P. & Waite, F. (2021) Identfying effective characteristics of beahviral weight management interventions for people with serious mental illness: A systematic review with a qualitative comparative analysis. Obesity Reviews, 23 (1), e13355.
Mc Elroy, S. (2009). Obesity in Patients with severe mental illness: Overview and management. Journal of Clinical Psychiatry, 70 (3), 12-21.